ROBERT L. EHRLICH, JR., Governor                             Ch. 259

Article - Insurance

15-112.

(a) (1) In this section the following words have the meanings indicated.

(2)     (i) "Carrier" means:

1.       an insurer;

2.       a nonprofit health service plan;

3.       a health maintenance organization;

4.       a dental plan organization; or

5.       any other person that provides health benefit plans
subject to regulation by the State.

(ii) "Carrier" includes an entity that arranges a provider panel for a
carrier.

(3)     "Enrollee" means a person entitled to health care benefits from a
carrier.

(4)     "Provider" means a health care practitioner or group of health care
practitioners licensed, certified, or otherwise authorized by law to provide health care
services.

(5)     (i) "Provider panel" means the providers that contract either
directly or through a subcontracting entity with a carrier to provide health care
services to the carrier's enrollees under the carrier's health benefit plan.

(ii) "Provider panel" does not include an arrangement in which any
provider may participate solely by contracting with the carrier to provide health care
services at a discounted fee-for-service rate.

(j) (1) A carrier shall provide to an enrollee at the time of initial enrollment
MAKE AVAILABLE TO PROSPECTIVE ENROLLEES ON THE INTERNET AND, ON
REQUEST OF A PROSPECTIVE ENROLLEE, IN PRINTED FORM:

(i) a [printed] list of providers on the carrier's provider panel; and

(ii) [printed] information on providers that are no longer accepting
new patients.

(2) A carrier shall [make available to prospective enrollees and] notify
each PROSPECTIVE ENROLLEE AND EACH emoting enrollee at the time of INITIAL
ENROLLMENT AND renewal [about] how to obtain the following information on the
Internet [and] OR in printed form:

(i) a list of providers on the carrier's provider panel; and

(ii) information on providers that are no longer accepting new
patients.

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