US Laws, Codes, Statutes & Cases

CAUTION: READ FULL TEXT OF SECTION FOR SPECIAL NOTE

      (a)      There is a State Employee and Retiree Health and Welfare Benefits Program, to be developed and administered by the Secretary.

      (b)      (1)      The Program:

                  (i)      subject to the regulations adopted under § 2-503 of this subtitle, shall encompass all units in the Executive, Judicial, and Legislative branches of State government, including any unit with an independent personnel system;

                  (ii)      except as provided in subsection (c) of this section, shall include the health insurance benefit options established by the Secretary; and

                  (iii)      except as provided in paragraph (2) of this subsection and subsection (c) of this section, may include any other benefit option that the Secretary considers appropriate.

            (2)      The Program may not contain any of the benefits provided under Division II or Title 35 or Title 37 of this article.

      (c)      (1)      Except as provided in paragraph (2) of this subsection, in fiscal years 2006 and 2007, the Program shall provide the same health insurance benefits options, prescription drug benefit options, co-premiums and co-payments to employees and retirees and their dependents as provided on January 1, 2005.

            (2)      In fiscal years 2006 and 2007:

                  (i)      the employee or retiree share of the premium for the employee or retiree and their dependents for the point of service health plan may increase to 17%;

                  (ii)      the Program may include disease management programs;

                  (iii)      the Prescription Drug Benefit Plan shall offer a voluntary mail order option and the Prescription Drug Benefit Plan may charge enrollees the following co-payments for prescription drugs:

                        1.      $5 for generic drugs;

                        2.      $15 for preferred drugs on the State formulary; and

                        3.      $25 for drugs that are not preferred drugs on the State formulary;

                  (iv)      the Prescription Drug Benefit Plan may charge a co-payment as provided in item (iii) of this subsection for each 45 day prescription;

                  (v)      for each fiscal year, the total amount of co-payments charged the employee or retiree and their dependents as provided in item (iii) of this subsection may not exceed $700; and

                  (vi)      the Prescription Drug Benefit Plan may include the following programmatic changes:

                        1.      implementation of a step therapy program to assure that lower cost alternatives are used first;

                        2.      changes in the pharmacy network;

                        3.      limitations on the first prescription for a maintenance drug;

                        4.      limitations on the quantity of drugs dispensed to reduce inappropriate or excessive drug usage;

                        5.      requirements for prior authorization of drugs to ensure that they are medically necessary; and

                        6.      implementation of a drug utilization review program.

// SPECIAL NOTE: THE ABOVE SECTION WAS CHANGED BY CHAPTER 444 OF 2005 AND WILL REMAIN IN EFFECT UNTIL JUNE 30, 2007 //

      (a)      There is a State Employee and Retiree Health and Welfare Benefits Program, to be developed and administered by the Secretary.

      (b)      (1)      The Program:

                  (i)      subject to the regulations adopted under § 2-503 of this subtitle, shall encompass all units in the Executive, Judicial, and Legislative branches of State government, including any unit with an independent personnel system;

                  (ii)      shall include the health insurance benefit options established by the Secretary; and

                  (iii)      except as provided in paragraph (2) of this subsection, may include any other benefit option that the Secretary considers appropriate.

            (2)      The Program may not contain any of the benefits provided under Division II or Title 35 or Title 37 of this article.