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<baltimore-city-law heading="§ 11-1 Definitions.">
  <section prefix="§" num="11-1" heading="Definitions.">
    <para num="(a)" heading="In general.">In this subtitle, the following words have the meanings indicated.</para>
    <para num="(b)" heading="Director.">“Director” means the Director of the Department of Finance.</para>
    <para num="(c)" heading="Exclusive employee organization.">“Exclusive employee organization” means an employee organization designated as an exclusive representative, as described under &lt;cite data-path="12|4"&gt;subtitle 4&lt;/cite&gt; of the &lt;cite data-path="12"&gt;Municipal Labor Relations Article&lt;/cite&gt; {“Certification and Recognition of Employee Organizations”}.</para>
    <para num="(d)" heading="Fund.">“Fund” means the Premium Stabilization Fund created under this subtitle.</para>
    <para num="(e)" heading="Generally Accepted Accounting Principles.">“Generally Accepted Accounting Principles” or “GAAP” means the accounting principles, standards, and procedures of the Financial Accounting Standards Board.</para>
    <para num="(f)" heading="Government Standards Accounting Board.">“Government Accounting Standards Board” or “GASB” means the organization that promulgates accounting and financial reporting standards for U.S. state and local governments that follow GAAP.</para>
    <para num="(g)" heading="Health benefit option.">“Health benefit option” means the type and components of a health benefit plan offered to:<para num="(1)">an employee;</para>
      <para num="(2)">a retiree;</para>
      <para num="(3)">an employee or retiree’s spouse; and</para>
      <para num="(4)">an employee or retiree’s dependent.</para>
    </para>
    <para num="(h)" heading="Health benefit option – Inclusions">“Health benefit option” includes:<para num="(1)">the structure of a health plan, including:<para num="(i)">a health maintenance organization;</para>
        <para num="(ii)">a participating provider organization;</para>
        <para num="(iii)">a point-of-service plan;</para>
        <para num="(iv)">a fee-for-service plan; and</para>
        <para num="(v)">a consumer-directed plan;</para>
      </para>
      <para num="(2)">covered benefits, including:<para num="(i)">medical benefits;</para>
        <para num="(ii)">dental benefits;</para>
        <para num="(iii)">prescription drug benefits; and</para>
        <para num="(iv)">vision benefits;</para>
      </para>
      <para num="(3)">the manner in which benefits are covered, including:<para num="(i)">group health plans; and</para>
        <para num="(ii)">health insurance exchanges;</para>
      </para>
      <para num="(4)">cost-sharing plan features, including:<para num="(i)">deductibles;</para>
        <para num="(ii)">co-pays;</para>
        <para num="(iii)">coinsurance; and</para>
        <para num="(iv)">out-of-pocket maximums; and</para>
      </para>
      <para num="(5)">cost-controlling plan features, including:<para num="(i)">prior approval requirements;</para>
        <para num="(ii)">prescription formularies; and</para>
        <para num="(iii)">management of investigative or trial treatments and services.</para>
      </para>
    </para>
    <para num="(i)" heading="Health benefit plan.">“Health benefit plan” means the health benefits and other options available to a participant under an insured plan or a self-insured plan offered by Baltimore City under the Program.</para>
    <para num="(j)" heading="Health Insurance Committee: HIC.">“Health Insurance Committee” or “HIC” means the labor management committee established by action of the City Board of Estimates on November 7, 2012.</para>
    <para num="(k)" heading="Participant.">“Participant” means any individual who is or may be eligible to receive benefits under the Program, including a:<para num="(1)">City employee;</para>
      <para num="(2)">retired City employee;</para>
      <para num="(3)">spouse of a City employee or retired City employee; and</para>
      <para num="(4)">dependent of a City employee or retired City employee.</para>
    </para>
    <para num="(l)" heading="Plan year.">“Plan year” means the calendar or fiscal year of each benefit plan offered  under the Program.</para>
    <para num="(m)" heading="Program.">“Program” means the City Employee and Retiree Health Benefits Program.</para>
    <para num="(n)" heading="Retiree: retired City employee.">“Retiree” or “retired City employee” means a former City employee who receives or is entitled to receive a defined benefit pension under City Code &lt;cite data-path="|22"&gt;Article 22 {“Retirement Systems”}&lt;/cite&gt;.</para>
    <para num="(o)" heading="Retiree health plan.">“Retiree health plan” means any health benefit plan, including any Medicare Advantage Plan, offered by or through the City to its retirees, their spouses, and their dependents.</para>
    <annotation type="History" />
  </section>
</baltimore-city-law>
