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Session Laws, 2000
Volume 797, Page 162   View pdf image
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Ch. 15 2000 LAWS OF MARYLAND
(3) " ELIGIBLE INDIVIDUAL" MEANS AN INDIVIDUAL WHO QUALIFIES TO
PARTICIPATE IN THE MARYLAND CHILDREN'S HEALTH PROGRAM UNDER § 15-301(B)
OF THIS SUBTITLE AND WHOSE FAMILY INCOME IS ABOVE 200 PERCENT, BUT AT OR
BELOW 300 PERCENT OF THE FEDERAL POVERTY GUIDELINES. (4) " FAMILY CONTRIBUTION" MEANS THE PORTION OF THE PREMIUM
COST PAID FOR AN ELIGIBLE INDIVIDUAL TO ENROLL AND PARTICIPATE IN THE
MARYLAND CHILDREN'S HEALTH PROGRAM. (5) " MCHP PRIVATE OPTION PLAN" MEANS THE PLAN ESTABLISHED
UNDER THIS SECTION TO PROVIDE ACCESS TO HEALTH INSURANCE COVERAGE TO
ELIGIBLE INDIVIDUALS THROUGH EMPLOYER-SPONSORED HEALTH BENEFIT PLANS
AND MANAGED CARE ORGANIZATIONS UNDER THE MARYLAND CHILDREN'S HEALTH
PROGRAM. (B) THIS SECTION APPLIES ONLY TO INDIVIDUALS WHOSE FAMILY INCOME IS
ABOVE 200 PERCENT, BUT AT OR BELOW 300 PERCENT OF THE FEDERAL POVERTY
GUIDELINES. (C) (1) AN ELIGIBLE INDIVIDUAL WHO IS ENROLLED IN THE MCHP PRIVATE
OPTION PLAN SHALL BE INSURED THROUGH AN EMPLOYER'S HEALTH BENEFIT
PLAN IF: (I) THE EMPLOYER OFFERS FAMILY HEALTH INSURANCE
COVERAGE TO THE PARENT OR GUARDIAN OF AN ELIGIBLE INDIVIDUAL; (II) THE EMPLOYER ELECTS TO PARTICIPATE IN THE MCHP
PRIVATE OPTION PLAN; (III) THE PARENT OR GUARDIAN OF AN ELIGIBLE INDIVIDUAL IS
INSURED UNDER THE EMPLOYER-SPONSORED HEALTH BENEFIT PLAN; (IV) THE EMPLOYER CONTRIBUTES TO FAMILY HEALTH
INSURANCE COVERAGE AT A RATE NO LESS THAN 50 PERCENT OF ANNUAL
PREMIUMS; (V) THE PLAN INCLUDES A BENEFIT PACKAGE THAT IS
DETERMINED BY THE DEPARTMENT TO BE AT LEAST EQUIVALENT TO THE
COMPREHENSIVE STANDARD HEALTH BENEFIT PLAN ESTABLISHED UNDER
§ 15-1207 OF THE INSURANCE ARTICLE; AND (VI) THE PLAN DOES NOT IMPOSE COSTSHARING REQUIREMENTS
ON ELIGIBLE INDIVIDUALS. (2) IF AN EMPLOYER-SPONSORED HEALTH BENEFIT PLAN THAT MEETS
THE CRITERIA UNDER PARAGRAPH (1) OF THIS SUBSECTION IS NOT AVAILABLE TO
THE ELIGIBLE INDIVIDUAL, THE ELIGIBLE INDIVIDUAL SHALL BE INSURED
THROUGH A MANAGED CARE ORGANIZATION AS DEFINED IN § 15-101(F) OF THIS
TITLE. (D) THE DEPARTMENT SHALL FACILITATE COVERAGE OF ELIGIBLE
INDIVIDUALS UNDER AN EMPLOYER-SPONSORED HEALTH BENEFIT PLAN BY:
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Session Laws, 2000
Volume 797, Page 162   View pdf image
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