(a) (1) Each carrier shall elect to become either a risk-assuming carrier or reinsuring carrier.
(2) The notification of election to become a risk-assuming carrier shall include an appropriate opinion by an independent qualified actuary that the risk-assuming carrier is able to assume and manage the risk of enrolling groups under this subtitle without the protection of the Pool.
(b) (1) The initial election under this section is binding for 3 years.
(2) After the initial 3 years, and every 5 years thereafter, each carrier shall again elect to be either a risk-assuming or reinsuring carrier.
(3) Each subsequent election is binding for 5 years.
(4) The Commissioner may allow a new carrier to make an election under conditions established by the Commissioner.
(c) (1) The Commissioner may allow a carrier to change its election at any time for good cause shown.
(2) In determining whether to approve an application by a carrier to change its election, the Commissioner shall consider:
(i) the applicant’s financial condition and the financial condition of any parent or guaranteeing corporation;
(ii) the applicant’s history of assuming and managing risk;
(iii) the applicant’s commitment to market fairly to all small employers in the State or in the applicant’s service area;
(iv) the applicant’s ability to assume and manage the risk of enrolling groups under this subtitle without the protection of the Pool; and
(v) the effect of approval of the application on the financial viability of the Pool.
(3) While the Commissioner is considering an application under this subsection, the carrier may request a hearing as provided under Title 11, Subtitle 5 of this article.
Structure Maryland Statutes
Subtitle 12 - Maryland Health Insurance Reform Act
Section 15-1202 - Scope of Subtitle
Section 15-1204 - Requirements and Limitations for Carriers
Section 15-1205 - Premium Rates for Health Benefit Plans
Section 15-1206 - Miscellaneous Operations Requirements for Carriers
Section 15-1207 - Comprehensive Standard Health Benefit Plan and Modified Plans
Section 15-1208 - Applicability of 15-508
Section 15-1208.1 - Special Enrollment Periods in Small Employer Health Benefit Plans
Section 15-1208.2 - Annual Open Enrollment Periods for Small Employers
Section 15-1209 - Issuance of Health Benefit Plans
Section 15-1210 - Offering of Coverage by Carriers
Section 15-1211 - Approval of Proposed Health Benefit Plans
Section 15-1212 - Renewal of Health Benefit Plans
Section 15-1213 - Benefits Additional to Standard Plan
Section 15-1214 - Reimbursement of Hospitals
Section 15-1215 - Election to Become Risk-Assuming Carrier or Reinsuring Carrier
Section 15-1216 - Small Employer Health Reinsurance Pool
Section 15-1217 - Requirements for Plan of Operation; Powers of Board
Section 15-1219 - Premiums for Reinsurance
Section 15-1220 - Management of Pool Money
Section 15-1221 - Assessments to Recoup Losses by Pool
Section 15-1222 - Reports; Audits
Section 15-1223 - Immunity of Pool and Reinsuring Carriers