This government document is issued by Maryland Insurance Administration for use in Maryland
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https://www.google.com/url?client=internal-element-cse&cx=007821330218074952993:f4zv_rasvj8&q=https://insurance.maryland.gov/Insurer/Documents/bulletins/21-04-2022-Affordable-Care-Act-Individual-and-Small-Employer-Form-and-Rate-Filing-Instructions.pdf&sa=U&ved=2ahUKEwiBn57qgYrxAhXisaQKHZsTBu0QFjAHegQIARAC&usg=AOvVaw2P9ZpiCn5rjPaiaiVfq400