Maryland health insurance exchange

Maryland Health Connection further along than most other state exchanges

By Carla Anderson
healthinsurance.org^TM contributor

Maryland was an early adopter of the health insurance exchanges envisioned by the Affordable Care Act (ACA). While many other states waited to see the outcome of the Supreme Court challenge to the ACA, Maryland moved ahead. The Maryland Health Benefit Exchange (MHBE) was signed into law in April 2011, with additional legislation passed in May 2012. In August, the state branded the exchange as the Maryland Health Connection. In December 2012, the Maryland Health Connection was among the first six state-based exchanges to be approved by the federal government.

The Maryland Health Connection is overseen by the nine-member Maryland Health Benefit Exchange (MHBE) board. The board has been driving decisions on the state’s exchange since 2011.

The Health Connection will function as a clearinghouse, meaning any qualified health plan (QHP) can sell policies on the exchange. After two years of operation, the exchange has the option to adopt an active purchaser model. The MHBE has defined a process to certify QHPs, published a manual with detailed instructions for health plans to apply for certification, and held workshops to familiarize plans with the process. Any health plan with significant market share in the state is required to participate in the Health Connection. Health plans are limited to selling four benefit packages per metal level (platinum, gold, silver, and bronze).

The Maryland Health Connection website began operating in August 2012. For now, the site provides an overview of the online marketplace and provides updates on the progress being made toward implementing the exchange. It also links to other health insurance-related websites. Beginning in October 2013, individuals and small businesses will be able to purchase health insurance through the website.

The Consolidated Service Center is the name for the call center that will provide phone support to individuals, employees, and small employers. The Consolidated Service Center is scheduled to begin taking calls in June 2013.

The Maryland Health Connection will have two Navigator programs: one for individuals and one for employers participating in the Small Business Health Options Program (SHOP). For the individual market, both certified Navigators and non-certified assisters will help consumers learn about and purchase insurance through the exchange. SHOP Navigators must be licensed by the Maryland insurance commissioner and be trained by the MHBE.

Maryland has received more than $157.5 million in federal grants toward establishing its exchange. Maryland has yet to finalize how ongoing operations will be financed. However, the Health Connection has legislative authorization to charge a fee to health plans operating on the exchange.

According to Kaiser’s statehealthfacts.org, about 770,000 Marylanders are uninsured. About 150,000 individuals are expected to purchase health insurance through the Health Connection in 2014, and the state estimates the exchange will save it $850 million over 10 years through lower costs for Medicaid and uncompensated emergency room visits.

Updated March 11, 2013

More Maryland health insurance exchange links

Maryland Health Connection
Online marketplace

Maryland Health Benefit Exchange (MHBE)
Details state’s effort to establish its exchange

State Exchange Profile: Maryland
The Henry J. Kaiser Family Foundation overview of Maryland’s progress toward creating a state health insurance exchange.

Affordable Care Act in Your State: Maryland

Health Education and Advocacy Unit, Office of the Attorney General
Serves residents and other consumers who receive health care from a Maryland health care provider or health insurance provider.
(877) 261-8807