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<section article="gin" article_name="Insurance" number="31-111" title_number="31" title_name="Maryland Health Benefit Exchange" subtitle_number="1" subtitle_name="Maryland Health Benefit Exchange">
  <level label="a">
    <text>The SHOP Exchange:</text>
    <level label="1">
      <text>shall be a separate insurance market within the Exchange for small employers; and</text>
    </level>
    <level label="2">
      <text>may not be merged with the individual market of the Individual Exchange.</text>
    </level>
  </level>
  <level label="b">
    <text>The SHOP Exchange shall be designed to balance:</text>
    <level label="1">
      <text>the viability of the SHOP Exchange as an alternative for qualified employers and their employees who have not been able historically to access and afford insurance in the small group market;</text>
    </level>
    <level label="2">
      <text>the need for stability and predictability in employers’ health insurance costs incurred on behalf of their employees;</text>
    </level>
    <level label="3">
      <text>the desirability of providing employees with a meaningful choice among high–quality and affordable health benefit plans; and</text>
    </level>
    <level label="4">
      <text>the need to facilitate continuity of care for employees who change employers or health benefit plans.</text>
    </level>
  </level>
  <level label="c">
    <text>The SHOP Exchange shall allow qualified employers to:</text>
    <level label="1">
      <text>as required by regulations adopted by the Secretary under the Affordable Care Act, designate a coverage level within which their employees may choose any qualified health plan; or</text>
    </level>
    <level label="2">
      <text>designate a carrier or an insurance holding company system, as defined in § 7–101 of this article, and a menu of qualified health plans offered by the carrier or the insurance holding company system in the SHOP Exchange from which their employees may choose.</text>
    </level>
  </level>
  <level label="d">
    <text>In addition to the options set forth in subsection (c) of this section, the SHOP Exchange also may allow qualified employers to designate one or more qualified dental plans and qualified vision plans to be made available to their employees.</text>
  </level>
  <level label="e">
    <level label="1">
      <text>A qualified employer is not required to contribute to the qualified plan premiums of its employees.</text>
    </level>
    <level label="2">
      <level label="i">
        <text>If a qualified employer chooses to contribute to the qualified plan premiums of its employees, the qualified employer shall:</text>
        <level label="1">
          <text>select a reference plan on which the contributions will be based; and</text>
        </level>
        <level label="2">
          <text>make a contribution that is:</text>
        </level>
        <level label="A">
          <text>a fixed percentage of the premium of the reference plan, based on the coverage level selected by the member and the member’s job classification, if otherwise permissible; or</text>
        </level>
        <level label="B">
          <text>a dollar amount that ensures that all of the qualified employer’s employees with the same coverage level and job classification would pay the same amount if they purchased the reference plan.</text>
        </level>
      </level>
      <level label="ii">
        <text>A reference plan selected under subparagraph (i)1 of this paragraph:</text>
        <level label="1">
          <text>under the employer choice model, shall be a qualified plan that is:</text>
        </level>
        <level label="A">
          <text>offered by the carrier or insurance holding company system selected by the qualified employer; and</text>
        </level>
        <level label="B">
          <text>among the qualified plans of the carrier or insurance holding company system selected by the qualified employer; or</text>
        </level>
        <level label="2">
          <text>under the employee choice model, shall be a qualified plan offered by any carrier at the metal level selected by the qualified employer.</text>
        </level>
      </level>
    </level>
  </level>
  <level label="f">
    <text>On or after January 1, 2016, in order to continue to promote the SHOP Exchange’s principles of accessibility, choice, affordability, and sustainability, and as it obtains more data on adverse selection, cost, enrollment, and other factors, the SHOP Exchange:</text>
    <level label="1">
      <text>may reassess and modify the manner in which the SHOP Exchange allows qualified employers to offer, and their employees to choose, qualified health plans and coverage levels;</text>
    </level>
    <level label="2">
      <text>in reassessing employer and employee choice, may consider options which would promote the additional objective of increasing the portability of employees’ health insurance as employees move from employer to employer or transition in and out of employment; and</text>
    </level>
    <level label="3">
      <text>shall implement any modification of offerings and choice through regulations adopted by the SHOP Exchange.</text>
    </level>
  </level>
</section>
