Maryland Insurance Section 14-106
§ 14-106.
CAUTION: READ FULL TEXT OF SECTION FOR SPECIAL NOTE
(a) It is the public policy of this State that the exemption from taxation for nonprofit health service plans under § 6-101(b)(1) of this article is granted so that funds which would otherwise be collected by the State and spent for a public purpose shall be used in a like manner and amount by the nonprofit health service plan.
(b) By March 1 of each year or a deadline otherwise imposed by the Commissioner for good cause, each nonprofit health service plan shall file with the Commissioner a premium tax exemption report that:
(1) is in a form approved by the Commissioner; and
(2) demonstrates that the plan has used funds equal to the value of the premium tax exemption provided to the plan under § 6-101(b) of this article, in a manner that serves the public interest in accordance with this section.
(c) A nonprofit health service plan may satisfy the public service requirement of this section by establishing that, to the extent the value of the nonprofit health service plan's premium tax exemption under § 6-101(b) of this article exceeds the subsidy required under the Senior Prescription Drug Program established under Subtitle 5, Part II of this title, the plan has:
(1) increased access to, or the affordability of, one or more health care products or services by offering and selling health care products or services that are not required or provided for by law;
(2) provided financial or in-kind support for public health programs;
(3) employed underwriting standards in a manner that increases the availability of one or more health care services or products;
(4) employed pricing policies that enhance the affordability of health care services or products and result in a higher medical loss ratio than that established by a comparable for-profit health insurer; or
(5) served the public interest by any method or practice approved by the Commissioner.
(d) (1) Notwithstanding subsection (c) of this section, a nonprofit health service plan that is subject to this section and issues comprehensive health care benefits in the State shall:
(i) offer health care products in the individual market;
(ii) offer health care products in the small employer group market in accordance with Title 15, Subtitle 12 of this article;
(iii) administer and subsidize the Senior Prescription Drug Assistance Program established under Title 14, Subtitle 5, Part II of this title;
(iv) subsidize the Medicare Option Prescription Drug Program under § 15-124.3 of the Health - General Article; and
(v) support the costs of the Community Health Resources Commission under Title 19, Subtitle 21 of the Health - General Article, including:
1. operating grants to community health resources;
2. funding for a unified data information system;
3. the documented direct costs of fulfilling the statutory and regulatory duties of the Commission; and
4. the administrative costs of the Commission.
(2) (i) The support provided under paragraph (1)(v)1, 3, and 4 of this subsection to the Community Health Resources Commission shall be limited to:
1. $2,000,000 in fiscal year 2006; and
2. in fiscal year 2007 and annually thereafter, the value of the premium tax exemption less:
A. the subsidy required under this subsection for the Senior Prescription Drug Assistance Program;
B. the subsidy required under this subsection for the Medicare Option Prescription Drug Program; and
C. the funding required under this subsection for the unified data information system.
(ii) The subsidy provided under paragraph (1)(iv) of this subsection for the Medicare Option Prescription Drug Program shall be limited to:
1. $500,000 in fiscal year 2006; and
2. $300,000 in fiscal year 2007 and annually thereafter.
(iii) The amount provided under paragraph (1)(v)2 of this subsection to fund a unified data information system shall be limited to:
1. $500,000 in fiscal year 2006; and
2. $1,700,000 in fiscal year 2007 and annually thereafter.
(3) For any year, the subsidy and funding required under this subsection by a nonprofit health service plan subject to this section may not exceed the value of the nonprofit health service plan's premium tax exemption under § 6-101(b) of this article.
(e) The subsidy required under the Senior Prescription Drug Program may not exceed the value of the nonprofit health service plan's premium tax exemption under § 6-101(b) of this article.
(f) (1) Subject to paragraph (2) of this subsection, each report filed with the Commissioner under subsection (b) of this section is a public record.
(2) In accordance with § 10-617(d) of the State Government Article, the Commissioner shall deny inspection of any part of a report filed under subsection (b) of this section that the Commissioner determines contains confidential commercial information or confidential financial information.
** SPECIAL NOTE: CONTINGENCY - CHAPTERS 281 AND 282 - 2005 **
(a) It is the public policy of this State that the exemption from taxation for nonprofit health service plans under § 6-101(b)(1) of this article is granted so that funds which would otherwise be collected by the State and spent for a public purpose shall be used in a like manner and amount by the nonprofit health service plan.
(b) By March 1 of each year or a deadline otherwise imposed by the Commissioner for good cause, each nonprofit health service plan shall file with the Commissioner a premium tax exemption report that:
(1) is in a form approved by the Commissioner; and
(2) demonstrates that the plan has used funds equal to the value of the premium tax exemption provided to the plan under § 6-101(b) of this article, in a manner that serves the public interest in accordance with this section.
(c) A nonprofit health service plan may satisfy the public service requirement of this section by establishing that, to the extent the value of the nonprofit health service plan's premium tax exemption under § 6-101(b) of this article exceeds the subsidy required under the Senior Prescription Drug Assistance Program established under Subtitle 5, Part II of this title, the plan has:
(1) increased access to, or the affordability of, one or more health care products or services by offering and selling health care products or services that are not required or provided for by law;
(2) provided financial or in-kind support for public health programs;
(3) employed underwriting standards in a manner that increases the availability of one or more health care services or products;
(4) employed pricing policies that enhance the affordability of health care services or products and result in a higher medical loss ratio than that established by a comparable for-profit health insurer; or
(5) served the public interest by any method or practice approved by the Commissioner.
(d) (1) Notwithstanding subsection (c) of this section, a nonprofit health service plan that is subject to this section and issues comprehensive health care benefits in the State shall:
(i) offer health care products in the individual market;
(ii) offer health care products in the small employer group market in accordance with Title 15, Subtitle 12 of this article;
(iii) subsidize the Senior Prescription Drug Assistance Program established under Title 14, Subtitle 5, Part II of this title;
(iv) subsidize the Medicare Option Prescription Drug Program under § 15-124.3 of the Health - General Article; and
(v) support the costs of the Community Health Resources Commission under Title 19, Subtitle 21 of the Health - General Article, including:
1. operating grants to community health resources;
2. funding for a unified data information system;
3. the documented direct costs of fulfilling the statutory and regulatory duties of the Commission; and
4. the administrative costs of the Commission.
(2) (i) The support provided under paragraph (1)(v)1, 3, and 4 of this subsection to the Community Health Resources Commission shall be limited to:
1. $2,000,000 in fiscal year 2006; and
2. in fiscal year 2007 and annually thereafter, the value of the premium tax exemption less:
A. the subsidy required under this subsection for the Senior Prescription Drug Assistance Program;
B. the subsidy required under this subsection for the Medicare Option Prescription Drug Program; and
C. the funding required under this subsection for the unified data information system.
(ii) The subsidy provided under paragraph (1)(iv) of this subsection for the Medicare Option Prescription Drug Program shall be limited to:
1. $500,000 in fiscal year 2006; and
2. $300,000 in fiscal year 2007 and annually thereafter.
(iii) The amount provided under paragraph (1)(v)2 of this subsection to fund a unified data information system shall be limited to:
1. $500,000 in fiscal year 2006; and
2. $1,700,000 in fiscal year 2007 and annually thereafter.
(3) For any year, the subsidy and funding required under this subsection by a nonprofit health service plan subject to this section may not exceed the value of the nonprofit health service plan's premium tax exemption under § 6-101(b) of this article.
(e) The subsidy required under the Senior Prescription Drug Assistance Program may not exceed:
(1) for the period of January 1, 2006 through June 30, 2006, $8,000,000;
(2) for fiscal year 2007, $14,000,000; and
(3) for any year, the value of the nonprofit health service plan's premium tax exemption under § 6-101(b) of this article.
(f) (1) Subject to paragraph (2) of this subsection, each report filed with the Commissioner under subsection (b) of this section is a public record.
(2) In accordance with § 10-617(d) of the State Government Article, the Commissioner shall deny inspection of any part of a report filed under subsection (b) of this section that the Commissioner determines contains confidential commercial information or confidential financial information.
