Maryland Statutes
Subtitle 14 - Maryland Health Insurance Portability and Accountability Act -- Large Group Market Reforms
Section 15-1411 - Disclosure of Aggregate Incurred Claims

(a)    (1)    In this section the following words have the meanings indicated.
        (2)    “Aggregate incurred claims” means the total claims incurred in the experience period that the carrier uses to experience rate a large employer’s health benefit plan.
        (3)    “Experience rating” means that a carrier develops the premium rates for an employer’s health benefit plan based in whole or in part on the claims experience of the group that consists of the employer’s employees or employees’ dependents.
        (4)    “Large employer” means an employer that is not a small employer as defined in § 31–101 of this article.
    (b)    If a carrier is experience rating a large employer’s health benefit plan, the carrier shall disclose the aggregate incurred claims of the group to the large employer within 30 days after receipt of a request from the large employer.
    (c)    The aggregate incurred claims required to be disclosed under subsection (b) of this section shall be provided in a format that complies with the privacy requirements of the federal Health Insurance Portability and Accessibility Act.

Structure Maryland Statutes