Ch. 35

1997 LAWS OF MARYLAND

Defined terms: "Health insurance" § 1-101
"Insurer" § 1-101
"Policy" § 1-101

15-109. MINIMUM LOSS RATIO FOR SPECIFIED DISEASE POLICIES.

(A) DEFINITIONS.

(1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

(2) "LOSS RATIO" MEANS THE RATIO OF LOSSES INCURRED TO
PREMIUMS EARNED ON POLICIES THAT ARE ISSUED, DELIVERED, OR RENEWED IN
THE STATE.

(3) "SPECIFIED DISEASE POLICY" MEANS A HEALTH INSURANCE POLICY
THAT PROVIDES:

(I) BENEFITS ONLY FOR A DISEASE OR DISEASES SPECIFIED IN
THE POLICY OR FOR A TREATMENT UNIQUE TO A SPECIFIED DISEASE OR DISEASES;
OR

(II) ADDITIONAL BENEFITS FOR A DISEASE OR DISEASES
SPECIFIED IN THE POLICY OR FOR TREATMENT UNIQUE TO A SPECIFIED DISEASE OR
DISEASES.

(B) APPLICABILITY OF SECTION.

THIS SECTION APPLIES TO EACH INDIVIDUAL, GROUP, OR BLANKET HEALTH
INSURANCE POLICY OR NONPROFIT HEALTH SERVICE PLAN THAT IS ISSUED OR
DELIVERED IN THE STATE.

(C) ESTABLISHMENT.

TO ADMINISTER §§ 12-203, 12-204, AND 12-205 OF THIS ARTICLE, THE
COMMISSIONER SHALL ESTABLISH A MINIMUM LOSS RATIO IN ACCORDANCE WITH
GENERALLY ACCEPTED ACTUARIAL PRINCIPLES WITH RESPECT TO SPECIFIED
DISEASE POLICIES.

REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 48A, §§ 468H, 354W(b), and 477V(b).

In subsection (b) of this section, the reference to each "individual" health
insurance policy that is issued or delivered in the State is added to clarify the
applicability of this section.

Defined terms: "Commissioner" § 1-101
"Health insurance" § 1-101
"Policy" § 1-101
"Premium" § 1-101

15-110. PROHIBITED REFERRALS.
(A) DEFINITIONS.

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