WILLIAM DONALD SCHAEFER, Governor                        H.B. 1563

SUBJECT TO A PUBLIC COMMENT PERIOD. THE HEALTH-CARE ACCESS AND COST
COMMISSION SHALL DISCLOSE THE RISK ADJUSTMENT MECHANISM TO
PARTICIPATING CARRIERS BEFORE IT IS IMPLEMENTED.

(C) TO ENSURE THAT PARTICIPATING CARRIERS ARE OPERATING IN
ACCORDANCE WITH THIS SUBTITLE, AT THE REQUEST OF THE REGIONAL HEALTH
COOPERATIVE OR AT THE COMMISSIONER'S DISCRETION, THE COMMISSIONER MAY
CONDUCT A MARKET CONDUCT SURVEY OF A PARTICIPATING CARRIER.

751. REGIONAL HEALTH COOPERATIVES—MARKETING.

(A) THE REGIONAL HEALTH COOPERATIVE SHALL USE APPROPRIATE AND
EFFICIENT MEANS TO NOTIFY EMPLOYERS AND INDIVIDUALS OF THE AVAILABILITY
OF HEALTH COVERAGE THROUGH THE PROGRAM.

(B) (1) THE REGIONAL HEALTH COOPERATIVE SHALL MAKE AVAILABLE TO
INDIVIDUALS AND ELIGIBLE EMPLOYEES MARKETING MATERIALS THAT
ACCURATELY SUMMARIZE THE BENEFIT PLANS, RATES, COSTS, ACCREDITATION,
AND OTHER INFORMATION RELATED TO PARTICIPATING CARRIERS OFFERING
HEALTH BENEFIT PLANS THROUGH THE PROGRAM.

(2) THE MARKETING MATERIALS REQUIRED BY THIS SECTION SHALL
INCLUDE A CLEAR DESCRIPTION OF EACH HEALTH CARE DELIVERY SYSTEM
OFFERED, INCLUDING A CLEAR DESCRIPTION OF THE LIMITATIONS ON THE CHOICE
OF PROVIDER UNDER THOSE DELIVERY SYSTEMS.

(C) (1) UNLESS AUTHORIZED BY THE REGIONAL HEALTH COOPERATIVE
AND SUBJECT TO APPROVAL BY THE COMMISSIONER, A PARTICIPATING CARRIER,
DIRECTLY, OR THROUGH AN EMPLOYEE, AGENT, BROKER, OR CONTRACTOR, MAY
NOT PROVIDE AN EMPLOYER, ELIGIBLE EMPLOYEES AND DEPENDENTS, OR
INDIVIDUALS WITH ANY MARKETING MATERIAL RELATING TO HEALTH BENEFIT
PLANS UNDER THE PROGRAM.

(2) THIS SECTION DOES NOT LIMIT OR RESTRICT A PARTICIPATING
CARRIER FROM OTHERWISE USING THE MEDIA OR OTHER MEANS TO ADVERTISE
AND MARKET TO THE PUBLIC, EMPLOYEES, OR ELIGIBLE EMPLOYEES AT LARGE
UNLESS THE REGIONAL HEALTH COOPERATIVE FINDS THAT SUCH EFFORTS ARE
CONTRARY TO THE PURPOSE AND GOALS OF THIS SUBTITLE.

(3) THE REGIONAL HEALTH COOPERATIVE SHALL DEVELOP
GUIDELINES FOR CARRIER COMPARISON SHEETS TO BE USED IN PROVIDING
MEMBER EMPLOYERS AND THEIR ELIGIBLE EMPLOYEES WITH INFORMATION
REGARDING PARTICIPATING CARRIERS.

752. EMPLOYER BASED HEALTH CARE PLANS.

(A) THE REGIONAL HEALTH COOPERATIVE SHALL OFFER THE PROGRAM TO
ANY ELIGIBLE EMPLOYEE.

(B) THE REGIONAL HEALTH COOPERATIVE SHALL ESTABLISH CONDITIONS
OF PARTICIPATION FOR EMPLOYERS AND ELIGIBLE EMPLOYEES AND THEIR
DEPENDENTS, INCLUDING;

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