MD
Maryland House Bill HB709

Maryland 2022 Regular Session

Maryland House Bill HB709 Compare Versions

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33 EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
44 [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.
85 *hb0709*
96
107 HOUSE BILL 709
118 J5, C3 2lr1675
12- CF SB 632
9+ CF 2lr1676
1310 By: Delegates R. Lewis, Lierman, and K. Young
1411 Introduced and read first time: January 31, 2022
1512 Assigned to: Health and Government Operations
16-Committee Report: Favorable with amendments
17-House action: Adopted
18-Read second time: March 30, 2022
1913
20-CHAPTER ______
14+A BILL ENTITLED
2115
2216 AN ACT concerning 1
2317
2418 Maryland Health Benefit Exchange – Small Business and Nonprofit Health 2
25-Insurance Subsidies Program – Workgroup 3
19+Insurance Subsidies Program 3
2620
2721 FOR the purpose of establishing a Small Business and Nonprofit Health Insurance 4
2822 Subsidies Program in the State to provide subsidies to small business and nonprofit 5
2923 employers and their employees for the purchase of qualified health benefit plans on 6
30-the Maryland Health Benefit Exchange requiring the Maryland Health Benefit 7
31-Exchange to convene a workgroup to study and make recommendations relating to 8
32-the establishment of a Small Business and Nonprofit Health Insurance Subsidies 9
33-Program to provide subsidies to small businesses and nonprofit employers and their 10
34-employees for the purchase of health benefit plans; and generally relating to the 11
35-Maryland Health Benefit Exchange and subsidies for small businesses and 12
36-nonprofits. 13
24+the Maryland Health Benefit Exchange; and generally relating to the Maryland 7
25+Health Benefit Exchange and subsidies for small businesses and nonprofits. 8
3726
38-BY repealing and reenacting, with amendments, 14
27+BY repealing and reenacting, with amendments, 9
28+ Article – Insurance 10
29+Section 31–107 11
30+ Annotated Code of Maryland 12
31+ (2017 Replacement Volume and 2021 Supplement) 13
32+
33+BY adding to 14
3934 Article – Insurance 15
40-Section 31–107 16
35+Section 31–123 16
4136 Annotated Code of Maryland 17
4237 (2017 Replacement Volume and 2021 Supplement) 18
4338
44-BY adding to 19
45- Article – Insurance 20
46-Section 31–123 21
47- Annotated Code of Maryland 22
48- (2017 Replacement Volume and 2021 Supplement) 23 2 HOUSE BILL 709
39+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 19
40+That the Laws of Maryland read as follows: 20
41+
42+Article – Insurance 21
43+
44+31–107. 22
45+
46+ (a) There is a Maryland Health Benefit Exchange Fund. 23
47+
48+ (b) (1) The purpose of the Fund is to: 24 2 HOUSE BILL 709
4949
5050
5151
52- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 1
53-That the Laws of Maryland read as follows: 2
52+ (i) provide funding for the operation and administration of the 1
53+Exchange in carrying out the purposes of the Exchange under this subtitle; 2
5454
55- (a) The Maryland Health Benefit Exchange shall convene a workgroup to study 3
56-and make recommendations relating to the establishment of a Small Business and 4
57-Nonprofit Health Insurance Subsidies Program to provide subsidies to small businesses 5
58-and nonprofit employers and their employees for the purchase of health benefit plans. 6
55+ (ii) provide funding for the establishment and operation of the State 3
56+Reinsurance Program authorized under this subtitle; 4
5957
60- (b) The Exchange shall invite the following persons to participate in the 7
61-workgroup convened under subsection (a) of this section: 8
58+ (iii) provide funding for the Medical Assistance Program and the 5
59+Senior Prescription Drug Assistance Program; 6
6260
63- (1) individuals from the small business and nonprofit community, 9
64-including owners, employers, and employees; 10
61+ (iv) provide funding for the establishment and operation of Health 7
62+Equity Resource Communities under Title 20, Subtitle 14 of the Health – General Article; 8
63+[and] 9
6564
66- (2) health insurance carrier representatives; 11
65+ (v) provide funding for the establishment and operation of the 10
66+State–Based Young Adult Health Insurance Subsidies Pilot Program authorized under this 11
67+subtitle; AND 12
6768
68- (3) licensed health insurance producers; 12
69+ (VI) PROVIDE FUNDING FOR THE ESTABLISHMENT AN D 13
70+OPERATION OF THE SMALL BUSINESS AND NONPROFIT HEALTH INSURANCE 14
71+SUBSIDIES PROGRAM AUTHORIZED UNDER THI S SUBTITLE. 15
6972
70- (4) representatives of business, nonprofit, consumer advocacy, and other 13
71-organizations; and 14
73+ (2) The operation and administration of the Exchange, the State 16
74+Reinsurance Program, [and] the State–Based Young Adult Health Insurance Subsidies 17
75+Pilot Program, AND THE SMALL BUSINESS AND NONPROFIT HEALTH INSURANCE 18
76+SUBSIDIES PROGRAM may include functions delegated by the Exchange to a third party 19
77+under law or by contract. 20
7278
73- (5) any other person who expresses interest in participating in the 15
74-workgroup. 16
79+ (c) The Exchange shall administer the Fund. 21
7580
76- (c) The workgroup convened under subsection (a) of this section shall study and 17
77-make findings and recommendations regarding: 18
81+ (d) (1) The Fund is a special, nonlapsing fund that is not subject to § 7–302 of 22
82+the State Finance and Procurement Article. 23
7883
79- (1) the health insurance coverage needs of small employers, nonprofit 19
80-employers, and their employees; 20
84+ (2) The State Treasurer shall hold the Fund separately, and the 24
85+Comptroller shall account for the Fund. 25
8186
82- (2) objectives and target metrics for the Program; 21
87+ (e) The Fund consists of: 26
8388
84- (3) the optimal scope and design features of a Small Business and 22
85-Nonprofit Health Insurance Subsidies Program, including: 23
89+ (1) any user fees or other assessments collected by the Exchange; 27
8690
87- (i) whether subsidies under the Program should be available for the 24
88-purchase of qualified health plans offered to small employers on the Exchange and the 25
89-purchase of health benefit plans offered to small employers outside the Exchange; 26
91+ (2) all revenue deposited into the Fund that is received from the 28
92+distribution of the premium tax under § 6–103.2 of this article; 29
9093
91- (ii) subsidy eligibility and payment parameters for the Program; 27
94+ (3) income from investments made on behalf of the Fund; 30
9295
93- (iii) the administrative structure and infrastructure investments 28
94-required for implementation of the Program, including any requirements for the Exchange, 29
95-health insurance carriers, and any other entities involved in the implementation of the 30
96-Program; and 31
97- HOUSE BILL 709 3
96+ (4) interest on deposits or investments of money in the Fund; 31 HOUSE BILL 709 3
9897
9998
100- (iv) the duration of the Program; 1
10199
102- (4) the cost to administer the Program, including the cost to provide 2
103-subsidies and operational costs; and 3
100+ (5) money collected by the Board as a result of legal or other actions taken 1
101+by the Board on behalf of the Exchange or the Fund; 2
104102
105- (5) the sources and levels of funding needed to support the Program. 4
103+ (6) money donated to the Fund; 3
106104
107- (d) On or before October 1, 2022, the Exchange shall submit a report to the 5
108-Governor and, in accordance with § 2–1257 of the State Government Article, the Senate 6
109-Finance Committee and the House Health and Government Operations Committee that 7
110-includes the findings and recommendations of the workgroup required under this section. 8
105+ (7) money awarded to the Fund through grants; 4
111106
112- SECTION 2. AND BE IT FURTHER ENACTED, That it is the intent of the General 9
113-Assembly that, beginning in fiscal year 2024 and in each fiscal year thereafter, the 10
114-Governor shall include in the annual budget bill an appropriation of funding to establish 11
115-and operate a Small Business and Nonprofit Health Insurance Subsidies Program with a 12
116-design as recommended by the workgroup under Section 1 of this Act. 13
107+ (8) any pass–through funds received from the federal government under a 5
108+waiver approved under § 1332 of the Affordable Care Act; 6
117109
118-Article – Insurance 14
110+ (9) any funds designated by the federal government to provide reinsurance 7
111+to carriers that offer individual health benefit plans in the State; 8
119112
120-31–107. 15
113+ (10) any funds designated by the State to provide reinsurance to carriers 9
114+that offer individual health benefit plans in the State; 10
121115
122- (a) There is a Maryland Health Benefit Exchange Fund. 16
116+ (11) any funds designated by the State to provide State–based health 11
117+insurance subsidies to young adults in the State; 12
123118
124- (b) (1) The purpose of the Fund is to: 17
119+ (12) ANY FEDERAL FUNDS AV AILABLE TO PROVIDE HEALTH 13
120+INSURANCE SUBSIDIES TO QUALIFIED SMALL BUSINESS AND NONPROFIT 14
121+EMPLOYERS AND THEIR EMPLOYEES IN T HE STATE, INCLUDING FUNDS FROM THE 15
122+FEDERAL AMERICAN RESCUE PLAN OF 2021; 16
125123
126- (i) provide funding for the operation and administration of the 18
127-Exchange in carrying out the purposes of the Exchange under this subtitle; 19
124+ [(12)] (13) any federal funds received in accordance with § 31–121 of this 17
125+subtitle for the administration of small business tax credits; and 18
128126
129- (ii) provide funding for the establishment and operation of the State 20
130-Reinsurance Program authorized under this subtitle; 21
127+ [(13)] (14) any other money from any other source accepted for the benefit 19
128+of the Fund. 20
131129
132- (iii) provide funding for the Medical Assistance Program and the 22
133-Senior Prescription Drug Assistance Program; 23
130+ (f) (1) The Fund may be used only: 21
134131
135- (iv) provide funding for the establishment and operation of Health 24
136-Equity Resource Communities under Title 20, Subtitle 14 of the Health – General Article; 25
137-[and] 26
132+ (i) 1. for the operation and administration of the Exchange in 22
133+carrying out the purposes authorized under this subtitle; 23
138134
139- (v) provide funding for the establishment and operation of the 27
140-State–Based Young Adult Health Insurance Subsidies Pilot Program authorized under this 28
141-subtitle; AND 29
135+ 2. for the establishment and operation of the State 24
136+Reinsurance Program; and 25
142137
143- (VI) PROVIDE FUNDING FOR THE ESTABLISHMENT AN D 30
144-OPERATION OF THE SMALL BUSINESS AND NONPROFIT HEALTH INSURANCE 31
145-SUBSIDIES PROGRAM AUTHORIZED UN DER THIS SUBTITLE . 32
138+ 3. for appropriations to the Health Equity Resource 26
139+Community Reserve Fund under § 20–1407 of the Health – General Article; 27
140+
141+ (ii) in fiscal years 2021 and 2022, for the Medical Assistance 28
142+Program within the Medical Care Programs Administration of the Maryland Department 29
143+of Health; 30
146144 4 HOUSE BILL 709
147145
148146
149- (2) The operation and administration of the Exchange, the State 1
150-Reinsurance Program, [and] the State–Based Young Adult Health Insurance Subsidies 2
151-Pilot Program, AND THE SMALL BUSINESS AND NONPROFIT HEALTH INSURANCE 3
152-SUBSIDIES PROGRAM may include functions delegated by the Exchange to a third party 4
153-under law or by contract. 5
147+ (iii) in fiscal year 2022, for the Senior Prescription Drug Assistance 1
148+Program established under Title 15, Subtitle 10 of the Health – General Article; [and] 2
154149
155- (c) The Exchange shall administer the Fund. 6
150+ (iv) for the establishment and operation of the State–Based Young 3
151+Adult Health Insurance Subsidies Pilot Program; AND 4
156152
157- (d) (1) The Fund is a special, nonlapsing fund that is not subject to § 7–302 of 7
158-the State Finance and Procurement Article. 8
153+ (V) FOR THE ESTABLISHMEN T AND OPERATION OF T HE SMALL 5
154+BUSINESS AND NONPROFIT HEALTH INSURANCE SUBSIDIES PROGRAM. 6
159155
160- (2) The State Treasurer shall hold the Fund separately, and the 9
161-Comptroller shall account for the Fund. 10
156+ (2) In each of fiscal years 2023 through 2025, the Governor shall: 7
162157
163- (e) The Fund consists of: 11
158+ (i) transfer $15,000,000 to the Health Equity Resource Community 8
159+Reserve Fund; and 9
164160
165- (1) any user fees or other assessments collected by the Exchange; 12
161+ (ii) include the funds transferred in accordance with item (i) of this 10
162+paragraph in the annual budget bill as an appropriation to the Health Equity Resource 11
163+Community Reserve Fund under § 20–1407 of the Health – General Article. 12
166164
167- (2) all revenue deposited into the Fund that is received from the 13
168-distribution of the premium tax under § 6–103.2 of this article; 14
165+ (g) (1) The Board shall maintain separate accounts within the Fund for 13
166+Exchange operations, for the State Reinsurance Program, [and] for the State–Based Young 14
167+Adult Health Insurance Subsidies Pilot Program, AND FOR THE SMALL BUSINESS AND 15
168+NONPROFIT HEALTH INSURANCE SUBSIDIES PROGRAM. 16
169169
170- (3) income from investments made on behalf of the Fund; 15
170+ (2) Accounts within the Fund shall contain the money that is intended to 17
171+support the purpose for which each account is designated. 18
171172
172- (4) interest on deposits or investments of money in the Fund; 16
173+ (3) Funds received from the distribution of the premium tax under § 19
174+6–103.2 of this article shall be placed in the account for Exchange operations and may be 20
175+used only for the purpose of funding the operation and administration of the Exchange. 21
173176
174- (5) money collected by the Board as a result of legal or other actions taken 17
175-by the Board on behalf of the Exchange or the Fund; 18
177+ (4) The following funds may be used only for the purposes of funding the 22
178+State Reinsurance Program: 23
176179
177- (6) money donated to the Fund; 19
180+ (i) any pass–through funds received from the federal government 24
181+under a waiver approved under § 1332 of the Affordable Care Act to provide reinsurance to 25
182+carriers that offer individual health benefit plans in the State; 26
178183
179- (7) money awarded to the Fund through grants; 20
184+ (ii) any funds designated by the federal government to provide 27
185+reinsurance to carriers that offer individual health benefit plans in the State; and 28
180186
181- (8) any pass–through funds received from the federal government under a 21
182-waiver approved under § 1332 of the Affordable Care Act; 22
187+ (iii) any funds designated by the State to provide reinsurance to 29
188+carriers that offer individual health benefit plans in the State. 30
183189
184- (9) any funds designated by the federal government to provide reinsurance 23
185-to carriers that offer individual health benefit plans in the State; 24
186-
187- (10) any funds designated by the State to provide reinsurance to carriers 25
188-that offer individual health benefit plans in the State; 26
189-
190- (11) any funds designated by the State to provide State–based health 27
191-insurance subsidies to young adults in the State; 28
192-
193- (12) ANY FEDERAL FUNDS AV AILABLE TO PROVIDE H EALTH 29
194-INSURANCE SUBSIDIES TO QUALIFIED SMALL BUSI NESS AND NONPROFIT 30 HOUSE BILL 709 5
190+ (h) (1) Expenditures from the Fund for the purposes authorized by this 31
191+subtitle may be made only: 32
192+ HOUSE BILL 709 5
195193
196194
197-EMPLOYERS AND THEIR EMPLOYEES IN THE STATE, INCLUDING FUNDS FROM THE 1
198-FEDERAL AMERICAN RESCUE PLAN OF 2021; 2
195+ (i) with an appropriation from the Fund approved by the General 1
196+Assembly in the State budget; or 2
199197
200- [(12)] (13) any federal funds received in accordance with § 31–121 of this 3
201-subtitle for the administration of small business tax credits; and 4
198+ (ii) by the budget amendment procedure provided for in Title 7, 3
199+Subtitle 2 of the State Finance and Procurement Article. 4
202200
203- [(13)] (14) any other money from any other source accepted for the benefit 5
204-of the Fund. 6
201+ (2) Notwithstanding § 7–304 of the State Finance and Procurement Article, 5
202+if the amount of the distribution from the premium tax under § 6–103.2 of this article 6
203+exceeds in any State fiscal year the actual expenditures incurred for the operation and 7
204+administration of the Exchange, funds in the Exchange operations account from the 8
205+premium tax that remain unspent at the end of the State fiscal year shall revert to the 9
206+General Fund of the State. 10
205207
206- (f) (1) The Fund may be used only: 7
208+ (3) If operating expenses of the Exchange may be charged to either State 11
209+or non–State fund sources, the non–State funds shall be charged before State funds are 12
210+charged. 13
207211
208- (i) 1. for the operation and administration of the Exchange in 8
209-carrying out the purposes authorized under this subtitle; 9
212+ (i) (1) The State Treasurer shall invest the money of the Fund in the same 14
213+manner as other State money may be invested. 15
210214
211- 2. for the establishment and operation of the State 10
212-Reinsurance Program; and 11
215+ (2) Any investment earnings of the Fund shall be credited to the Fund. 16
213216
214- 3. for appropriations to the Health Equity Resource 12
215-Community Reserve Fund under § 20–1407 of the Health – General Article; 13
217+ (3) Except as provided in subsection (h)(2) of this section, no part of the 17
218+Fund may revert or be credited to the General Fund or any special fund of the State. 18
216219
217- (ii) in fiscal years 2021 and 2022, for the Medical Assistance 14
218-Program within the Medical Care Programs Administration of the Maryland Department 15
219-of Health; 16
220+ (j) A debt or an obligation of the Fund is not a debt of the State or a pledge of 19
221+credit of the State. 20
220222
221- (iii) in fiscal year 2022, for the Senior Prescription Drug Assistance 17
222-Program established under Title 15, Subtitle 10 of the Health – General Article; [and] 18
223+31–123. 21
223224
224- (iv) for the establishment and operation of the State–Based Young 19
225-Adult Health Insurance Subsidies Pilot Program; AND 20
225+ (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 22
226+INDICATED. 23
226227
227- (V) FOR THE ESTABLISHMEN T AND OPERATION OF T HE SMALL 21
228-BUSINESS AND NONPROFIT HEALTH INSURANCE SUBSIDIES PROGRAM. 22
228+ (2) “PROGRAM” MEANS THE SMALL BUSINESS AND NONPROFIT 24
229+HEALTH INSURANCE SUBSIDIES PROGRAM. 25
229230
230- (2) In each of fiscal years 2023 through 2025, the Governor shall: 23
231+ (3) (I) “QUALIFIED EMPLOYER ” MEANS AN EMPLOYER WITH 26
232+FEWER THAN 25 FULL–TIME EQUIVALENT EMPL OYEES. 27
231233
232- (i) transfer $15,000,000 to the Health Equity Resource Community 24
233-Reserve Fund; and 25
234+ (II) “QUALIFIED EMPLOYER ” INCLUDES A NONPROFIT 28
235+ORGANIZATION EMPLOYER WITH FEWER THAN 25 FULL–TIME EQUIVALENT 29
236+EMPLOYEES. 30
234237
235- (ii) include the funds transferred in accordance with item (i) of this 26
236-paragraph in the annual budget bill as an appropriation to the Health Equity Resource 27
237-Community Reserve Fund under § 20–1407 of the Health – General Article. 28
238+ (B) THE EXCHANGE, IN CONSULTATION WITH THE COMMISSIONER AND AS 31
239+APPROVED BY THE BOARD, SHALL ESTABLISH AND IMPLEMENT A SMALL BUSINESS 32 6 HOUSE BILL 709
238240
239- (g) (1) The Board shall maintain separate accounts within the Fund for 29
240-Exchange operations, for the State Reinsurance Program, [and] for the State–Based Young 30
241-Adult Health Insurance Subsidies Pilot Program, AND FOR THE SMALL BUSINESS AND 31
242-NONPROFIT HEALTH INSURANCE SUBSIDIES PROGRAM. 32 6 HOUSE BILL 709
241+
242+AND NONPROFIT HEALTH INSURANCE SUBSIDIES PROGRAM TO PROVIDE 1
243+SUBSIDIES TO QUALIFIED EMPLOYERS AND THEIR EMPLOYEES FOR THE PURCHASE 2
244+OF QUALIFIED HEALTH BENEFIT PLANS ON THE EXCHANGE. 3
245+
246+ (C) THE PROGRAM REQUIRED UNDE R THIS SECTION SHALL BE DESIGNED 4
247+TO REDUCE THE AMOUNT TH AT QUALIFIED EMPLOYERS AND THEIR EMPLOYEES PAY 5
248+FOR QUALIFIED HEALTH BENEFIT PLANS ON THE EXCHANGE. 6
249+
250+ (D) FOR CALENDAR YEARS 2024 THROUGH 2028, THE EXCHANGE, IN 7
251+CONSULTATION WITH TH E COMMISSIONER AND AS A PPROVED BY THE BOARD, 8
252+SHALL ESTABLISH SUBS IDY ELIGIBILITY AND PAYMENT PARAMETERS F OR THE 9
253+PROGRAM. 10
254+
255+ (E) SUBJECT TO AVAILABLE FUNDS, IN EACH OF FISCAL YE ARS 2023 11
256+THROUGH 2029, THE EXCHANGE MAY DESIGNAT E FUNDS FROM THE FUND TO BE 12
257+USED FOR THE PROGRAM SO THAT FOR CALENDAR YEARS 2024 THROUGH 2028 NOT 13
258+MORE THAN: 14
259+
260+ (1) $45,000,000 IN ANNUAL SUBSIDIES MAY BE PR OVIDED TO 15
261+QUALIFIED EMPLOYERS AND THEIR EMPLOYEES WHO MEET THE SUBSIDY 16
262+ELIGIBILITY AND PAYM ENT PARAMETERS ESTAB LISHED UNDER SUBSECT ION (D) OF 17
263+THIS SECTION; AND 18
264+
265+ (2) $3,000,000 MAY BE SPENT IN SMALL BUSINESS OU TREACH 19
266+ACTIVITIES FOR THE PURPOSE OF E DUCATING QUALIFIED E MPLOYERS ABOUT THE 20
267+PROGRAM. 21
268+
269+ (F) ON OR BEFORE JANUARY 1, 2023, THE EXCHANGE SHALL ADOPT 22
270+REGULATIONS CARRYING OUT THIS SECTION. 23
271+
272+ (G) (1) THE EXCHANGE SHALL TRACK ON A MONTHLY BASIS 24
273+EXPENDITURES ON SUBS IDIES PROVIDE D UNDER THE PROGRAM, INCLUDING: 25
274+
275+ (I) THE AVERAGE NUMBER O F QUALIFIED EMPLOYERS AND 26
276+THEIR EMPLOYEES RECEIVING SUBSIDIES UNDER THE PROGRAM; AND 27
277+
278+ (II) THE AVERAGE SUBSIDY AMOUNT RECEIVED BY QUALIFIED 28
279+EMPLOYERS AND THEIR EMPLOYEES UNDER THE PROGRAM. 29
280+
281+ (2) THE INFORMATION TRACK ED BY THE EXCHANGE UNDER 30
282+PARAGRAPH (1) OF THIS SUBSECTION S HALL BE: 31
283+
284+ (I) POSTED ON THE WEBSIT E OF THE EXCHANGE; 32 HOUSE BILL 709 7
243285
244286
245287
246- (2) Accounts within the Fund shall contain the money that is intended to 1
247-support the purpose for which each account is designated. 2
288+ (II) INCLUDED IN THE ANNU AL REPORT REQUIRED U NDER § 1
289+31–119(D) OF THIS SUBTITLE; AND 2
248290
249- (3) Funds received from the distribution of the premium tax under § 3
250-6–103.2 of this article shall be placed in the account for Exchange operations and may be 4
251-used only for the purpose of funding the operation and administration of the Exchange. 5
291+ (III) ON OR BEFORE DECEMBER 1, 2028, REPORTED TO THE 3
292+SENATE FINANCE COMMITTEE AND THE HOUSE HEALTH AND GOVERNMENT 4
293+OPERATIONS COMMITTEE, IN ACCORDANCE WITH § 2–1257 OF THE STATE 5
294+GOVERNMENT ARTICLE. 6
252295
253- (4) The following funds may be used only for the purposes of funding the 6
254-State Reinsurance Program: 7
255-
256- (i) any pass–through funds received from the federal government 8
257-under a waiver approved under § 1332 of the Affordable Care Act to provide reinsurance to 9
258-carriers that offer individual health benefit plans in the State; 10
259-
260- (ii) any funds designated by the federal government to provide 11
261-reinsurance to carriers that offer individual health benefit plans in the State; and 12
262-
263- (iii) any funds designated by the State to provide reinsurance to 13
264-carriers that offer individual health benefit plans in the State. 14
265-
266- (h) (1) Expenditures from the Fund for the purposes authorized by this 15
267-subtitle may be made only: 16
268-
269- (i) with an appropriation from the Fund approved by the General 17
270-Assembly in the State budget; or 18
271-
272- (ii) by the budget amendment procedure provided for in Title 7, 19
273-Subtitle 2 of the State Finance and Procurement Article. 20
274-
275- (2) Notwithstanding § 7–304 of the State Finance and Procurement Article, 21
276-if the amount of the distribution from the premium tax under § 6–103.2 of this article 22
277-exceeds in any State fiscal year the actual expenditures incurred for the operation and 23
278-administration of the Exchange, funds in the Exchange operations account from the 24
279-premium tax that remain unspent at the end of the State fiscal year shall revert to the 25
280-General Fund of the State. 26
281-
282- (3) If operating expenses of the Exchange may be charged to either State 27
283-or non–State fund sources, the non–State funds shall be charged before State funds are 28
284-charged. 29
285-
286- (i) (1) The State Treasurer shall invest the money of the Fund in the same 30
287-manner as other State money may be invested. 31
288-
289- (2) Any investment earnings of the Fund shall be credited to the Fund. 32
290- HOUSE BILL 709 7
291-
292-
293- (3) Except as provided in subsection (h)(2) of this section, no part of the 1
294-Fund may revert or be credited to the General Fund or any special fund of the State. 2
295-
296- (j) A debt or an obligation of the Fund is not a debt of the State or a pledge of 3
297-credit of the State. 4
298-
299-31–123. 5
300-
301- (A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 6
302-INDICATED. 7
303-
304- (2) “PROGRAM” MEANS THE SMALL BUSINESS AND NONPROFIT 8
305-HEALTH INSURANCE SUBSIDIES PROGRAM. 9
306-
307- (3) (I) “QUALIFIED EMPLOYER ” MEANS AN EMPLOYER WI TH 10
308-FEWER THAN 25 FULL–TIME EQUIVALENT EMPL OYEES. 11
309-
310- (II) “QUALIFIED EMPLOYER ” INCLUDES A NONPROFIT 12
311-ORGANIZATION EMPLOYE R WITH FEWER THAN 25 FULL–TIME EQUIVALENT 13
312-EMPLOYEES. 14
313-
314- (B) THE EXCHANGE, IN CONSULTATION WITH THE COMMISSIONER AND AS 15
315-APPROVED BY THE BOARD, SHALL ESTABLISH AND IMPLEMENT A SMALL BUSINESS 16
316-AND NONPROFIT HEALTH INSURANCE SUBSIDIES PROGRAM TO PROVIDE 17
317-SUBSIDIES TO QUALIFIED EMPLOYERS AND THEIR EMPLOYEES FOR THE PURCHASE 18
318-OF QUALIFIED HEALTH BENEFIT PLANS ON THE EXCHANGE. 19
319-
320- (C) THE PROGRAM REQUIRED UNDE R THIS SECTION SHALL BE DESIGNED 20
321-TO REDUCE THE AMOUNT THAT QUALIFIED EMPLO YERS AND THEIR EMPLO YEES PAY 21
322-FOR QUALIFIED HEALTH BENEFIT PLANS ON THE EXCHANGE. 22
323-
324- (D) FOR CALENDAR YEARS 2024 THROUGH 2028, THE EXCHANGE, IN 23
325-CONSULTATION WITH TH E COMMISSIONER AND AS A PPROVED BY THE BOARD, 24
326-SHALL ESTABLISH SUBS IDY ELIGIBILITY AND PAYMENT PARAMETERS F OR THE 25
327-PROGRAM. 26
328-
329- (E) SUBJECT TO AVAILABLE FUNDS , IN EACH OF FISCAL YE ARS 2023 27
330-THROUGH 2029, THE EXCHANGE MAY DESIGNAT E FUNDS FROM THE FUND TO BE 28
331-USED FOR THE PROGRAM SO THAT FOR C ALENDAR YEARS 2024 THROUGH 2028 NOT 29
332-MORE THAN: 30
333-
334- (1) $45,000,000 IN ANNUAL SUBSIDIES MAY BE PROVIDED TO 31
335-QUALIFIED EMPLOYERS A ND THEIR EMPLOYEES W HO MEET THE SUBSIDY 32 8 HOUSE BILL 709
336-
337-
338-ELIGIBILITY AND PAYM ENT PARAMETERS ESTAB LISHED UNDER SUBSECT ION (D) OF 1
339-THIS SECTION; AND 2
340-
341- (2) $3,000,000 MAY BE SPENT IN SMAL L BUSINESS OUTREACH 3
342-ACTIVITIES FOR THE P URPOSE OF EDUCATING QUALIFIED EMPLOYERS ABOUT THE 4
343-PROGRAM. 5
344-
345- (F) ON OR BEFORE JANUARY 1, 2023, THE EXCHANGE SHALL ADOPT 6
346-REGULATIONS CARRYING OUT THIS SECTION . 7
347-
348- (G) (1) THE EXCHANGE SHALL TRACK ON A MONTHLY BASIS 8
349-EXPENDITURES ON SUBS IDIES PROVIDED UNDER THE PROGRAM, INCLUDING: 9
350-
351- (I) THE AVERAGE NUMBER O F QUALIFIED EMPLOYER S AND 10
352-THEIR EMPLOYEES RECE IVING SUBSIDIES UNDE R THE PROGRAM; AND 11
353-
354- (II) THE AVERAGE SUBSIDY AMOUNT RECEIVED BY Q UALIFIED 12
355-EMPLOYERS AND THEIR EMPLOYEES UNDER THE PROGRAM. 13
356-
357- (2) THE INFORMATION TRACK ED BY THE EXCHANGE UNDER 14
358-PARAGRAPH (1) OF THIS SUBSECTION S HALL BE: 15
359-
360- (I) POSTED ON THE WEBSIT E OF THE EXCHANGE; 16
361-
362- (II) INCLUDED IN THE ANNU AL REPORT REQUIRED U NDER § 17
363-31–119(D) OF THIS SUBTITLE; AND 18
364-
365- (III) ON OR BEFORE DECEMBER 1, 2028, REPORTED TO THE 19
366-SENATE FINANCE COMMITTEE AND THE HOUSE HEALTH AND GOVERNMENT 20
367-OPERATIONS COMMITTEE, IN ACCORDANCE WITH § 2–1257 OF THE STATE 21
368-GOVERNMENT ARTICLE. 22
369-
370- SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 23
371-October June 1, 2022. It Section 1 of this Act shall remain effective for a period of 7 years 24
372-1 year and 1 month and, at the end of September 30, 2029, June 30, 2023, Section 1 of this 25
373-Act, with no further action required by the General Assembly, shall be abrogated and of no 26
374-further force and effect. 27
375-
296+ SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 7
297+October 1, 2022. It shall remain effective for a period of 7 years and, at the end of September 8
298+30, 2029, this Act, with no further action required by the General Assembly, shall be 9
299+abrogated and of no further force and effect. 10