State Health Exchange Making Key Decisions

The Maryland Health Benefit Exchange Board is concluding its recommendations on key issues that will reshape Maryland’s health insurance market for employers and individuals. Although the General Assembly enacted legislation earlier this year establishing the Board, it is prohibited from exercising most functions until specified issues are studied and approved by further legislation in 2012. The Board conducted the studies with input from public advisory committees, and will meet twice more before issuing its final recommendations to the Governor and General Assembly on December 23.

The Board has made the following tentative decisions of importance to employers:

  • The Board sees value in selectively contracting with certain health insurance carriers (rather than all qualified carriers), and may seek to impose additional eligibility criteria above those in federal law after 2014.
  • Health insurance carriers that offer products in Maryland should also be required to participate in the Exchange once they reach a minimum market size.
  • There must be a binding mechanism to establish and reconcile the essential health benefits offered in health insurance plans by late 2012.
  • Brokers should continue to receive commissions from carriers for health insurance policies sold outside and inside the Exchange, and Exchange Navigators should receive specialized training to serve individual, group, and Medicaid plans.
  • An aggressive and comprehensive marketing campaign should be conducted to attract individuals and employers to the Exchange.

At its December 12 meeting the Board will take up other key issues, including small employer participation in the Exchange, licensing of Navigators, and alternatives for financing the cost of operating the Exchange.  See the website of the Exchange for additional materials. For further information contact Ron Wineholt at .(JavaScript must be enabled to view this email address).

About Ronald W. Wineholt