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Statutes Text

Article - Insurance




§14–106.

    (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 Title 15, Subtitle 10 of the Health – General Article, 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 15, Subtitle 10 of the Health – General Article;

            (iv)    subsidize the Kidney Disease Program under Title 13, Subtitle 3 of the Health – General Article;

            (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; and

            (vi)    subsidize the provision of mental health services to the uninsured under Title 10, Subtitle 2 of the Health – General Article.

        (2)    (i)    Except as provided in subparagraph (ii) of this paragraph, the support provided under paragraph (1)(iv), (v), and (vi) of this subsection to the Kidney Disease Program, the Community Health Resources Commission, and the Maryland Department of Health, respectively, shall be the value of the premium tax exemption less the subsidy required under this subsection for the Senior Prescription Drug Assistance Program.

            (ii)    The subsidy provided under this subsection to the Community Health Resources Commission may not be less than:

                1.    $3,000,000 for each of fiscal years 2012 and 2013; and

                2.    $8,000,000 for fiscal year 2014 and each fiscal year 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 that a nonprofit health service plan is required to provide to the Senior Prescription Drug Assistance Program under subsection (d)(1)(iii) of this section may not exceed:

        (1)    for the period of January 1, 2006 through June 30, 2006, $8,000,000;

        (2)    for fiscal years 2008 through 2025, $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 § 4–335 of the General Provisions 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.