|
|
|
|
|
|
|
|
|
|
|
|
|
|
ROBERT L. EHRLICH, JR., Governor S.B. 961
(3) [A] SUBJECT TO PARAGRAPHS (4) THROUGH (7) OF THIS
SUBSECTION, A carrier may adjust the community rate only for:
(i) age; [and]
(ii) geography based on the following contiguous arena 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 ACE 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 25% ABOVE OR BELOW THE COMMUNITY RATE.
(II) ON RENEWAL, A CARRIER MAY ADJUST THE COMMUNITY RATE
FOR A HEALTH BENEFIT PLAN BASED ON CHANGES IN HEALTH STATUS THAT OCCUR
AFTER THE HEALTH BENEFIT PLAN IS ISSUED BY THE CARRIER BY NO MORE THAN
15%.
(7) (I) ON RENEWAL, A CARRIER MAY NOT INCREASE THE PREMIUM
RATE BY MORE THAN 25% OF THE RATE THAT WAS CHARGED IN THE PRECEDING
YEAR.
(II) THE LIMITATION IN SUBPARAGRAPH (I) OF THIS PARAGRAPH
MAY NOT INCLUDE ANY PREMIUM RATE INCREASE THAT IS BASED ON A CARRIER'S
ANNUAL COST AND UTILIZATION TRENDS OR 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 40% above or below the community rate.]
|
|
|
|
|
|
|
|
|
|
- 3957 -
|
|
|
|
|
|
|
|
|
|
|
|
|
|
 |
