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Ch. 26 2006 LAWS OF MARYLAND
3. Western Maryland; and
4. Eastern and Southern Maryland; AND
(III) HEALTH STATUS.
(3) Rates for a health benefit plan may vary based on family composition
as approved by the Commissioner.
(4) BASED ON THE ADJUSTMENT FOR HEALTH STATUS ALLOWED
UNDER PARAGRAPH (2)(III) OF THIS SUBSECTION, A CARRIER MAY CHARGE A RATE
THAT IS 10% ABOVE OR 25% BELOW THE COMMUNITY RATE.
(5) A CARRIER MAY ADJUST THE COMMUNITY RATE FOR HEALTH
STATUS ONLY FOR HEALTH BENEFIT PLANS ISSUED TO SMALL EMPLOYERS WITH 15
OR FEWER ELIGIBLE EMPLOYEES AT THE TIME OF INITIAL ISSUANCE OF A HEALTH
BENEFIT PLAN.
(6) (I) ON RENEWAL, A CARRIER MAY NOT INCREASE THE PREMIUM
RATE FOR A HEALTH BENEFIT PLAN BY MORE THAN 25% OF THE RATE THAT WAS
CHARGED IN THE PRECEDING YEAR.
(II) THE LIMITATION UNDER SUBPARAGRAPH (I) OF THIS
PARAGRAPH DOES NOT APPLY TO A PREMIUM RATE INCREASE THAT IS BASED ON;
1. A CARRIER'S ANNUAL COST AND UTILIZATION TRENDS; OR
2. A CHANGE IN THE RATING FACTOR FOR ATTAINED AGE
FOR COVERED PERSONS.
(b) A carrier shall apply all risk adjustment factors under subsection (a) of this
section consistently with respect to all health benefit plans that are issued, delivered,
or renewed in the State.
[(e) Based on the adjustments allowed under subsection (a)(2) of this section, a
carrier may charge a rate that is 10% above or below the community rate.]
[(d)] (C) (1) A carrier shall base its rating methods and practices on
commonly accepted actuarial assumptions and sound actuarial principles.
(2) A carrier that is a health maintenance organization and that includes
a subrogation provision in its contract as authorized under § 19-713.1(d) of the
Health—General Article shall:
(i) use in its rating methodology an adjustment that reflects the
subrogation; and
(ii) identify in its rate filing with the Administration, and annually
in a form approved by the Commissioner, all amounts recovered through subrogation.
(3) A CARRIER MAY USE HEALTH STATEMENTS, IN A FORM APPROVED
BY THE COMMISSIONER, AND HEALTH SCREENINGS TO ESTABLISH PREMIUM RATES
AS PROVIDED IN THIS SECTION.
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