MD
Maryland House Bill HB413

Maryland 2022 Regular Session

Maryland House Bill HB413 Compare Versions

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1- LAWRENCE J. HOGAN, JR., Governor Ch. 59
21
3-– 1 –
4-Chapter 59
5-(House Bill 413)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTING LA W.
4+ [Brackets] indicate matter deleted from existing law.
5+ Underlining indicates amendments to bill.
6+ Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7+amendment.
8+ *hb0413*
89
9-Health Insurance – Individual Market Stabilization – Extension of Provider Fee
10+HOUSE BILL 413
11+J5 2lr0144
12+ CF SB 395
13+By: The Speaker (By Request – Administration) and Delegates Hornberger,
14+Kittleman, Long, and Metzgar
15+Introduced and read first time: January 19, 2022
16+Assigned to: Health and Government Operations
17+Committee Report: Favorable with amendments
18+House action: Adopted
19+Read second time: March 8, 2022
1020
11-FOR the purpose of continuing the stabilization of the individual health insurance market
12-by extending to a certain calendar year the assessment of a health insurance
13-provider fee; exempting stand–alone vision and dental plan carriers that are subject
14-to the health insurance provider fee assessment from the health care regulatory
15-assessment fee and annual assessment fee in certain years; providing that funds
16-from the distribution of the health insurance provider fee assessment can only be
17-used for certain purposes; and generally relating to the individual health insurance
18-market.
21+CHAPTER ______
1922
20-BY repealing and reenacting, with amendments,
21-Article – Insurance
22-Section 6–102.1 and 31–107(g)(4)
23-Annotated Code of Maryland
24-(2017 Replacement Volume and 2021 Supplement)
23+AN ACT concerning 1
2524
26-BY adding to
27- Article – Insurance
28- Section 6–105.3
29- Annotated Code of Maryland
30- (2017 Replacement Volume and 2021 Supplement)
25+Health Insurance – Individual Market Stabilization – Extension of Provider Fee 2
3126
32-SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
33-That the Laws of Maryland read as follows:
27+FOR the purpose of continuing the stabilization of the individual health insurance market 3
28+by extending to a certain calendar year the assessment of a health insurance 4
29+provider fee; exempting stand–alone vision and dental plan carriers that are subject 5
30+to the health insurance provider fee assessment from the health care regulatory 6
31+assessment fee and annual assessment fee in certain years; providing that funds 7
32+from the distribution of the health insurance provider fee assessment can only be 8
33+used for certain purposes; and generally relating to the individual health insurance 9
34+market. 10
3435
35-Article – Insurance
36+BY repealing and reenacting, with amendments, 11
37+Article – Insurance 12
38+Section 6–102.1 and 31–107(g)(4) 13
39+Annotated Code of Maryland 14
40+(2017 Replacement Volume and 2021 Supplement) 15
3641
37-6–102.1.
42+BY adding to 16
43+ Article – Insurance 17
44+ Section 6–105.3 18
45+ Annotated Code of Maryland 19
46+ (2017 Replacement Volume and 2021 Supplement) 20
47+ 2 HOUSE BILL 413
3848
39- (a) This section applies to:
4049
41- (1) an insurer, a nonprofit health service plan, a health maintenance
42-organization, a dental plan organization, a fraternal benefit organization, and any other
43-person subject to regulation by the State that provides a product that:
50+SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
51+That the Laws of Maryland read as follows: 2
4452
45- (i) was subject to § 9010 of the Affordable Care Act, as in effect on
46-December 1, 2019; and
53+Article – Insurance 3
4754
48- (ii) may be subject to an assessment by the State; and
49- Ch. 59 2022 LAWS OF MARYLAND
55+6–102.1. 4
5056
51-– 2 –
52- (2) a managed care organization authorized under Title 15, Subtitle 1 of
53-the Health – General Article.
57+ (a) This section applies to: 5
5458
55- (b) The purpose of this section is to assist in the stabilization of the individual
56-health insurance market by assessing a health insurance provider fee that is attributable
57-to State health risk for calendar years 2019 through [2023] 2028, both inclusive, as
58-provided for under subsection (c) of this section.
59+ (1) an insurer, a nonprofit health service plan, a health maintenance 6
60+organization, a dental plan organization, a fraternal benefit organization, and any other 7
61+person subject to regulation by the State that provides a product that: 8
5962
60- (c) (1) In calendar year 2019, in addition to the amounts otherwise due under
61-this subtitle, an entity subject to this section shall be subject to an assessment of 2.75% on
62-all amounts used to calculate the entity’s premium tax liability under § 6–102 of this
63-subtitle or the amount of the entity’s premium tax exemption value for calendar year 2018.
63+ (i) was subject to § 9010 of the Affordable Care Act, as in effect on 9
64+December 1, 2019; and 10
6465
65- (2) In calendar years 2020 through [2023] 2028, both inclusive, in addition
66-to the amounts otherwise due under this subtitle, an entity subject to this section shall be
67-subject to an assessment of 1% on all amounts used to calculate the entity’s premium tax
68-liability under § 6–102 of this subtitle or the amount of the entity’s premium tax exemption
69-value for the immediately preceding calendar year.
66+ (ii) may be subject to an assessment by the State; and 11
7067
71- (3) The assessments required in paragraphs (1) and (2) of this subsection
72-are for products that:
68+ (2) a managed care organization authorized under Title 15, Subtitle 1 of 12
69+the Health – General Article. 13
7370
74- (i) were subject to § 9010 of the Affordable Care Act, as in effect on
75-December 1, 2019; and
71+ (b) The purpose of this section is to assist in the stabilization of the individual 14
72+health insurance market by assessing a health insurance provider fee that is attributable 15
73+to State health risk for calendar years 2019 through [2023] 2028, both inclusive, as 16
74+provided for under subsection (c) of this section. 17
7675
77- (ii) may be subject to an assessment by the State.
76+ (c) (1) In calendar year 2019, in addition to the amounts otherwise due under 18
77+this subtitle, an entity subject to this section shall be subject to an assessment of 2.75% on 19
78+all amounts used to calculate the entity’s premium tax liability under § 6–102 of this 20
79+subtitle or the amount of the entity’s premium tax exemption value for calendar year 2018. 21
7880
79- (4) The calculation of the assessments required under paragraphs (1) and
80-(2) of this subsection shall be made without regard to:
81+ (2) In calendar years 2020 through [2023] 2028, both inclusive, in addition 22
82+to the amounts otherwise due under this subtitle, an entity subject to this section shall be 23
83+subject to an assessment of 1% on all amounts used to calculate the entity’s premium tax 24
84+liability under § 6–102 of this subtitle or the amount of the entity’s premium tax exemption 25
85+value for the immediately preceding calendar year. 26
8186
82- (i) the threshold limits established in § 9010(b)(2)(A) of the
83-Affordable Care Act; or
87+ (3) The assessments required in paragraphs (1) and (2) of this subsection 27
88+are for products that: 28
8489
85- (ii) the partial exclusion of net premiums provided for in §
86-9010(b)(2)(B) of the Affordable Care Act.
90+ (i) were subject to § 9010 of the Affordable Care Act, as in effect on 29
91+December 1, 2019; and 30
8792
88- (d) (1) (i) In each of fiscal years 2021 and 2022, $100,000,000 of the funds
89-collected from the assessment required under this section shall be transferred in accordance
90-with subparagraphs (ii) and (iii) of this paragraph to Medical Care Provider
91-Reimbursements (M00Q01.03) within the Medical Care Programs Administration of the
92-Maryland Department of Health.
93+ (ii) may be subject to an assessment by the State. 31
9394
94- (ii) If all or a portion of the funds required to be transferred under
95-subparagraph (i) of this paragraph have been received and are held in the Maryland Health
96-Benefit Exchange Fund established under § 31–107 of this article, the Governor shall
97-transfer the available amount in the Fund. LAWRENCE J. HOGAN, JR., Governor Ch. 59
95+ (4) The calculation of the assessments required under paragraphs (1) and 32
96+(2) of this subsection shall be made without regard to: 33 HOUSE BILL 413 3
9897
99-– 3 –
10098
101- (iii) If the amount of funds transferred under subparagraph (ii) of this
102-paragraph is less than the amount required to be transferred under subparagraph (i) of
103-this paragraph, the Insurance Commissioner shall transfer the remaining amount from the
104-funds collected from the assessment required under this section.
10599
106- (2) At the beginning of each of fiscal years 2023 and 2024, the Governor
107-shall transfer the first $8,000,000 of the funds collected from the assessment required
108-under this section to the Community Health Resources Commission.
100+ (i) the threshold limits established in § 9010(b)(2)(A) of the 1
101+Affordable Care Act; or 2
109102
110- (3) Notwithstanding § 2–114 of this article, the remainder of the
111-assessment required under this section after any transfers made under paragraphs (1) and
112-(2) of this subsection shall be distributed by the Commissioner to the Maryland Health
113-Benefit Exchange Fund established under § 31–107 of this article.
103+ (ii) the partial exclusion of net premiums provided for in § 3
104+9010(b)(2)(B) of the Affordable Care Act. 4
114105
115-6–105.3.
106+ (d) (1) (i) In each of fiscal years 2021 and 2022, $100,000,000 of the funds 5
107+collected from the assessment required under this section shall be transferred in accordance 6
108+with subparagraphs (ii) and (iii) of this paragraph to Medical Care Provider 7
109+Reimbursements (M00Q01.03) within the Medical Care Programs Administration of the 8
110+Maryland Department of Health. 9
116111
117- A STAND–ALONE DENTAL PLAN CA RRIER OR A STAND –ALONE VISION PLAN
118-CARRIER THAT IS SUBJ ECT TO THE HEALTH IN SURANCE PROVIDER FEE
119-ASSESSMENT IMPOSED U NDER § 6–102.1 OF THIS SUBTITLE IN CALENDAR YEAR
120-2024 AND EACH CALENDAR YE AR THEREAFTER IS EXE MPT FROM THE HEALTH CARE
121-REGULATORY ASSESSMEN T UNDER § 2–112.2 OF THIS ARTICLE AND THE ANNUAL
122-ASSESSMENT FEE UNDER § 2–502 OF THIS ARTICLE FO R EACH YEAR IN WHICH THE
123-HEALTH INSURANCE PRO VIDER FEE IS PAID.
112+ (ii) If all or a portion of the funds required to be transferred under 10
113+subparagraph (i) of this paragraph have been received and are held in the Maryland Health 11
114+Benefit Exchange Fund established under § 31–107 of this article, the Governor shall 12
115+transfer the available amount in the Fund. 13
124116
125-31–107.
117+ (iii) If the amount of funds transferred under subparagraph (ii) of this 14
118+paragraph is less than the amount required to be transferred under subparagraph (i) of 15
119+this paragraph, the Insurance Commissioner shall transfer the remaining amount from the 16
120+funds collected from the assessment required under this section. 17
126121
127- (g) (4) The following funds may be used only for the purposes of funding the
128-State Reinsurance Program:
122+ (2) At the beginning of each of fiscal years 2023 and 2024, the Governor 18
123+shall transfer the first $8,000,000 of the funds collected from the assessment required 19
124+under this section to the Community Health Resources Commission. 20
129125
130- (i) any pass–through funds received from the federal government
131-under a waiver approved under § 1332 of the Affordable Care Act to provide reinsurance to
132-carriers that offer individual health benefit plans in the State;
126+ (3) Notwithstanding § 2–114 of this article, the remainder of the 21
127+assessment required under this section after any transfers made under paragraphs (1) and 22
128+(2) of this subsection shall be distributed by the Commissioner to the Maryland Health 23
129+Benefit Exchange Fund established under § 31–107 of this article. 24
133130
134- (ii) any funds designated by the federal government to provide
135-reinsurance to carriers that offer individual health benefit plans in the State; [and]
131+6–105.3. 25
136132
137- (iii) any funds designated by the State to provide reinsurance to
138-carriers that offer individual health benefit plans in the State; AND
133+ A STAND–ALONE DENTAL PLAN CA RRIER OR A STAND –ALONE VISION PLAN 26
134+CARRIER THAT IS S UBJECT TO THE HEALTH INSURANCE PROVIDER F EE 27
135+ASSESSMENT IMPOSED U NDER § 6–102.1 OF THIS SUBTITLE IN CALENDAR YEAR 28
136+2024 AND EACH CALENDAR YE AR THEREAFTER IS EXE MPT FROM THE HEALTH CARE 29
137+REGULATORY ASSESSMEN T UNDER § 2–112.2 OF THIS ARTICLE AND THE ANNUAL 30
138+ASSESSMENT FEE UNDER § 2–502 OF THIS ARTICLE FOR EACH YEAR IN WHICH T HE 31
139+HEALTH INSURANCE PRO VIDER FEE IS PAID. 32
139140
140- (IV) EXCEPT AS PROVIDED I N SUBSECTION (F) OF THIS SECTION,
141-FUNDS RECEIVED FROM THE DI STRIBUTION OF THE AS SESSMENT UNDER § 6–102.1
142-OF THIS ARTICLE .
141+31–107. 33
143142
144- SECTION 2. AND BE IT FURTHER ENACTED, That: Ch. 59 2022 LAWS OF MARYLAND
143+ (g) (4) The following funds may be used only for the purposes of funding the 34
144+State Reinsurance Program: 35 4 HOUSE BILL 413
145145
146-– 4 –
147146
148- (a) On or before December 1, 2023, the Maryland Insurance Administration, in
149-consultation with the Maryland Health Benefit Exchange and the Maryland Health Care
150-Commission, shall report to the Governor and, in accordance with § 2–1257 of the State
151-Government Article, the General Assembly, on the impact of the State Reinsurance
152-Program.
153147
154- (b) In developing the report, the Maryland Insurance Administration shall:
148+ (i) any pass–through funds received from the federal government 1
149+under a waiver approved under § 1332 of the Affordable Care Act to provide reinsurance to 2
150+carriers that offer individual health benefit plans in the State; 3
155151
156- (1) consider whether the level of funding is appropriate, taking into
157-account future population growth and projected premium growth;
152+ (ii) any funds designated by the federal government to provide 4
153+reinsurance to carriers that offer individual health benefit plans in the State; [and] 5
158154
159- (2) consider whether the assessment established under § 6–102.1 of the
160-Insurance Article:
155+ (iii) any funds designated by the State to provide reinsurance to 6
156+carriers that offer individual health benefit plans in the State; AND 7
161157
162- (i) is appropriately apportioned among the carriers;
158+ (IV) EXCEPT AS PROVID ED IN SUBSECTION (F) OF THIS SECTION, 8
159+FUNDS RECEIVED FROM THE DISTRIBUTION OF THE ASSESSMENT UNDER § 6–102.1 9
160+OF THIS ARTICLE . 10
163161
164- (ii) should be broadened to include other business sectors; and
162+ SECTION 2. AND BE IT FURTHER ENACTED, That: 11
165163
166- (iii) should be supplemented with General Funds;
164+ (a) On or before December 1, 2023, the Maryland Insurance Administration, in 12
165+consultation with the Maryland Health Benefit Exchange and the Maryland Health Care 13
166+Commission, shall report to the Governor and, in accordance with § 2–1257 of the State 14
167+Government Article, the General Assembly, on the impact of the State Reinsurance 15
168+Program. 16
167169
168- (3) consider what market reforms are needed to provide affordable health
169-coverage in the individual market, including:
170+ (b) In developing the report, the Maryland Insurance Administration shall: 17
170171
171- (i) continuation of the Program past 2026;
172+ (1) consider whether the level of funding is appropriate, taking into 18
173+account future population growth and projected premium growth; 19
172174
173- (ii) providing State–based premium subsidies; and
175+ (2) consider whether the assessment established under § 6–102.1 of the 20
176+Insurance Article: 21
174177
175- (iii) expanding eligibility for the Maryland Medical Assistance
176-Program; and
178+ (i) is appropriately apportioned among the carriers; 22
177179
178- (4) evaluate the design of the Program, including whether the program
179-parameters established under § 31–117 of the Insurance Article are appropriate in light of
180-other individual market reforms at the State and federal level, including:
180+ (ii) should be broadened to include other business sectors; and 23
181181
182- (i) the Young Adult Subsidies Program;
182+ (iii) should be supplemented with General Funds; 24
183183
184- (ii) the Easy Enrollment Health Insurance Program;
184+ (3) consider what market reforms are needed to provide affordable health 25
185+coverage in the individual market, including: 26
185186
186- (iii) a special or other enrollment period opened under § 31–108 of the
187-Insurance Article; and
187+ (i) continuation of the Program past 2026; 27
188188
189- (iv) premium subsidies available under the American Rescue Plan
190-Act or any other federal law.
191- LAWRENCE J. HOGAN, JR., Governor Ch. 59
189+ (ii) providing State–based premium subsidies; and 28
192190
193-– 5 –
194- (c) The report shall include options for obtaining sustainable funding sources to
195-support stability in the individual market.
191+ (iii) expanding eligibility for the Maryland Medical Assistance 29
192+Program; and 30
193+ HOUSE BILL 413 5
196194
197-SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
198-October 1, 2022.
199195
200-Approved by the Governor, April 12, 2022.
196+ (4) evaluate the design of the Program, including whether the program 1
197+parameters established under § 31–117 of the Insurance Article are appropriate in light of 2
198+other individual market reforms at the State and federal level, including: 3
199+
200+ (i) the Young Adult Subsidies Program; 4
201+
202+ (ii) the Easy Enrollment Health Insurance Program; 5
203+
204+ (iii) a special or other enrollment period opened under § 31–108 of the 6
205+Insurance Article; and 7
206+
207+ (iv) premium subsidies available under the American Rescue Plan 8
208+Act or any other federal law. 9
209+
210+ (c) The report shall include options for obtaining sustainable funding sources to 10
211+support stability in the individual market. 11
212+
213+SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effec t 12
214+October 1, 2022. 13
215+
216+
217+
218+
219+
220+Approved:
221+________________________________________________________________________________
222+ Governor.
223+________________________________________________________________________________
224+ Speaker of the House of Delegates.
225+________________________________________________________________________________
226+ President of the Senate.