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Ch. 409
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2005 LAWS OF MARYLAND
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BY repealing and reenacting, with amendments,
Article—Insurance
Section 15-1205
Annotated Code of Maryland
(2002 Replacement Volume and 2004 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:
Article—Insurance
15-1205.
(a) (1) In establishing a community rate for a health benefit plan, a carrier
shall use a rating methodology that is based on the experience of all risks covered by
that health benefit plan without regard to [health statue or occupation or] any
[other] factor not specifically authorized under this subsection.
(2) [A] SUBJECT TO PARAGRAPHS (1) THROUGH (7) OF THIS
SUBSECTION, A carrier may adjust the community rate only for:
(i) age; [and]
(ii) geography based on the following contiguous areas of the State:
1. the Baltimore metropolitan area;
2. the District of Columbia metropolitan area;
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 AGE ALLOWED UNDER
PARAGRAPH (2)(I) OF THIS SUBSECTION, A CARRIER MAY CHARGE A RATE THAT IS 60%
ABOVE OR BELOW THE COMMUNITY RATE.
(5) BASED ON THE ADJUSTMENT FOR GEOGRAPHY ALLOWED UNDER
PARAGRAPH (2)(II) OF THIS SECTION, A CARRIER MAY CHARGE A RATE THAT IS 15%
ABOVE OR BELOW THE COMMUNITY RATE.
(6) (I) BASED ON THE ADJUSTMENT FOR HEALTH STATUS ALLOWED
UNDER PARAGRAPH (2)(III) OF THIS SUBSECTION, A CARRIER MAY CHARGE A RATE
THAT IS 35% ABOVE OR BELOW THE COMMUNITY RATE.
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- 1902 -
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