An issuer may not issue which type of contract?

In the context of Maryland laws, an issuer typically refers to a licensed entity that provides various types of insurance products. The unique aspect of Health Maintenance Organization (HMO) contracts is that they operate under specific regulations that distinguish them from traditional insurance contracts.

An issuer is not permitted to issue HMO contracts unless it is specifically licensed as an HMO by the Maryland Insurance Administration. This licensing ensures that the organization adheres to the regulations that govern HMO operations, including how it manages care, promotes health services, and contracts with healthcare providers.

In contrast, life insurance, Medicare, and auto insurance contracts can be issued by entities that possess the appropriate licenses for those particular lines of insurance. Each of these types of contracts is governed by distinct frameworks but does not require a different operational structure like that of HMO contracts.

Therefore, the correct answer identifies the HMO contract as the type of contract that an issuer cannot issue without the specific licensing that pertains to HMOs, highlighting the regulatory environment surrounding health insurance products in Maryland.