1993 LAWS OF MARYLAND

(3) EXCEPT FOR A PLAN OFFERED IN ACCORDANCE WITH PARAGRAPH
(2) OF THIS SUBSECTION, A CARRIER MAY NOT OFFER A HEALTH BENEFIT PLAN
THAT HAS FEWER THAN THE BENEFITS IN THE COMPREHENSIVE STANDARD
HEALTH BENEFIT PLAN.

700.                                                             

(A)     (1) THE COMMISSION SHALL ADOPT REGULATIONS SPECIFYING THE
COMPREHENSIVE STANDARD HEALTH BENEFIT PLAN TO APPLY UNDER THIS
SUBTITLE, IN ACCORDANCE WITH THE PROVISIONS OF TITLE 19, SUBTITLE 15 OF THE
HEALTH - GENERAL ARTICLE.

(2) THE COMMISSION SHALL REQUIRE THAT THE MINIMUM BENEFITS
PERMITTED TO BE OFFERED IN THE COMPREHENSIVE STANDARD HEALTH BENEFIT
PLAN:

(I) BY A HEALTH MAINTENANCE ORGANIZATION SHALL INCLUDE AT
LEAST THE ACTUARIAL EQUIVALENT OF THE MINIMUM BENEFITS REQUIRED TO BE
OFFERED BY A FEDERALLY QUALIFIED HEALTH MAINTENANCE ORGANIZATION; AND

            (II) ON AN EXPENSE-INCURRED BASIS BY AN INSURER OR NONPROFIT

HEALTH SERVICE PLAN, SHALL BE ACTUARIALLY EQUIVALENT TO AT LEAST THE
MINIMUM BENEFITS REQUIRED TO BE OFFERED UNDER ITEM (I) OF THIS PARAGRAPH.

(3) THE AVERAGE COMMUNITY RATE FOR THE COMPREHENSIVE
STANDARD HEALTH BENEFIT PLAN, AS DETERMINED ANNUALLY BY THE COMMISSION,
BASED ON THE AVERAGE COMMUNITY RATE SUBMITTED BY EACH CARRIER OFFERING
THE COMPREHENSIVE STANDARD HEALTH BENEFIT PLAN MAY NOT EXCEED 12 PERCENT
OF MARYLAND'S AVERAGE ANNUAL WAGE.

(2) (4) IN ESTABLISHING BENEFITS, THE COMMISSION SHALL JUDGE
PREVENTIVE SERVICES, MEDICAL TREATMENTS, PROCEDURES, AND RELATED
HEALTH SERVICES BASED ON:

(I)  THEIR EFFECTIVENESS IN IMPROVING THE HEALTH STATUS OF
INDIVIDUALS;

(II)     THEIR IMPACT ON MAINTAINING AND IMPROVING HEALTH
AND ON REDUCING THE UNNECESSARY CONSUMPTION OF HEALTH CARE SERVICES;
AND

(III)    THEIR IMPACT ON THE AFFORDABILITY OF HEALTH CARE
COVERAGE.

(3) (5) THE COMMISSION MAY EXCLUDE ANY MANDATED BENEFIT.

(B)     THE COMPREHENSIVE STANDARD HEALTH BENEFIT PLAN SHALL
INCLUDE UNIFORM DEDUCTIBLES AND COST-SHARING ASSOCIATED WITH ITS
BENEFITS, AS DETERMINED BY THE COMMISSION.

(C)     IN ESTABLISHING COST-SHARING AS PART OF THE COMPREHENSIVE
STANDARD HEALTH BENEFIT PLAN, THE COMMISSION SHALL:

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Ch. 9