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Session Laws, 2002
Volume 800, Page 1728   View pdf image
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Ch. 197
2002 LAWS OF MARYLAND
(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 30 percent of annual premiums] THE EMPLOYEE RECEIVES
THE FULL PREMIUM CONTRIBUTION AVAILABLE FROM THE EMPLOYER; (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 cost sharing requirements on eligible individuals. (2). (I) THE STATE'S COST FOR COVERAGE OF AN ELIGIBLE
INDIVIDUAL ENROLLED IN THE MCHP PRIVATE OPTION PLAN MAY NOT BE GREATER
THAN THE COST OF COVERAGE IF THE ELIGIBLE INDIVIDUAL WAS INSURED
THROUGH A MANAGED CARE ORGANIZATION AS DEFINED IN § 15-101(F) OF THIS
TITLE. [(2)] (II) If an employer-sponsored health benefit plan that meets the
criteria under paragraph (1) of this subsection is not available to the eligible
individual OR IF THE DEPARTMENT DETERMINES THAT THE EMPLOYER-SPONSORED
HEALTH BENEFIT PLAN IS NOT COST EFFECTIVE AS REQUIRED IN ITEM (I) OF THIS
PARAGRAPH, 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: (1) Evaluating employer-sponsored health benefit plans to determine
whether specific plans meet applicable State and federal requirements; (2) Assisting employers that wish to participate in the MCHP private
option plan to meet the eligibility criteria established under subsection (c) of this
section;
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Session Laws, 2002
Volume 800, Page 1728   View pdf image
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