Ch. 35

1997 LAWS OF MARYLAND

(II) EACH REINSURING CARRIER'S SHARE OF THE PREMIUMS
EARNED IN THE PRECEDING CALENDAR YEAR FROM NEWLY ISSUED HEALTH
BENEFIT PLANS THAT ARE DELIVERED OR ISSUED FOR DELIVERY DURING THAT
CALENDAR YEAR TO SMALL EMPLOYERS IN THE STATE BY REINSURING CARRIERS.

(3) THE ASSESSMENT FORMULA MAY NOT RESULT IN AN ASSESSMENT
SHARE FOR A REINSURING CARRIER THAT IS LESS THAN 50% NOR MORE THAN 150%
OF AN AMOUNT THAT IS BASED ON THE PROPORTION OF THE REINSURING
CARRIER'S TOTAL PREMIUMS EARNED IN THE PRECEDING CALENDAR YEAR FROM
HEALTH BENEFIT PLANS THAT ARE DELIVERED OR ISSUED FOR DELIVERY TO
SMALL EMPLOYERS IN THE STATE TO TOTAL PREMIUMS EARNED BY ALL
REINSURING CARRIERS IN THE PRECEDING CALENDAR YEAR FROM HEALTH
BENEFIT PLANS THAT ARE DELIVERED OR ISSUED FOR DELIVERY TO SMALL
EMPLOYERS IN THE STATE.

(4) AS APPROPRIATE AND WITH THE APPROVAL OF THE
COMMISSIONER, THE BOARD MAY CHANGE THE ASSESSMENT FORMULA
ESTABLISHED IN ACCORDANCE WITH THIS SUBSECTION.

(5) THE BOARD MAY PROVIDE FOR ASSESSMENT SHARES
ATTRIBUTABLE TO PREMIUMS FROM ALL HEALTH BENEFIT PLANS AND TO
PREMIUMS FROM NEWLY ISSUED HEALTH BENEFIT PLANS TO VARY DURING A
TRANSITION PERIOD.

(6) SUBJECT TO APPROVAL BY THE COMMISSIONER, THE BOARD SHALL
MAKE AN ADJUSTMENT TO THE ASSESSMENT FORMULA FOR REINSURING CARRIERS
THAT ARE APPROVED HEALTH MAINTENANCE ORGANIZATIONS AND THAT ARE
FEDERALLY QUALIFIED UNDER THE HEALTH MAINTENANCE ORGANIZATION ACT
OF 1973 TO THE EXTENT THAT RESTRICTIONS ARE IMPOSED ON THE HEALTH
MAINTENANCE ORGANIZATIONS THAT ARE NOT IMPOSED ON OTHER CARRIERS.

(7) PREMIUMS AND BENEFITS PAID BY A REINSURING CARRIER THAT
ARE LESS THAN AN AMOUNT DETERMINED BY THE BOARD TO JUSTIFY THE COST OF
COLLECTION MAY NOT BE CONSIDERED IN DETERMINING ASSESSMENTS.

(D) ESTIMATE OF ASSESSMENTS NEEDED.

(1) ON OR BEFORE THE LAST DAY OF FEBRUARY OF EACH YEAR, THE
BOARD SHALL DETERMINE AND FILE WITH THE COMMISSIONER AN ESTIMATE OF
THE ASSESSMENTS NEEDED TO FUND THE LOSSES INCURRED BY THE POOL IN THE
PREVIOUS CALENDAR YEAR.

(2) IF THE BOARD DETERMINES THAT THE ASSESSMENTS NEEDED TO
FUND THE LOSSES INCURRED BY THE POOL IN THE PREVIOUS CALENDAR YEAR
WILL EXCEED 5% OF THE TOTAL PREMIUMS EARNED THAT YEAR FROM HEALTH
BENEFIT PLANS THAT ARE DELIVERED OR ISSUED FOR DELIVERY IN THE STATE,
THE BOARD SHALL EVALUATE THE OPERATION OF THE POOL AND REPORT ITS
FINDINGS TO THE COMMISSIONER WITHIN 90 DAYS AFTER THE END OF THE
CALENDAR YEAR IN WHICH THE LOSSES WERE INCURRED.

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