Title 31. Maryland Health Benefit Exchange — Subtitle 2. Maryland Easy Enrollment Health Insurance Program

the Maryland Medical Assistance Program;

the Maryland Children’s Health Program;

premium tax credits; or

cost–sharing reductions.

making multiple attempts to contact the uninsured individual as requested on a State income tax return in accordance with § 2–115(b)(2) of the Tax – General Article;

if the attempts described in item (1) of this subsection do not successfully reach the uninsured individual or if no specific methods for contacting the uninsured individual were requested, making multiple attempts to contact the uninsured individual through telephonic and electronic means; and

if the attempts described in items (1) and (2) of this subsection do not successfully reach the uninsured individual to obtain the requested information, sending paper forms or notices to the uninsured individual by mail.

establish a State–based reporting system to provide information about the health insurance status of State residents through the use of State income tax returns to identify uninsured individuals and determine whether an uninsured individual is interested in obtaining minimum essential coverage;

determine whether an uninsured individual who is interested in obtaining minimum essential coverage qualifies for an insurance affordability program;

proactively contact an uninsured individual who is interested in obtaining minimum essential coverage to assist in enrolling the uninsured individual in an insurance affordability program and minimum essential coverage; and

maximize enrollment of eligible uninsured individuals in insurance affordability programs and minimum essential coverage to improve access to care and reduce insurance costs for all residents of the State.

The Exchange, the Department, and the Comptroller shall develop and implement systems, policies, and practices that encourage, facilitate, and streamline determination of eligibility for insurance affordability programs and enrollment in minimum essential coverage to achieve the purposes of the Program.

Except as provided in § 2–115(d) of the Tax – General Article, the systems, policies, and practices shall be:

enter into agreements;

adopt regulations;

adopt guidelines;

establish accounts;

conduct trainings;

provide public information;

educate tax preparers; and

take any other steps as may be necessary to accomplish the purpose of the Program.

the Office of the Comptroller;

consumer groups;

employers;

insurers;

health care providers;

navigators or other consumer assisters;

insurance brokers or agents;

labor organizations;

income tax preparers;

national policy experts; and

any other organizations or groups selected by the Exchange.

To the maximum extent practicable, the Exchange or the Department, as applicable, shall verify an uninsured individual’s eligibility for an insurance affordability program:

If additional attestations or documentation from the uninsured individual are required to establish eligibility for an insurance affordability program, the Exchange or the Department, as applicable, shall take steps to limit the burden on the uninsured individual, including:

Before determining eligibility of an uninsured individual for an insurance affordability program, the Exchange or the Department, as applicable, shall attempt to verify the citizenship status of the uninsured individual and each household member listed on the State income tax return, based on the information available from the return and reliable third–party sources of citizenship data.

If the process described in paragraph (1) of this subsection does not confirm that the uninsured individual and each household member listed on the State income tax return is a United States citizen, the Exchange and the Department may not seek additional verification or take other steps to determine eligibility for or enroll the uninsured individual in an insurance affordability program until the uninsured individual provides affirmative consent using forms and procedures approved by the Exchange.

The affirmative consent required under paragraph (2) of this subsection may be satisfied through the procedures described in 42 U.S.C. § 1320b–7(d).

If citizenship is not verified and affirmative consent is not provided in accordance with paragraph (2) of this subsection, the Exchange and the Department may not take any further steps to determine an uninsured individual’s eligibility for or enroll an uninsured individual in an insurance affordability program.

If an uninsured individual is determined to be eligible for the Maryland Medical Assistance Program or the Maryland Children’s Health Program, the procedures described in this subsection and guidelines established by the Exchange, in consultation with the Department, to implement this subsection shall apply.

If an uninsured individual fails to select a managed care organization plan within a period of time established by the Exchange, the Department shall assign the uninsured individual to and promptly enroll the uninsured individual in a managed care organization plan.

Before the Department assigns an uninsured individual to a managed care organization plan, the uninsured individual shall receive:

A special or other enrollment period for the individual market shall begin on the date an income tax return is filed by or on behalf of an uninsured individual that includes the choice described in § 2–115(c)(3) of the Tax – General Article, if the return is filed on or before the date specified by the Exchange.

The enrollment period described in this subsection shall last for a period of time determined by the Exchange before the start of the calendar year that may not be shorter than 14 days.

Information about the enrollment period described in subsection (b) of this section shall be communicated to the public and affected individuals through measures that may include language in the instructions for the State individual income tax return, if inclusion of the language is approved by the Comptroller.

The Exchange is authorized to conduct outreach to individuals described in paragraph (1) of this subsection, using methods that may include written notices and the provision of individualized assistance by insurance agents and brokers, navigators, tax preparers, and Exchange contractors and staff.

Notwithstanding any other provision of this article, the Exchange may compensate an entity for outreach described in paragraph (2) of this subsection in a manner that reflects, in whole or in part, the number of uninsured individuals enrolled under this section and § 31–204 of this subtitle by that entity.