(a) (1) (i) As part of the plan of operation, the Board shall establish a methodology to determine premium rates to be charged by the Pool to reinsure small employers and individuals under this section and § 15-1218 of this subtitle.
(ii) The methodology shall provide for the development of base reinsurance premium rates that shall be multiplied by the factors set forth in paragraph (2) of this subsection to determine the premium rates for the Pool.
(iii) The Board shall establish the base reinsurance premium rates at levels that reasonably approximate gross premiums charged to small employers by carriers for health benefit plans up to the level of coverage that the Board determines.
(2) Premiums for the Pool shall be as follows:
(i) an entire group may be reinsured for a rate that is 1.5 times the base reinsurance premium rate for the group established under this subsection; and
(ii) an individual may be reinsured for a rate that is 5 times the base reinsurance premium rate for the individual established under this subsection.
(3) (i) The Board periodically shall review the methodology established under paragraph (1) of this subsection, including the system of classification and any rating factors, to ensure that it reasonably reflects the claims experience of the Pool.
(ii) The Board may propose changes to the methodology, subject to the approval of the Commissioner.
(b) If a health benefit plan for a small employer is entirely or partially reinsured with the Pool, the premium charged to the small employer for any rating period for the coverage issued shall meet the requirements that relate to premium rates set forth in § 15-1205 of this subtitle.
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