Section 14-501 - Definitions [Amendment subject to abrogation]. - Maryland Statutes

§ 14-501. Definitions [Amendment subject to abrogation].
 

(a)  In general.- In this subtitle the following words have the meanings indicated. 

(b)  Administrator.- "Administrator" means: 

(1) a person that is registered as an administrator under Title 8, Subtitle 3 of this article; or 

(2) a carrier as defined under subsection (d) of this section. 

(c)  Board.- "Board" means the Board of Directors for the Maryland Health Insurance Plan. 

(d)  Carrier.- "Carrier" means: 

(1) an authorized insurer that provides health insurance in the State; 

(2) a nonprofit health service plan that is licensed to operate in the State; or 

(3) a health maintenance organization that is licensed to operate in the State. 

(e)  Creditable coverage.- "Creditable coverage" has the meaning stated in § 15-1301 of this article. 

(f)  Eligible individual.- "Eligible individual" has the meaning stated in § 15-1301 of this article. 

(g)  Fund.- "Fund" means the Maryland Health Insurance Plan Fund. 

(h)  Medically uninsurable individual.-  

(1) "Medically uninsurable individual" means an individual who is a resident of the State and who: 

(i) provides evidence that, for health reasons, a carrier has refused to issue substantially similar coverage to the individual; 

(ii) provides evidence that, for health reasons, a carrier has refused to issue substantially similar coverage to the individual, except at a rate that exceeds the Plan rate; 

(iii) satisfies the definition of "eligible individual" under § 15-1301 of this article; 

(iv) has a history of or suffers from a medical or health condition that is included on a list promulgated in regulation by the Board; 

(v) is eligible for the tax credit for health insurance costs under § 35 of the Internal Revenue Code; 

(vi) is a dependent of an individual who is eligible for coverage under this subsection; or 

(vii) satisfies the eligibility requirements established by federal law to enroll in a national temporary high risk pool program that is: 

1. established by the Secretary of Health and Human Services; and 

2. administered by the Plan for the State. 

(2) "Medically uninsurable individual" does not include an individual who is eligible for coverage under: 

(i) the federal Medicare program; 

(ii) unless the individual is eligible for a subsidy of Plan costs provided by the Department of Health and Mental Hygiene under a Medicaid waiver program, the Maryland Medical Assistance Program; 

(iii) the Maryland Children's Health Program; or 

(iv) an employer-sponsored group health insurance plan that includes benefits comparable to Plan benefits, unless the individual is eligible for the tax credit for health insurance costs under § 35 of the Internal Revenue Code. 

(i)  Medicare Part D coverage gap.- "Medicare Part D coverage gap" means the gap in coverage under Medicare Part D: 

(1) above the initial coverage limit and before catastrophic coverage begins; and 

(2) during which an individual enrolled in Medicare Part D is responsible for 100% coinsurance costs. 

(j)  Plan.- "Plan" means the Maryland Health Insurance Plan. 

(k)  Plan of operation.- "Plan of operation" means the articles, bylaws, and operating rules and procedures adopted by the Board in accordance with § 14-503 of this subtitle. 
 

[2002, ch. 153, § 7; 2003, ch. 2; 2004, ch. 60, § 1; ch. 510; 2005, ch. 347; 2008, chs. 557, 558; 2009, ch. 487, § 1; 2010, ch. 173.]