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 31-120 – Criminal History Records Check for Contractors With Access to Federal Tax Information
(a) (1) In this section the following words have the meanings indicated. (2) “Central Repository” means the Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services. (3) “Contractor” means an individual who: (i) is not a State employee with a position in the State Personnel Management System; and (ii) performs work functions for the Exchange […]
Section 31-121 – State Innovation Waiver
(a) The Exchange, in consultation with the Commissioner and as approved by the Board, may submit a State Innovation Waiver application under § 1332 of the Affordable Care Act to allow the State to administer the federal Small Business Health Care Tax Credit to small businesses for monthly premium payments. (b) Before applying for a State Innovation […]
Section 31-122 – State-Based Young Adult Health Insurance Subsidies Pilot Program — Purpose — Subsidy Eligibility and Payment Parameters Established — Funding — Monthly Tracking of Subsidy Expenditures
// EFFECTIVE UNTIL JUNE 30, 2024 PER CHAPTERS 777 AND 778 OF 2021 // (a) In this section, “Pilot Program” means the State–Based Young Adult Health Insurance Subsidies Pilot Program. (b) The Exchange, in consultation with the Commissioner and as approved by the Board, shall establish and implement a State–Based Young Adult Health Insurance Subsidies Pilot Program […]
Section 31-109 – Interstate Agreements and Memoranda of Understanding
(a) Subject to subsection (b) of this section, the Exchange may enter into agreements or memoranda of understanding with another state to: (1) develop joint or reciprocal certification processes; (2) develop consistency in qualified plans offered across states; and (3) coordinate resources for administrative processes necessary to support: (i) certification of qualified plans; and (ii) other functions of the Exchange. (b) Any […]