(V) A THIRD PARTY ADMINISTRATOR; OR

(VI) EXCEPT FOR A MANAGED CARE ORGANIZATION AS DEFINED IN
TITLE 15, SUBTITLE 1 OF THE HEALTH - GENERAL ARTICLE, ANY OTHER PERSON
THAT PROVIDES HEALTH BENEFIT PLANS SUBJECT TO REGULATION BY THE STATE.

(4) "DIRECT CARE EXPENSES" MEANS THE PAYMENT TO A HEALTH CARE
PROVIDER BY A MANAGED BEHAVIORAL HEALTH CARE ORGANIZATION FOR THE
PROVISION OF BEHAVIORAL HEALTH CARE SERVICES TO A MEMBER.

(5) "DIRECT PAYMENTS" MEANS THE MONEY THAT A CARRIER
DISBURSES TO A MANAGED BEHAVIORAL HEALTH CARE ORGANIZATION FOR THE
PROVISION OF BEHAVIORAL HEALTH CARE SERVICES TO A MEMBER

(6) "MANAGED BEHAVIORAL HEALTH CARE ORGANIZATION" MEANS A
COMPANY, ORGANIZATION, OR SUBSIDIARY THAT:

(I) CONTRACTS WITH A CARRIER TO PROVIDE, UNDERTAKE TO
ARRANGE, OR ADMINISTER BEHAVIORAL HEALTH CARE SERVICES TO MEMBERS; OR

(II) OTHERWISE MAKES BEHAVIORAL HEALTH CARE SERVICES
AVAILABLE TO MEMBERS THROUGH CONTRACTS WITH HEALTH CARE PROVIDERS.

(7) (I) "MEMBER" MEANS AN INDIVIDUAL ENTITLED TO BEHAVIORAL
HEALTH CARE SERVICES FROM A CARRIER OR A MANAGED BEHAVIORAL HEALTH
CARE ORGANIZATION UNDER A POLICY, PLAN, OR CERTIFICATE POLICY OR PLAN
ISSUED OR DELIVERED IN THE STATE.

(II) "MEMBER" INCLUDES A SUBSCRIBER

(8) "MENTAL HEALTH EXPENSE RATIO" MEANS THE RATIO OF THE
TOTAL INCURRED DIRECT CARE EXPENSES FOR BEHAVIORAL HEALTH CARE
SERVICES IN RELATION TO THE TOTAL DIRECT PAYMENTS FOR BEHAVIORAL
HEALTH CARE SERVICES.

(9) "PROVIDER" MEANS A PERSON LICENSED, CERTIFIED, OR
OTHERWISE AUTHORIZED UNDER THE HEALTH OCCUPATIONS ARTICLE OR THE
HEALTH - GENERAL ARTICLE TO PROVIDE HEALTH CARE SERVICES.

(B) A CARRIER THAT OWNS OR CONTRACTS WITH A MANAGED BEHAVIORAL
HEALTH CARE ORGANIZATION SHALL DISTRIBUTE TO ITS MEMBERS AT THE TIME OF
ENROLLMENT AN EXPLANATION OF:

(1) THE SPECIFIC BEHAVIORAL HEALTH CARE SERVICES COVERED AND
THE SPECIFIC EXCLUSIONS UNDER THE MEMBER'S CONTRACT;

(2) THE MEMBER'S RESPONSIBILITIES FOR OBTAINING BEHAVIORAL
HEALTH CARE SERVICES;

(3) THE REIMBURSEMENT METHODOLOGY THAT THE CARRIER AND
MANAGED BEHAVIORAL HEALTH CARE ORGANIZATION USE TO REIMBURSE
PROVIDERS FOR BEHAVIORAL HEALTH CARE SERVICES; AND