Maryland Code § IN-31-117

Section IN-31-117
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(a) The Exchange, in consultation with the Commissioner and as approved
by the Board, shall establish and implement a State Reinsurance Program:
(1) to provide reinsurance to carriers that offer individual health
benefit plans in the State;
(2) that meets the requirements of a waiver approved under § 1332
of the Affordable Care Act; and
(3) that is consistent with State and federal law.
(b) The State Reinsurance Program shall be designed to mitigate the impact
of high-risk individuals on rates in the individual insurance market inside and
outside the Exchange.
(c) (1) Based on available funds, the Exchange, in consultation with the
Commissioner and as approved by the Board, shall establish reinsurance payment
parameters for calendar year 2019 and each subsequent calendar year that include:

(i) an attachment point;
(ii) a coinsurance rate; and
(iii) a coinsurance cap.
(2) The Exchange, in consultation with the Commissioner and as
approved by the Board, may alter the parameters established in accordance with
paragraph (1) of this subsection as necessary to secure federal approval for a waiver
submitted in accordance with § 31-117.1(a) of this subtitle.
(d) Beginning January 1, 2019, funding for reinsurance in the individual
market through the State Reinsurance Program may be made by using:
(1) any pass-through funds received from the federal government
under a waiver approved under § 1332 of the Affordable Care Act;
(2) any funds designated by the federal government to provide
reinsurance to carriers that offer individual health benefit plans in the State; and
(3) any funds designated by the State to provide reinsurance to
carriers that offer individual health benefit plans in the State.
(e) The implementation of a State Reinsurance Program for reinsurance in
the individual market shall be contingent on approval from the U.S. Secretary of
Health and Human Services and the U.S. Secretary of the Treasury of a State
Innovation Waiver application under § 1332 of the Affordable Care Act.
(f) On or before January 1, 2019, the Exchange shall adopt regulations
implementing the provisions of this section.

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