EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTING LA W.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb0413*
HOUSE BILL 413
J5 2lr0144
CF SB 395
By: The Speaker (By Request – Administration) and Delegates Hornberger,
Kittleman, Long, and Metzgar
Introduced and read first time: January 19, 2022
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 8, 2022
CHAPTER ______
AN ACT concerning 1
Health Insurance – Individual Market Stabilization – Extension of Provider Fee 2
FOR the purpose of continuing the stabilization of the individual health insurance market 3
by extending to a certain calendar year the assessment of a health insurance 4
provider fee; exempting stand–alone vision and dental plan carriers that are subject 5
to the health insurance provider fee assessment from the health care regulatory 6
assessment fee and annual assessment fee in certain years; providing that funds 7
from the distribution of the health insurance provider fee assessment can only be 8
used for certain purposes; and generally relating to the individual health insurance 9
market. 10
BY repealing and reenacting, with amendments, 11
Article – Insurance 12
Section 6–102.1 and 31–107(g)(4) 13
Annotated Code of Maryland 14
(2017 Replacement Volume and 2021 Supplement) 15
BY adding to 16
Article – Insurance 17
Section 6–105.3 18
Annotated Code of Maryland 19
(2017 Replacement Volume and 2021 Supplement) 20
2 HOUSE BILL 413
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
That the Laws of Maryland read as follows: 2
Article – Insurance 3
6–102.1. 4
(a) This section applies to: 5
(1) an insurer, a nonprofit health service plan, a health maintenance 6
organization, a dental plan organization, a fraternal benefit organization, and any other 7
person subject to regulation by the State that provides a product that: 8
(i) was subject to § 9010 of the Affordable Care Act, as in effect on 9
December 1, 2019; and 10
(ii) may be subject to an assessment by the State; and 11
(2) a managed care organization authorized under Title 15, Subtitle 1 of 12
the Health – General Article. 13
(b) The purpose of this section is to assist in the stabilization of the individual 14
health insurance market by assessing a health insurance provider fee that is attributable 15
to State health risk for calendar years 2019 through [2023] 2028, both inclusive, as 16
provided for under subsection (c) of this section. 17
(c) (1) In calendar year 2019, in addition to the amounts otherwise due under 18
this subtitle, an entity subject to this section shall be subject to an assessment of 2.75% on 19
all amounts used to calculate the entity’s premium tax liability under § 6–102 of this 20
subtitle or the amount of the entity’s premium tax exemption value for calendar year 2018. 21
(2) In calendar years 2020 through [2023] 2028, both inclusive, in addition 22
to the amounts otherwise due under this subtitle, an entity subject to this section shall be 23
subject to an assessment of 1% on all amounts used to calculate the entity’s premium tax 24
liability under § 6–102 of this subtitle or the amount of the entity’s premium tax exemption 25
value for the immediately preceding calendar year. 26
(3) The assessments required in paragraphs (1) and (2) of this subsection 27
are for products that: 28
(i) were subject to § 9010 of the Affordable Care Act, as in effect on 29
December 1, 2019; and 30
(ii) may be subject to an assessment by the State. 31
(4) The calculation of the assessments required under paragraphs (1) and 32
(2) of this subsection shall be made without regard to: 33 HOUSE BILL 413 3
(i) the threshold limits established in § 9010(b)(2)(A) of the 1
Affordable Care Act; or 2
(ii) the partial exclusion of net premiums provided for in § 3
9010(b)(2)(B) of the Affordable Care Act. 4
(d) (1) (i) In each of fiscal years 2021 and 2022, $100,000,000 of the funds 5
collected from the assessment required under this section shall be transferred in accordance 6
with subparagraphs (ii) and (iii) of this paragraph to Medical Care Provider 7
Reimbursements (M00Q01.03) within the Medical Care Programs Administration of the 8
Maryland Department of Health. 9
(ii) If all or a portion of the funds required to be transferred under 10
subparagraph (i) of this paragraph have been received and are held in the Maryland Health 11
Benefit Exchange Fund established under § 31–107 of this article, the Governor shall 12
transfer the available amount in the Fund. 13
(iii) If the amount of funds transferred under subparagraph (ii) of this 14
paragraph is less than the amount required to be transferred under subparagraph (i) of 15
this paragraph, the Insurance Commissioner shall transfer the remaining amount from the 16
funds collected from the assessment required under this section. 17
(2) At the beginning of each of fiscal years 2023 and 2024, the Governor 18
shall transfer the first $8,000,000 of the funds collected from the assessment required 19
under this section to the Community Health Resources Commission. 20
(3) Notwithstanding § 2–114 of this article, the remainder of the 21
assessment required under this section after any transfers made under paragraphs (1) and 22
(2) of this subsection shall be distributed by the Commissioner to the Maryland Health 23
Benefit Exchange Fund established under § 31–107 of this article. 24
6–105.3. 25
A STAND–ALONE DENTAL PLAN CA RRIER OR A STAND –ALONE VISION PLAN 26
CARRIER THAT IS S UBJECT TO THE HEALTH INSURANCE PROVIDER F EE 27
ASSESSMENT IMPOSED U NDER § 6–102.1 OF THIS SUBTITLE IN CALENDAR YEAR 28
2024 AND EACH CALENDAR YE AR THEREAFTER IS EXE MPT FROM THE HEALTH CARE 29
REGULATORY ASSESSMEN T UNDER § 2–112.2 OF THIS ARTICLE AND THE ANNUAL 30
ASSESSMENT FEE UNDER § 2–502 OF THIS ARTICLE FOR EACH YEAR IN WHICH T HE 31
HEALTH INSURANCE PRO VIDER FEE IS PAID. 32
31–107. 33
(g) (4) The following funds may be used only for the purposes of funding the 34
State Reinsurance Program: 35 4 HOUSE BILL 413
(i) any pass–through funds received from the federal government 1
under a waiver approved under § 1332 of the Affordable Care Act to provide reinsurance to 2
carriers that offer individual health benefit plans in the State; 3
(ii) any funds designated by the federal government to provide 4
reinsurance to carriers that offer individual health benefit plans in the State; [and] 5
(iii) any funds designated by the State to provide reinsurance to 6
carriers that offer individual health benefit plans in the State; AND 7
(IV) EXCEPT AS PROVID ED IN SUBSECTION (F) OF THIS SECTION, 8
FUNDS RECEIVED FROM THE DISTRIBUTION OF THE ASSESSMENT UNDER § 6–102.1 9
OF THIS ARTICLE . 10
SECTION 2. AND BE IT FURTHER ENACTED, That: 11
(a) On or before December 1, 2023, the Maryland Insurance Administration, in 12
consultation with the Maryland Health Benefit Exchange and the Maryland Health Care 13
Commission, shall report to the Governor and, in accordance with § 2–1257 of the State 14
Government Article, the General Assembly, on the impact of the State Reinsurance 15
Program. 16
(b) In developing the report, the Maryland Insurance Administration shall: 17
(1) consider whether the level of funding is appropriate, taking into 18
account future population growth and projected premium growth; 19
(2) consider whether the assessment established under § 6–102.1 of the 20
Insurance Article: 21
(i) is appropriately apportioned among the carriers; 22
(ii) should be broadened to include other business sectors; and 23
(iii) should be supplemented with General Funds; 24
(3) consider what market reforms are needed to provide affordable health 25
coverage in the individual market, including: 26
(i) continuation of the Program past 2026; 27
(ii) providing State–based premium subsidies; and 28
(iii) expanding eligibility for the Maryland Medical Assistance 29
Program; and 30
HOUSE BILL 413 5
(4) evaluate the design of the Program, including whether the program 1
parameters established under § 31–117 of the Insurance Article are appropriate in light of 2
other individual market reforms at the State and federal level, including: 3
(i) the Young Adult Subsidies Program; 4
(ii) the Easy Enrollment Health Insurance Program; 5
(iii) a special or other enrollment period opened under § 31–108 of the 6
Insurance Article; and 7
(iv) premium subsidies available under the American Rescue Plan 8
Act or any other federal law. 9
(c) The report shall include options for obtaining sustainable funding sources to 10
support stability in the individual market. 11
SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effec t 12
October 1, 2022. 13
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.