Ch. 510                                    2004 LAWS OF MARYLAND

(ii) reimbursement required by statute, by a health benefit plan for
a service when that service is performed by a health care provider who is licensed
under the Health Occupations Article and whose scope of practice includes that
service.

(b)     (1) The Board shall establish a premium rate for Plan coverage subject to
review and approval by the Commissioner.

(2) The premium rate may vary only on the basis of family composition.

(3) THE PREMIUM RATE MAY BE ADJUSTED FOR GEOGRAPHY BASED ON
THE FOLLOWING CONTIGUOUS AREAS OF THE STATE;

(I) THE BALTIMORE METROPOLITAN AREA;

(II) THE DISTRICT OF COLUMBIA METROPOLITAN AREA;

(III) WESTERN MARYLAND; AND

(IV) EASTERN AND SOUTHERN MARYLAND.

[(3)](4) If the Board determines that a standard risk rate would create
market dislocation, the Board may adjust the premium rate based on member age.

(c)      (1) The Board shall determine a standard risk rate by considering the
premium rates charged by carriers in the State for coverage comparable to that of the
Plan.

(2)     The premium rate for Plan coverage:

(i) may not be less than 110% of the standard risk rate established
under paragraph (1) of this subsection; and

(ii) may not exceed 200% of the standard risk rate.

(3)     Premium rates shall be reasonably calculated to encourage
enrollment in the Plan.

(4)      THE BOARD MAY SUBSIDIZE PREMIUMS, DEDUCTIBLES, AND OTHER
POLICY EXPENSES, BASED ON THE A MEMBER'S INCOME.

(d)     Losses incurred by the Plan shall be subsidized by the Fund.

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take
effect October July 1, 2004.

Approved May 26, 2004.

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