Maryland insurance law and regulation
News that affects your health insurance and planning
September 24, 2020 – CareFirst Blue Cross Blue Shield, the region’s largest health insurer that serves 3.3 million residents of Maryland, will adopt the GuidingCare online platform for delivering the best patient care. Here at Freedom Benefits we joke about health plans morphing into cell phone apps but the reality is that the integration of the two is essential to the future of quality health care.
September 8, 2019 – A temporary mobile health care clinic operated in northwest Baltimore by the nonprofit Remote Area Medical (RAM) appears to be wildly successful. The mobile clinic is a collaboration of RAM and insurance company Aetna uses more than 200 volunteers. The Washington Post reports that half of RAM patients lack health insurance and 84 percent lacked insurance for vision or dental care that are among the most popular services at the mobile clinics. Jeff Eastman, RAM’s chief executive says “If you look at someone who’s making $15,000 to $20,000 per year, and they have a $5,000 deductible — they have insurance, but they don’t have health care”.
June 16, 2019 – Status of alternative non-ACA health plans: Maryland does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage and permits insurers to sell non-compliant transitional policies in the individual market. Maryland limits the sale of short-term coverage more strictly than the federal government. A maximum policy of 3 months is allowed on an initial policy but subsequent policies are allowed.
March 19, 2019 – A recently passed law allows launch of the Maryland Easy Enrollment Health Program that will steer residents toward available health insurance plans when they file their income tax returns either through the state insurance exchange or by auto-enrolling them in Medicaid, if they check a box on their state tax return saying they lack insurance. Residents could alternatively check a box saying they prefer to remain uninsured. Maryland is the first state to adapt this ovation that will be effective June 1. The bill was overwhelmingly bipartisan support in both the House and Senate
January 1, 2019 – New state mandated coverage for people with pre-diabetes and lymphedema go into effect today. About 1.6 million adults in Maryland have prediabetes, according to the American Diabetes Association. These conditions are primarily addressed with changes to diet and exercise.
December 19, 2018 – More Marylanders enrolled for health insurance for 2019 than in 2018, according to early reports from Maryland Health Connection. Lower premium rates combined with bipartisan political support are credited for the success.
December 12, 2018 – Maryland is one of the few states that allows open enrollment year round on its state insurance exchange web site. The good news: coverage for serious pre-existing medical conditions is always available. The bad news: you have to be broke to qualify.
The history of health care planning in Maryland (Information is outdated and links may be expired)
2/11/ 2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683.
7/26/2013 Affordable Smart Term Life Insurance is now available to most Maryland residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.
3/11/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.
12/14/2012 Maryland is one of a minority of states that will run a health insurance exchange for individuals and small businesses that is not managed by the federal government. Consumer advocates who once viewed a state-run exchange as a positive are growing concerned that the state may not be fully committed to implementing all of the funding and features expected to be part of the federal health insurance exchanges that are expected to open in the fall of 2013.
8/26/2012 Maryland will spend another $123 million on its health insurance marketing systems funded by a grant from the federal government. This will bring total spending to $157 million for a system that will sell insurance to up to 150,000 of the state’s residents without insurance. Freedom Benefits previously noted that the selling cost (advertising, computer systems and overhead) for a policy through the Maryland insurance exchange will be more than $1,000 in the first year of operation. This cost is paid by taxpayers separately from the cost of the insurance itself that is already an expensive purchase. Consumer groups oppose spending on the insurance exchange noting that none of this overhead goes toward patient care.
2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 CareFirst BlueChoice is the state’s largest health insurance provider and as such, earns the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
1/19/2012 With just under two year remaining until final individual health insurance reform laws take effect, Maryland is one of only five states that does not have a short term medical insurance plan available to bridge the gap until affordable basic health insurance becomes available to everyone. Short term medical insurance is popular basic coverage because it is exempt from the restrictions of health reform law and therefore priced less than half of the rate of a plan that includes all state and federally mandated coverage. The lack of short term coverage in the state has boosted medical insurance tourism among those who need immediate coverage for 2012. A policy purchased while residing outside the state provides valid coverage nationwide including within Maryland.
6/15/2011 UnitedHealthcare’s Golden Rule Insurance Company will no longer offer Short Term Medical plans to new customers in Maryland as of June 16, 2011. This change does not affect existing customers in the state who have Golden Rule’s Short Term Medical coverage. Regular renewable individual major medical insurance continues to be available. Alternative short term major medical insurance products are available in Maryland from Markel Insurance Company and Standard Security Life Insurance.
2/17/2011 Maryland was granted more than $6 million by the U.S. Department of Health and Human Services to build off a prototype that models the point of access for the insurance exchange. The technology foundation used by Maryland in its Healthy Maryland initiative is currently being used by several other states. This “point” solution will extend the existing Healthy Maryland platform.
1/19/2011 Child-only health insurance for children with significant medical problems will be available through an open enrollment period mandated by federal state law during the month of July. All children, regardless of medical condition, continue to be eligible for insurance when applying as a dependent on a parent’s policy and healthy children are eligible for child-only insurance at any time. When applying for child-only insurance for more than one child, make a separate application for each child.
12/16/2010 Maryland Department of Health and Mental Hygiene officials met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.
In its initial federal grant request for the insurance exchange project, Maryland Department of Health and Mental Hygiene said that it would: 1) Utilize the previously established Maryland Health Care Reform Coordinating Council to outline issues pertaining to: engaging the public, gathering and analyzing public comment, conducting focused research, and developing options for consideration by the Coordinating Council, 2) Create an information infrastructure plan that assesses existing information systems, identifies gaps and needs, and proposes strategies to achieve seamless eligibility and enrollment in health coverage, 3) Develop an outreach and communications strategy for 2011-2014, including market research to guide the design of the Exchange 4) Fund Maryland-specific studies of public and private health insurance coverage and health care expenditures to determine whether to merge the individual and small group markets and whether to provide additional protection against adverse selection, development of governance options for the successful operation of the Exchange, and development of operational plans and a sustainable business model for the Exchange, 5) Assess current public sector technological capabilities, current private sector technological capabilities and technology solutions that may be available from the federal government, and 6) Determine whether the existing public or private sector capacity could be adapted for online public access to facilitate eligibility determination, choice of coverage, application, enrollment, the specific options for connecting an eligibility determination system with other components of the Exchange, and develop an RFP for eligibility system expansion or acquisition.
The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.
5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in Maryland is now available at Freedom Benefits.