§31–107.    IN EFFECT

    (a)    There is a Maryland Health Benefit Exchange Fund.

    (b)    (1)    The purpose of the Fund is to:

            (i)    provide funding for the operation and administration of the Exchange in carrying out the purposes of the Exchange under this subtitle;

            (ii)    provide funding for the establishment and operation of the State Reinsurance Program authorized under this subtitle;

            (iii)    provide funding for the Medical Assistance Program and the Senior Prescription Drug Assistance Program;

            (iv)    provide funding for the establishment and operation of Health Equity Resource Communities under Title 20, Subtitle 14 of the Health – General Article; and

            (v)    provide funding for the establishment and operation of the State–Based Young Adult Health Insurance Subsidies Pilot Program authorized under this subtitle.

        (2)    The operation and administration of the Exchange, the State Reinsurance Program, and the State–Based Young Adult Health Insurance Subsidies Pilot Program may include functions delegated by the Exchange to a third party under law or by contract.

    (c)    The Exchange shall administer the Fund.

    (d)    (1)    The Fund is a special, nonlapsing fund that is not subject to § 7–302 of the State Finance and Procurement Article.

        (2)    The State Treasurer shall hold the Fund separately, and the Comptroller shall account for the Fund.

    (e)    The Fund consists of:

        (1)    any user fees or other assessments collected by the Exchange;

        (2)    all revenue deposited into the Fund that is received from the distribution of the premium tax under § 6–103.2 of this article;

        (3)    income from investments made on behalf of the Fund;

        (4)    interest on deposits or investments of money in the Fund;

        (5)    money collected by the Board as a result of legal or other actions taken by the Board on behalf of the Exchange or the Fund;

        (6)    money donated to the Fund;

        (7)    money awarded to the Fund through grants;

        (8)    any pass–through funds received from the federal government under a waiver approved under § 1332 of the Affordable Care Act;

        (9)    any funds designated by the federal government to provide reinsurance to carriers that offer individual health benefit plans in the State;

        (10)    any funds designated by the State to provide reinsurance to carriers that offer individual health benefit plans in the State;

        (11)    any funds designated by the State to provide State–based health insurance subsidies to young adults in the State;

        (12)    any federal funds received in accordance with § 31–121 of this subtitle for the administration of small business tax credits; and

        (13)    any other money from any other source accepted for the benefit of the Fund.

    (f)    (1)    The Fund may be used only:

            (i)    1.    for the operation and administration of the Exchange in carrying out the purposes authorized under this subtitle;

                2.    for the establishment and operation of the State Reinsurance Program; and

                3.    for appropriations to the Health Equity Resource Community Reserve Fund under § 20–1407 of the Health – General Article;

            (ii)    in fiscal years 2021 and 2022, for the Medical Assistance Program within the Medical Care Programs Administration of the Maryland Department of Health;

            (iii)    in fiscal year 2022, for the Senior Prescription Drug Assistance Program established under Title 15, Subtitle 10 of the Health – General Article; and

            (iv)    for the establishment and operation of the State–Based Young Adult Health Insurance Subsidies Pilot Program.

        (2)    In each of fiscal years 2023 through 2025, the Governor shall:

            (i)    transfer $15,000,000 to the Health Equity Resource Community Reserve Fund; and

            (ii)    include the funds transferred in accordance with item (i) of this paragraph in the annual budget bill as an appropriation to the Health Equity Resource Community Reserve Fund under § 20–1407 of the Health – General Article.

    (g)    (1)    The Board shall maintain separate accounts within the Fund for Exchange operations, for the State Reinsurance Program, and for the State–Based Young Adult Health Insurance Subsidies Pilot Program.

        (2)    Accounts within the Fund shall contain the money that is intended to support the purpose for which each account is designated.

        (3)    Funds received from the distribution of the premium tax under § 6–103.2 of this article shall be placed in the account for Exchange operations and may be used only for the purpose of funding the operation and administration of the Exchange.

        (4)    The following funds may be used only for the purposes of funding the State Reinsurance Program:

            (i)    any pass–through funds received from the federal government under a waiver approved under § 1332 of the Affordable Care Act to provide reinsurance to carriers that offer individual health benefit plans in the State;

            (ii)    any funds designated by the federal government to provide reinsurance to carriers that offer individual health benefit plans in the State;

            (iii)    any funds designated by the State to provide reinsurance to carriers that offer individual health benefit plans in the State; and

            (iv)    except as provided in subsection (f) of this section, funds received from the distribution of the assessment under § 6–102.1 of this article.

    (h)    (1)    Expenditures from the Fund for the purposes authorized by this subtitle may be made only:

            (i)    with an appropriation from the Fund approved by the General Assembly in the State budget; or

            (ii)    by the budget amendment procedure provided for in Title 7, Subtitle 2 of the State Finance and Procurement Article.

        (2)    Notwithstanding § 7–304 of the State Finance and Procurement Article, if the amount of the distribution from the premium tax under § 6–103.2 of this article exceeds in any State fiscal year the actual expenditures incurred for the operation and administration of the Exchange, funds in the Exchange operations account from the premium tax that remain unspent at the end of the State fiscal year shall revert to the General Fund of the State.

        (3)    If operating expenses of the Exchange may be charged to either State or non–State fund sources, the non–State funds shall be charged before State funds are charged.

    (i)    (1)    The State Treasurer shall invest the money of the Fund in the same manner as other State money may be invested.

        (2)    Any investment earnings of the Fund shall be credited to the Fund.

        (3)    Except as provided in subsection (h)(2) of this section, no part of the Fund may revert or be credited to the General Fund or any special fund of the State.

    (j)    A debt or an obligation of the Fund is not a debt of the State or a pledge of credit of the State.

§31–107.    // EFFECTIVE JUNE 30, 2026 PER CHAPTERS 256 AND 257 OF 2023 //

    (a)    There is a Maryland Health Benefit Exchange Fund.

    (b)    (1)    The purpose of the Fund is to:

            (i)    provide funding for the operation and administration of the Exchange in carrying out the purposes of the Exchange under this subtitle;

            (ii)    provide funding for the establishment and operation of the State Reinsurance Program authorized under this subtitle;

            (iii)    provide funding for the Medical Assistance Program and the Senior Prescription Drug Assistance Program; and

            (iv)    provide funding for the establishment and operation of Health Equity Resource Communities under Title 20, Subtitle 14 of the Health – General Article.

        (2)    The operation and administration of the Exchange and the State Reinsurance Program may include functions delegated by the Exchange to a third party under law or by contract.

    (c)    The Exchange shall administer the Fund.

    (d)    (1)    The Fund is a special, nonlapsing fund that is not subject to § 7–302 of the State Finance and Procurement Article.

        (2)    The State Treasurer shall hold the Fund separately, and the Comptroller shall account for the Fund.

    (e)    The Fund consists of:

        (1)    any user fees or other assessments collected by the Exchange;

        (2)    all revenue deposited into the Fund that is received from the distribution of the premium tax under § 6–103.2 of this article;

        (3)    income from investments made on behalf of the Fund;

        (4)    interest on deposits or investments of money in the Fund;

        (5)    money collected by the Board as a result of legal or other actions taken by the Board on behalf of the Exchange or the Fund;

        (6)    money donated to the Fund;

        (7)    money awarded to the Fund through grants;

        (8)    any pass–through funds received from the federal government under a waiver approved under § 1332 of the Affordable Care Act;

        (9)    any funds designated by the federal government to provide reinsurance to carriers that offer individual health benefit plans in the State;

        (10)    any funds designated by the State to provide reinsurance to carriers that offer individual health benefit plans in the State;

        (11)    any federal funds received in accordance with § 31–121 of this subtitle for the administration of small business tax credits; and

        (12)    any other money from any other source accepted for the benefit of the Fund.

    (f)    (1)    The Fund may be used only:

            (i)    1.    for the operation and administration of the Exchange in carrying out the purposes authorized under this subtitle;

                2.    for the establishment and operation of the State Reinsurance Program; and

                3.    for appropriations to the Health Equity Resource Community Reserve Fund under § 20–1407 of the Health – General Article;

            (ii)    in fiscal years 2021 and 2022, for the Medical Assistance Program within the Medical Care Programs Administration of the Maryland Department of Health; and

            (iii)    in fiscal year 2022, for the Senior Prescription Drug Assistance Program established under Title 15, Subtitle 10 of the Health – General Article.

        (2)    In each of fiscal years 2023 through 2025, the Governor shall:

            (i)    transfer $15,000,000 to the Health Equity Resource Community Reserve Fund; and

            (ii)    include the funds transferred in accordance with item (i) of this paragraph in the annual budget bill as an appropriation to the Health Equity Resource Community Reserve Fund under § 20–1407 of the Health – General Article.

    (g)    (1)    The Board shall maintain separate accounts within the Fund for Exchange operations and for the State Reinsurance Program.

        (2)    Accounts within the Fund shall contain the money that is intended to support the purpose for which each account is designated.

        (3)    Funds received from the distribution of the premium tax under § 6–103.2 of this article shall be placed in the account for Exchange operations and may be used only for the purpose of funding the operation and administration of the Exchange.

        (4)    The following funds may be used only for the purposes of funding the State Reinsurance Program:

            (i)    any pass–through funds received from the federal government under a waiver approved under § 1332 of the Affordable Care Act to provide reinsurance to carriers that offer individual health benefit plans in the State;

            (ii)    any funds designated by the federal government to provide reinsurance to carriers that offer individual health benefit plans in the State;

            (iii)    any funds designated by the State to provide reinsurance to carriers that offer individual health benefit plans in the State; and

            (iv)    except as provided in subsection (f) of this section, funds received from the distribution of the assessment under § 6–102.1 of this article.

    (h)    (1)    Expenditures from the Fund for the purposes authorized by this subtitle may be made only:

            (i)    with an appropriation from the Fund approved by the General Assembly in the State budget; or

            (ii)    by the budget amendment procedure provided for in Title 7, Subtitle 2 of the State Finance and Procurement Article.

        (2)    Notwithstanding § 7–304 of the State Finance and Procurement Article, if the amount of the distribution from the premium tax under § 6–103.2 of this article exceeds in any State fiscal year the actual expenditures incurred for the operation and administration of the Exchange, funds in the Exchange operations account from the premium tax that remain unspent at the end of the State fiscal year shall revert to the General Fund of the State.

        (3)    If operating expenses of the Exchange may be charged to either State or non–State fund sources, the non–State funds shall be charged before State funds are charged.

    (i)    (1)    The State Treasurer shall invest the money of the Fund in the same manner as other State money may be invested.

        (2)    Any investment earnings of the Fund shall be credited to the Fund.

        (3)    Except as provided in subsection (h)(2) of this section, no part of the Fund may revert or be credited to the General Fund or any special fund of the State.

    (j)    A debt or an obligation of the Fund is not a debt of the State or a pledge of credit of the State.