Maryland 2023 Regular Session

Maryland House Bill HB604 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2
3	3	EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTING LAW.
4	4	[Brackets] indicate matter deleted from existing law.
5	5	hb0604
6	6
7	7	HOUSE BILL 604
8	8	J5 3lr1232
9	9	CF 3lr1248
10	10	By: Delegate Qi
11	11	Introduced and read first time: February 3, 2023
12	12	Assigned to: Health and Government Operations
13	13
14	14	A BILL ENTITLED
15	15
16	16	AN ACT concerning 1
17	17
18	18	Health Insurance – Health Benefit Plans Issued Through Professional Employer 2
19	19	Organizations – Exemption 3
20	20
21	21	FOR the purpose of exempting from certain requirements relating to the offering of health 4
22	22	benefit plans to individuals and small employers in the State health benefit plans 5
23	23	issued through a professional employer organization, coemployer, or other 6
24	24	organization located in the State or another state that engages in employee leasing; 7
25	25	and generally relating to health benefit plans issued through professional employer 8
26	26	organizations, coemployers, and other organizations that engage in employee 9
27	27	leasing. 10
28	28
29	29	BY repealing and reenacting, with amendments, 11
30	30	Article – Insurance 12
31	31	Section 15–1204.1 and 15–1303 13
32	32	Annotated Code of Maryland 14
33	33	(2017 Replacement Volume and 2022 Supplement) 15
34	34
35	35	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 16
36	36	That the Laws of Maryland read as follows: 17
37	37
38	38	Article – Insurance 18
39	39
40	40	15–1204.1. 19
41	41
42	42	(a) (1) This section applies to a carrier with respect to any health benefit plan 20
43	43	that: 21
44	44
45	45	[(1)] (I) is not a grandfathered health plan, as defined in § 1251 of the 22
46	46	Affordable Care Act; and 23
47	47	2 HOUSE BILL 604
48	48
49	49
50	50	[(2)] (II) is issued, delivered, or renewed in the State on or after January 1
51	51	1, 2014. 2
52	52
53	53	(2) THIS SECTION DOES NOT APPLY TO A HEALTH BENEFIT PLAN 3
54	54	ISSUED THROUGH A PRO FESSIONAL EMPLOYER O RGANIZATION, COEMPLOYER , OR 4
55	55	OTHER ORGANIZATION L OCATED IN THIS STATE OR ANOTHER STAT E THAT ENGAGES 5
56	56	IN EMPLOYEE LEASING . 6
57	57
58	58	(b) (1) Except as provided in this subsection and § 31–110(f) of this article, a 7
59	59	carrier may not offer health benefit plans to small employers in the State unless the carrier 8
60	60	also offers qualified health plans, as defined in § 31–101 of this article, in the Small 9
61	61	Business Health Options Program of the Maryland Health Benefit Exchange in compliance 10
62	62	with the requirements of Title 31 of this article. 11
63	63
64	64	(2) A carrier is exempt from the requirement in paragraph (1) of this 12
65	65	subsection if: 13
66	66
67	67	(i) the reported total aggregate annual earned premium from all 14
68	68	health benefit plans offered to small employers in the State for the carrier and any other 15
69	69	carriers in the same insurance holding company system, as defined in § 7–101 of this 16
70	70	article, is less than $20,000,000; 17
71	71
72	72	(ii) the Commissioner determines that the carrier complies with the 18
73	73	procedures established under paragraph (3) of this subsection; and 19
74	74
75	75	(iii) when the carrier ceases to meet the requirements for the 20
76	76	exemption, the carrier provides to the Commissioner immediate notice and its plan for 21
77	77	complying with the requirement in paragraph (1) of this subsection. 22
78	78
79	79	(3) The Commissioner shall establish procedures for a carrier to submit 23
80	80	evidence each year that the carrier meets the requirements necessary to qualify for an 24
81	81	exemption under paragraph (2) of this subsection. 25
82	82
83	83	(4) Notwithstanding the exemption provided in paragraph (2) of this 26
84	84	subsection, the Commissioner, in consultation with the Maryland Health Benefit 27
85	85	Exchange: 28
86	86
87	87	(i) may assess the impact of the exemption provided in paragraph 29
88	88	(2) of this subsection and, based on that assessment, alter the limit on the amount of annual 30
89	89	premiums that may not be exceeded to qualify for the exemption; and 31
90	90
91	91	(ii) shall make any change in the exemption requirement by 32
92	92	regulation. 33
93	93
94	94	15–1303. 34
95	95	HOUSE BILL 604 3
96	96
97	97
98	98	(A) THIS SECTION DOES NOT APPLY TO AN INDIVIDUAL HEALTH BE NEFIT 1
99	99	PLAN ISSUED THROUGH A PROFESSIONAL EMPLO YER ORGANIZATION , 2
100	100	COEMPLOYER , OR OTHER ORGANIZATIO N LOCATED IN THIS STATE OR ANOTHER 3
101	101	STATE THAT ENGAGES I N EMPLOYEE LEASING . 4
102	102
103	103	[(a)] (B) In addition to any other requirements under this article, a carrier that 5
104	104	offers individual health benefit plans in the State shall: 6
105	105
106	106	(1) have demonstrated the capacity to administer the individual health 7
107	107	benefit plans, including adequate numbers and types of administrative staff; 8
108	108
109	109	(2) have a satisfactory grievance procedure and ability to respond to calls, 9
110	110	questions, and complaints from enrollees or insureds; and 10
111	111
112	112	(3) design policies to help ensure that enrollees or insureds have adequate 11
113	113	access to providers of health care. 12
114	114
115	115	[(b)] (C) (1) Except as provided in this subsection and § 31–110(f) of this 13
116	116	article, a carrier may not offer individual health benefit plans in the State unless the carrier 14
117	117	also offers qualified health plans, as defined in § 31–101 of this article, in the Individual 15
118	118	Exchange of the Maryland Health Benefit Exchange in compliance with the requirements 16
119	119	of Title 31 of this article. 17
120	120
121	121	(2) A carrier is exempt from the requirement in paragraph (1) of this 18
122	122	subsection if: 19
123	123
124	124	(i) 1. the reported total aggregate annual earned premium from 20
125	125	all individual health benefit plans in the State for the carrier and any other carriers in the 21
126	126	same insurance holding company system, as defined in § 7–101 of this article, is less than 22
127	127	$10,000,000; or 23
128	128
129	129	2. the only individual health benefit plans that the carrier 24
130	130	offers in the State are student health plans as defined in 45 C.F.R. § 147.145; 25
131	131
132	132	(ii) the Commissioner determines that the carrier complies with the 26
133	133	procedures established under paragraph (3) of this subsection; and 27
134	134
135	135	(iii) when the carrier ceases to meet the requirements for the 28
136	136	exemption, the carrier provides to the Commissioner immediate notice and its plan for 29
137	137	complying with the requirement in paragraph (1) of this subsection. 30
138	138
139	139	(3) The Commissioner shall establish procedures for a carrier to submit 31
140	140	evidence each year that the carrier meets the requirements necessary to qualify for an 32
141	141	exemption under paragraph (2) of this subsection. 33
142	142	4 HOUSE BILL 604
143	143
144	144
145	145	(4) Notwithstanding the exemption provided in paragraph (2) of this 1
146	146	subsection, any carrier that offers a catastrophic plan, as defined by the Affordable Care 2
147	147	Act, in the State also must offer at least one catastrophic plan in the Maryland Health 3
148	148	Benefit Exchange. 4
149	149
150	150	(5) Notwithstanding the exemption provided in paragraph (2) of this 5
151	151	subsection, the Commissioner, in consultation with the Maryland Health Benefit 6
152	152	Exchange: 7
153	153
154	154	(i) may assess the impact of the exemption provided in paragraph 8
155	155	(2) of this subsection and, based on that assessment, alter the limit on the amount of annual 9
156	156	premiums that may not be exceeded to qualify for the exemption; and 10
157	157
158	158	(ii) shall make any change in the exemption requirement by 11
159	159	regulation. 12
160	160
161	161	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 13
162	162	policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 14
163	163	after January 1, 2024. 15
164	164
165	165	SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 16
166	166	January 1, 2024. 17