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31.11.14.00.htm 31.11.14.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 11 HEALTH INSURANCE ― GROUP Chapter 14 Wellness Benefits Under Small Employer Health Benefit Plans Authority: Health General Article, §19-108; Insurance Article, §2-109, 15-1201, 15-1204(g) and 15-1207(a) Annotated Code of Maryland
31.11.14.01.htm 31.11.14.01. 01 Purpose.. This chapter specifies the requirements for:. A. A wellness benefit offered by a carrier to a small employer under Insurance Article, Title 15, Subtitle 12, Annotated Code of Maryland;B. Determining if a carrier is considered a prominent carrier; and. C. Carriers offering wellness benefits to small employers..
31.11.14.02.htm 31.11.14.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Carrier" has the meaning stated in Insurance Article, §15-1201, Annotated Code of Maryland.. 2) "Case management program" means a program that involves a collaborative process of assessment, planning, implementation, coordination, monitoring, and evaluation of the options and services required to meet an individual's health needs through communication and available
31.11.14.03.htm 31.11.14.03. 03 Components of a Wellness Benefit.. A. Each wellness benefit shall include:. 1) A health risk assessment that is:. a) Available at no cost to all employees covered under the small employer's wellness benefit; and. b) Completed by each employee on a voluntary basis;. 2) Written feedback to each employee who completes the health risk assessment, with recommendations for lowering risks identified in the completed health risk assessment; and3) A financial incentive to promote:.
31.11.14.04.htm 31.11.14.04. 04 General Requirements for Wellness Benefits Offered to Small Employers.. A. A wellness benefit offered to a small employer:. 1) Shall satisfy the requirements of an additional benefit found in COMAR 31.11.06.07; and. 2) May not violate any requirement regarding wellness programs as described in 45 CFR §146.121.. B. A wellness benefit may appear in an additional benefit rider as the only benefit in the rider, or it may be bundled with other benefits in an additional benefit rider.
31.11.14.05.htm 31.11.14.05. 05 Requirement for Carriers to Offer a Wellness Benefit.. A. A prominent carrier shall offer a wellness benefit to a small employer for a health benefit plan offered in Maryland.B. A carrier that is not a prominent carrier may offer a wellness benefit to a small employer for a health benefit plan offered in Maryland.C. The determination of which carriers are prominent carriers shall be determined each calendar year, based on the market share that each carrier had
31.11.14.9999.htm 31.11.14.9999. Administrative History Effective date:. Regulations .01―05 adopted as an emergency provision effective April 1, 2008 (35:9 Md. R. 896) adopted permanently effective July 17, 2008 (35:14 Md. R. 1248)Regulation .02B amended effective October 19, 2009 (36:21 Md. R. 1594). Regulation .05A amended effective October 19, 2009 (36:21 Md. R. 1594).
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