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Session Laws, 1999
Volume 796, Page 3394   View pdf image
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(iv) a dental plan organization; or

(v) 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.

(3) (I) "HEALTH BENEFIT PLAN" MEANS:

1. A HOSPITAL OR MEDICAL POLICY POLICY. CONTRACT, OR
CERTIFICATE, INCLUDING THOSE ISSUED UNDER MULTIPLE EMPLOYER TRUSTS OR
ASSOCIATIONS LOCATED IN MARYLAND OR ANY OTHER STATE COVERING MARYLAND
RE
SIDENTS;

2. A HOSPITAL OR MEDICAL POLICY, CONTRACT, OR
CERTIFICATE ISSUED BY A NONPROFIT HEALTH SERVICE PLAN THAT COVERS
MARYLAND RESIDENTS;

3. A HEALTH MAINTENANCE ORGANIZATION CONTRACT; OR

4. A DENTAL PLAN.

(II) "HEALTH BENEFIT PLAN" DOES NOT INCLUDE ONE OR MORE,
OR ANY COMBINATION OF THE FOLLOWING:

1. LONG-TERM CARE INSURANCE;

2. DISABILITY INSURANCE;

3. ACCIDENTAL TRAVEL AND ACCIDENTAL DEATH AND
DISMEMBERMENT INSURANCE;

4. CREDIT HEALTH INSURANCE;

5. ANY INSURANCE, MEDICAL POLICY, OR CERTIFICATE FOR
WHICH PAYMENT OF BENEFITS ARE IS CONDITIONED ON A DETERMINATION OF
MEDICAL NECESSITY MADE SOLELY BY THE TREATING HEALTH CARE PROVIDER NOT
ACTING ON BEHALF OF THE CARRIER:

6. ANY OTHER INSURANCE, MEDICAL POLICY, OR
CERTIFICATE FOR WHICH PAYMENT OF BENEFITS IS NOT CONDITIONED ON A
DETERMINATION OF MEDICAL NECESSITY; OR

7. A HEALTH BENEFIT PLAN ISSUED BY A MANAGED CARE
ORGANIZATION, AS DEFINED IN TITLE 15, SUBTITLE 1 OF THE HEALTH - GENERAL
ARTICLE.

[(3)] (4) (i) "Premium" has the meaning stated in § 1-101 of this
article to the extent it is allocable to health insurance policies or contracts issued or
delivered in this State.

(ii) "Premium" includes any amounts paid to a health maintenance
organization as compensation for providing to members and subscribers the services
specified in Title 19, Subtitle 7 of the Health - General Article to the extent the
amounts are allocable to this State.

 

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Session Laws, 1999
Volume 796, Page 3394   View pdf image
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