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Ch. 153 2002 LAWS OF MARYLAND
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(3) PREMIUM RATES SHALL BE REASONABLY CALCULATED TO
ENCOURAGE ENROLLMENT IN THE PLAN.
(D) LOSSES INCURRED BY THE PLAN SHALL BE SUBSIDIZED BY THE FUND.
14-506.
(A) (1) THE BOARD SHALL SELECT AN ADMINISTRATOR TO ADMINISTER THE
PLAN.
(2) THE ADMINISTRATOR SHALL BE SELECTED BASED ON CRITERIA
ADOPTED BY THE BOARD IN REGULATION, WHICH SHALL INCLUDE:
(I) THE ADMINISTRATOR'S PROVEN ABILITY TO PROVIDE HEALTH
INSURANCE COVERAGE TO INDIVIDUALS;
(II) THE EFFICIENCY AND TIMELINESS OF THE ADMINISTRATOR'S
CLAIM PROCESSING PROCEDURES;
(III) AN ESTIMATE OF TOTAL CHARGES FOR ADMINISTERING THE
FUND;
(IV) THE ADMINISTRATOR'S PROVEN ABILITY TO APPLY EFFECTIVE
COST CONTAINMENT PROGRAMS AND PROCEDURES; AND
(V) THE FINANCIAL CONDITION AND STABILITY OF THE
ADMINISTRATOR.
(B) THE ADMINISTRATOR SHALL SERVE FOR A PERIOD OF TIME SPECIFIED IN
ITS CONTRACT WITH THE PLAN SUBJECT TO REMOVAL FOR CAUSE AND ANY OTHER
TERMS, CONDITIONS, AND LIMITATIONS CONTAINED IN THE CONTRACT.
(C) THE ADMINISTRATOR SHALL PERFORM FUNCTIONS RELATING TO THE
PLAN AS REQUIRED BY THE BOARD, INCLUDING:
(1) DETERMINATION OF ELIGIBILITY;
(2) DATA COLLECTION;
(3) CASE MANAGEMENT;
(4) FINANCIAL TRACKING AND REPORTING;
(5) PAYMENT OF CLAIMS; AND
(6) PREMIUM BILLING.
(D) (1) EACH YEAR, THE PLAN ADMINISTRATOR SHALL SUBMIT TO THE
COMMISSIONER AN ACCOUNTING OF MEDICAL CLAIMS INCURRED, ADMINISTRATIVE
EXPENSES, AND PREMIUMS PAID COLLECTED.
(2) PLAN LOSSES SHALL BE CERTIFIED BY THE COMMISSIONER IN
ACCORDANCE WITH PARAGRAPH (3) OF THIS SUBSECTION AND RETURNED TO THE
ADMINISTRATOR BY THE BOARD.
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