State Innovation Waiver Application – Maryland

September 17, 2019 State Reinsurance Program Update
Each year, the Maryland Health Benefit Exchange Board of Trustees must set the payment parameters for the SRP by determining the attachment point, the coinsurance rate, and the reinsurance cap. MHBE has contracted with the actuarial firm, Lewis & Ellis, to provide an updated actuarial analysis of the Maryland individual health insurance market to assist the Board in setting the 2020 payment parameters and the 2020 dampening factor for the SRP.

A final draft of the report is available here.

Please submit any comments on the draft report by October 17th to mhbe.policy@maryland.gov.

MAY 2, 2019 PUBLIC FORUM
On May 2, 2019, MHBE hosted the first post-award forum regarding the State Reinsurance Program. The forum is an opportunity for the public to present meaningful comments on the progress of the State Reinsurance Program.

Below are links to the presentation from the forum, the attendee sign-in sheet, and the minutes from the meeting:
Presentation on for the First Annual State Reinsurance Program Public Forum, May 2, 2019
Attendee Sign-In Sheet
Minutes
Written Testimony

1332 GENERAL INFORMATION
Under Section 1332 of the Affordable Care Act, states may apply for State Innovation Waivers to waive certain federal requirements with the goal of improving their health insurance markets. During the 2018 legislative session, the Maryland General Assembly passed House Bill 1795 – Establishment of a State Reinsurance Program. Governor Larry Hogan signed House Bill 1795 on April 5, 2018.

House Bill 1795, as an emergency measure, directs the Maryland Health Benefit Exchange to submit a State Innovation Waiver to the U.S. Secretaries of Health and Human Services and the Treasury to establish a State Reinsurance Program.

The purpose of the State Reinsurance Program is to mitigate the premium impact of high cost enrollees on carriers that participate in the individual market. The State Reinsurance Program will reduce rates from what they would have been without the program, creating some relief for Marylanders who have experienced high rate increases on their health insurance premiums.

For more information on State Innovation Waivers, visit the CMS Section 1332: State Innovation Waivers website.

SUBMITTED APPLICATION:
Please see the submitted application at the link below:
Final Maryland 1332 State Innovation Waiver to Establish a State Reinsurance Program – May 31 2018

Maryland 1332 State Innovation Waiver to Establish a State Reinsurance Program UPDATED August 15, 2018

Please see the analysis performed by Wakely Consulting Group on the interaction between the Reinsurance and Risk Adjustment programs below:
Wakely Consulting Group Analysis on Reinsurance / Risk Adjustment Interaction – Draft

MHBE Board Resolution on Interaction Between Risk Adjustment and Reinsurance Programs

PUBLIC COMMENT AND HEARINGS:

States are required to post State Innovation Waiver Applications for public comment for a minimum of 30 days. All comments should be submitted to the Maryland Health Benefit Exchange at mhbe.publiccomments@maryland.gov. The comment period is from April 20 to May 20, 2018.

As a requirement of the State Innovation Waiver application process, the Maryland Health Benefit Exchange, in conjunction with the Maryland Insurance Administration, held four public hearings around the state.

Below are links to the agenda and the presentation at those hearings:
1332 Waiver Public Hearing Agenda
Presentation on “Maryland State Innovation Waiver Application: State Reinsurance Program, April 20-May 20, 2018”

Below is additional information from the four hearings:

1. April 26, Talbot County Department of Parks and Recreation (Chesapeake Room), Easton, MD
Attendee Sign-In Sheet
Minutes
Audio of Public Hearing #1

2. May 3, Office of the Maryland Health Benefit Exchange, Baltimore, MD
Attendee Sign-In Sheet
Minutes
Audio of Public Hearing #2

3. May 7, Frederick County Local Health Department, Frederick, MD
Attendee Sign-In Sheet
Minutes
Audio of Public Hearing #3

4. May 10, Charles County Local Health Department, White Plains, MD
Attendee Sign-In Sheet
Minutes
Audio of Public Hearing #4

Section 1332 State Innovation Waiver Application – Public Comments

RESOURCES

Please see the below resource for important information.

Enacting Legislation:
HB 1795 – Establishment of a State Reinsurance Program
SB 387 – Maryland Health Access Act of 2018

Authorizing Resolution:
MHBE Board Resolution on the State Reinsurance Program and Submission of a State Innovation Waiver Application – April 16, 2018
Section 1332 Waiver -Public Comment – Board Presentation – May 21, 2018
Resolution 1332 State Innovation Waiver Application – May 21, 2018

FAQs

Click here to view answers to Frequently Asked Questions about the 1332 waiver application process