Maryland Code § IN-6-102

Section IN-6-102
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(a) A tax is imposed on all new and renewal gross direct premiums of each
person subject to taxation under this subtitle that are:
(1) allocable to the State; and
(2) written during the preceding calendar year.
(b) Premiums to be taxed include:
(1) the consideration for a surety contract, guaranty contract, or
annuity contract;
(2) gross receipts received as a result of capitation payments,
supplemental payments, and bonus payments, made to a managed care organization
for provider services to an individual who is enrolled in a managed care organization;

(3) subscription charges or other amounts paid to a for-profit health
maintenance organization on a predetermined periodic rate basis by a person other
than a person subject to the tax under this subtitle as compensation for providing
health care services to members;
(4) dividends on life insurance policies that have been applied to buy
additional insurance or to shorten the period during which a premium is payable;
(5) the part of the gross receipts of a title insurer that is derived from
insurance business or guaranty business; and
(6) the amount allocable to travel insurance, excluding any amount
received for travel assistance services or cancellation fee waivers, sold to:
(i) an individual primary policyholder who is a resident of the
State;
(ii) a primary certificate holder who:
1. is a resident of the State; and
2. elects coverage under a group travel insurance
policy; or
(iii) a blanket travel insurance policyholder that:
1. is a resident of the State or has its principal place of
business or the principal place of an affiliate or subsidiary in the State; and
2. has purchased blanket travel insurance in the State
for eligible blanket group members, subject to any apportionment rules that:
A. apply to the insurer across multiple taxing
jurisdictions; or
B. allow the insurer to allocate premiums on an
apportioned basis in a reasonable and equitable manner in those jurisdictions.
(c) Premiums not to be taxed include:
(1) premiums on policies covering weekly disability benefits on which
premiums are payable weekly; or

(2) credits allowed on premiums under policies of industrial
insurance because of payment being made to the home office or a branch office of the
insurer.
(d) (1) Gross direct premiums or parts of gross direct premiums that are
derived from or reasonably attributable to insurance business in the State shall be
allocated to the State.
(2) By regulation, the Commissioner may require or allow a method
of allocating gross direct premiums written by a person subject to taxation under this
subtitle that justly and fairly determines the part of the gross direct premiums that
is derived from or reasonably attributable to the person's insurance business in the
State.
(e) (1) Funds accepted by a life insurer under a group contract that
provides for an accumulation of funds to buy annuities at future dates may be
considered as "gross premiums written":
(i) on receipt of the funds; or
(ii) on the actual application of the funds to buy annuities.
(2) Any funds taxed on receipt and any interest later credited to those
funds are not subject to taxation on the purchase of annuities.
(3) Any interest credited to funds that are not taxed on receipt also
shall be included in "gross premiums written".
(4) Each life insurer shall elect between alternatives in paragraph (1)
of this subsection.
(5) A life insurer may not change an election between alternatives in
paragraph (1) of this subsection without the consent of the Commissioner.
(6) If funds that have been taxed as gross premiums are withdrawn
before actually applied to buy annuities, the funds are eligible to be included as
returned premiums if otherwise eligible under § 6-104(a)(1) of this subtitle.
(f) For purposes of determining the premiums subject to taxation under
subsection (b)(6) of this section, a travel insurer shall document the state of residence,
which shall be:
(1) for individual policies, the primary policyholder's state, as
specified by the primary policyholder during the purchase of the policy;

(2) for group policies, the primary certificate holder's state, as
specified during the purchase of the coverage; or
(3) for blanket policies, the state of the principal place of business of
the primary blanket policyholder, affiliate, or subsidiary, as specified during the
purchase of the policy.
§6-102.1. IN EFFECT
(a) This section applies to:
(1) an insurer, a nonprofit health service plan, a health maintenance
organization, a dental plan organization, a fraternal benefit organization, and any
other person subject to regulation by the State that provides a product that:
(i) was subject to § 9010 of the Affordable Care Act, as in effect
on December 1, 2019; and
(ii) may be subject to an assessment by the State; and
(2) a managed care organization authorized under Title 15, Subtitle
1 of the Health - General Article.
(b) The purpose of this section is to assist in the stabilization of the
individual health insurance market by assessing a health insurance provider fee that
is attributable to State health risk for calendar years 2019 through 2028, both
inclusive, as provided for under subsection (c) of this section.
(c) (1) In calendar year 2019, in addition to the amounts otherwise due
under this subtitle, an entity subject to this section shall be subject to an assessment
of 2.75% on all amounts used to calculate the entity's premium tax liability under §
6-102 of this subtitle or the amount of the entity's premium tax exemption value for
calendar year 2018.
(2) In calendar years 2020 through 2028, both inclusive, in addition
to the amounts otherwise due under this subtitle, an entity subject to this section
shall be subject to an assessment of 1% on all amounts used to calculate the entity's
premium tax liability under § 6-102 of this subtitle or the amount of the entity's
premium tax exemption value for the immediately preceding calendar year.
(3) The assessments required in paragraphs (1) and (2) of this
subsection are for products that:

(i) were subject to § 9010 of the Affordable Care Act, as in
effect on December 1, 2019; and
(ii) may be subject to an assessment by the State.
(4) The calculation of the assessments required under paragraphs (1)
and (2) of this subsection shall be made without regard to:
(i) the threshold limits established in § 9010(b)(2)(A) of the
Affordable Care Act; or
(ii) the partial exclusion of net premiums provided for in §
9010(b)(2)(B) of the Affordable Care Act.
(d) (1) (i) In each of fiscal years 2021 and 2022, $100,000,000 of the
funds collected from the assessment required under this section shall be transferred
in accordance with subparagraphs (ii) and (iii) of this paragraph to Medical Care
Provider Reimbursements (M00Q01.03) within the Medical Care Programs
Administration of the Maryland Department of Health.
(ii) If all or a portion of the funds required to be transferred
under subparagraph (i) of this paragraph have been received and are held in the
Maryland Health Benefit Exchange Fund established under § 31-107 of this article,
the Governor shall transfer the available amount in the Fund.
(iii) If the amount of funds transferred under subparagraph (ii)
of this paragraph is less than the amount required to be transferred under
subparagraph (i) of this paragraph, the Insurance Commissioner shall transfer the
remaining amount from the funds collected from the assessment required under this
section.
(2) At the beginning of each of fiscal years 2023 and 2024, the
Governor shall transfer the first $8,000,000 of the funds collected from the
assessment required under this section to the Community Health Resources
Commission.
(3) Notwithstanding § 2-114 of this article, the remainder of the
assessment required under this section after any transfers made under paragraphs
(1) and (2) of this subsection shall be distributed by the Commissioner to the
Maryland Health Benefit Exchange Fund established under § 31-107 of this article.
§6-102.1. ** CONTINGENCY - NOT IN EFFECT - CHAPTERS 597 AND 598 OF
2019 **

(a) (1) This section applies to:
(i) except as provided in paragraph (2) of this subsection, an
insurer, a nonprofit health service plan, a health maintenance organization, a dental
plan organization, a fraternal benefit organization, and any other person subject to
regulation by the State that provides a product that:
1. was subject to the fee under § 9010 of the Affordable
Care Act, as in effect on December 1, 2019; and
2. may be subject to an assessment by the State; and
(ii) a managed care organization authorized under Title 15,
Subtitle 1 of the Health - General Article.
(2) This section does not apply to a stand-alone dental plan carrier
or a stand-alone vision plan carrier.
(b) The purpose of this section is to recoup the aggregate amount of the
health insurance provider fee that otherwise would have been assessed under § 9010
of the Affordable Care Act that is attributable to State health risk for calendar year
2019 as a bridge to stability in the individual health insurance market.
(c) (1) In calendar year 2019, in addition to the amounts otherwise due
under this subtitle, an entity subject to this section shall be subject to an assessment
of 2.75% on all amounts used to calculate the entity's premium tax liability under §
6-102 of this subtitle or the amount of the entity's premium tax exemption value for
calendar year 2018.
(2) Notwithstanding § 2-114 of this article, the assessment required
under this section shall be distributed by the Commissioner to the Maryland Health
Benefit Exchange Fund established under § 31-107 of this article.

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