Vote Smart's Synopsis:

Vote to pass a bill that establishes the state's health benefit exchange.

Highlights:

• Establishes a health benefit exchange to meet all the minimum functions required by the Patient Protection and Affordable Care Act on or before January 1, 2014 (Sec. 3).

• Defines “exchange” to include the following parts (Sec. 3):
• The “individual exchange”; and
• The Small Business Health Options Program (SHOP Exchange).

• Defines “individual exchange” as the division of the exchange that serves the individual health insurance market (Sec. 3).

• Requires carriers approved by the exchange to offer qualified health care plans for qualified individuals and employers (Sec. 3).

• Defines “carrier” as any of the following (Sec 3):
• An insurer authorized to sell health insurance;
• A nonprofit health service plan;
• A health maintenance organization;
• A dental plan organization; or
• Any other entity providing health insurance, benefits, or services.

• Defines “qualified health plan” as a health benefit plan that has been certified by the exchange to meet the criteria for certification under the Patient Protection and Affordable Care Act (Sec. 3).

• Defines “qualified individuals” as anyone who meets the following criteria (Sec. 3):
• Is seeking to enroll in a qualified health plan offered to individuals through the exchange;
• Resides in the state of Maryland;
• Is not incarcerated; and
• Is a citizen, national, or a legal alien of the United States.

• Defines “qualified employer” as a small business owner who makes their full-time employees eligible for one or more qualified health plans offered through the small business health options exchange, provided that the employer (Sec. 3):
• Has its principal place of business in the Maryland and elects to provide coverage through the SHOP exchange to all its eligible employees wherever they are employed; or
• Elects to provide coverage through the SHOP exchange to all its employees who are “principally” employed in Maryland.

• Specifies that when a carrier sets a community rate for a health benefit plan the rate must be  based on a rating methodology based on the experience of all risks covered by the health benefit plan and may only use the following factors to adjust the community rate (Sec. 2):
• Age;
• Geography; and
• “Health Status”.

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that establishes the state's health benefit exchange.

Highlights:

• Establishes a health benefit exchange to meet all the minimum functions required by the Patient Protection and Affordable Care Act on or before January 1, 2014 (Sec. 3).

• Defines “exchange” to include the following parts (Sec. 3):
• The “individual exchange”; and
• The Small Business Health Options Program (SHOP Exchange).

• Defines “individual exchange” as the division of the exchange that serves the individual health insurance market (Sec. 3).

• Requires carriers approved by the exchange to offer qualified health care plans for qualified individuals and employers (Sec. 3).

• Defines “carrier” as any of the following (Sec 3):
• An insurer authorized to sell health insurance;
• A nonprofit health service plan;
• A health maintenance organization;
• A dental plan organization; or
• Any other entity providing health insurance, benefits, or services.

• Defines “qualified health plan” as a health benefit plan that has been certified by the exchange to meet the criteria for certification under the Patient Protection and Affordable Care Act (Sec. 3).

• Defines “qualified individuals” as anyone who meets the following criteria (Sec. 3):
• Is seeking to enroll in a qualified health plan offered to individuals through the exchange;
• Resides in the state of Maryland;
• Is not incarcerated; and
• Is a citizen, national, or a legal alien of the United States.

• Defines “qualified employer” as a small business owner who makes their full-time employees eligible for one or more qualified health plans offered through the small business health options exchange, provided that the employer (Sec. 3):
• Has its principal place of business in the Maryland and elects to provide coverage through the SHOP exchange to all its eligible employees wherever they are employed; or
• Elects to provide coverage through the SHOP exchange to all its employees who are “principally” employed in Maryland.

• Specifies that when a carrier sets a community rate for a health benefit plan the rate must be  based on a rating methodology based on the experience of all risks covered by the health benefit plan and may only use the following factors to adjust the community rate (Sec. 2):
• Age;
• Geography; and
• “Health Status”.

Full Bill Text