Section 31-206 – Eligibility for Premium Tax Credits or Cost-Sharing Reduction; Enrollment Period
(a) If an uninsured individual is not determined to be eligible for the Maryland Medical Assistance Program or the Maryland Children’s Health Program under § 31–205 of this subtitle, the Exchange shall determine, in accordance with § 31–204 of this subtitle, whether the uninsured individual is eligible for premium tax credits or cost–sharing reductions as determined […]
Section 31-114 – Specific Financial Support for Services Not Required
(a) Nothing in this subtitle requires the Maryland Medical Assistance Program or the Maryland Children’s Health Program to provide any specific financial support to the Individual Exchange for the services provided by an Individual Exchange navigator or an Individual Exchange connector entity. (b) The financing arrangements between the Individual Exchange, the Maryland Medical Assistance Program, and the […]
Section 31-207 – Data Privacy and Security Safeguards
(a) The Exchange shall develop a detailed set of data privacy and data security safeguards to govern the conveyance, storage, and utilization of data under the Program. (b) The safeguards developed under subsection (a) of this section shall ensure that the conveyance, storage, and utilization of data under the Program comply with applicable requirements of federal and […]
Section 31-115 – Certification of Health Benefit, Dental, Vision Plans, and Stand-Alone Dental Plans
(a) The Exchange shall certify: (1) health benefit plans as qualified health plans; (2) dental plans as qualified dental plans, which may be offered by carriers as: (i) stand–alone dental plans; or (ii) dental plans sold in conjunction with or as an endorsement to qualified health plans; (3) vision plans as qualified vision plans, which may be offered by carriers as: […]
Section 31-116 – Essential Health Benefits to Be Benefits in State Benchmark Plan and Other Plans Under This Subtitle
(a) The essential health benefits required under § 1302(a) of the Affordable Care Act: (1) shall be the benefits in the State benchmark plan, selected in accordance with this section; and (2) notwithstanding any other benefits mandated by State law, shall be the benefits required in: (i) subject to subsection (f) of this section, all individual health benefit plans […]
Section 31-117 – State Reinsurance Program
(a) The Exchange, in consultation with the Commissioner and as approved by the Board, shall establish and implement a State Reinsurance Program: (1) to provide reinsurance to carriers that offer individual health benefit plans in the State; (2) that meets the requirements of a waiver approved under § 1332 of the Affordable Care Act; and (3) that is consistent […]
Section 31-117.1 – Submission of Application; Waivers
(a) As soon as practicable but not later than July 1, 2018, the Exchange, in consultation with the Commissioner and as approved by the Board, shall submit a State Innovation Waiver application under § 1332 of the Affordable Care Act to establish a program for reinsurance and seek federal pass–through funding. (b) On or before December 31, […]
Section 31-118 – Funding for Operations of Exchange
(a) Beginning January 1, 2014, subject to subsections (b) and (c) of this section, the Exchange may: (1) impose user fees, licensing or other regulatory fees, or other assessments that do not exceed reasonable projections regarding the amount necessary to support the operations of the Exchange under this subtitle; or (2) otherwise generate funding necessary to support its […]
Section 31-119 – Administration of Exchange
(a) The Exchange shall be administered in a manner designed to: (1) prevent discrimination on the basis of race, color, national origin, disability, age, sex, gender identity, or sexual orientation; (2) streamline enrollment and other processes to minimize expenses and achieve maximum efficiency; (3) prevent waste, fraud, and abuse; and (4) promote financial integrity. (b) (1) The Exchange shall establish a full–scale […]
Section 31-107.1 – Trust Account
(a) The Board shall establish a trust account to hold premium payments accepted from qualified plan enrollees and small employers by the Exchange on behalf of a carrier under contract or other agreement. (b) The trust account may be used only to hold a premium payment until the Exchange transmits the premium payment to the carrier on […]