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Ch. 467
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2007 Laws of Maryland
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(i) a health care service, benefit, coverage, or reimbursement
for covered health care services that is required under this article or the
Health - General Article to be provided or offered in a health benefit plan that is
issued or delivered in the State by a carrier; or
(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 on the basis of family composition.
(3) If the Board determines that a standard risk rate would create
market dislocation, the Board may adjust the premium rate based on member age.
(4) The Board may charge different premiums based on the benefit
package delivery system OR COST-SHARING ARRANGEMENT when more than one
benefit package delivery system OR COST-SHARING ARRANGEMENT is offered.
(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 a member's income.
(D) (1) NOTWITHSTANDING THE PROVISIONS OF SUBSECTION (B) OF
THIS SECTION, IF THE BOARD HAS IMPLEMENTED A PREEXISTING CONDITION
LIMITATION, THE BOARD MAY OFFER MEMBERS AN OPTIONAL ENDORSEMENT
TO REMOVE THE PREEXISTING CONDITION LIMITATION.
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- 2750 -
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