In this subtitle the following words have the meanings indicated. “Advisory Workgroup” means the Maryland Easy Enrollment Health Insurance Program Advisory Workgroup established under § 31–203 of this subtitle. “Cost–sharing reduction” means a reduction described in § 1402(c) of the Affordable Care Act. “Department” means the Maryland Department of Health. “Insurance affordability program” means: the Maryland Medical Assistance Program; the Maryland Children’s Health Program; premium tax credits; or cost–sharing reductions. “Modified adjusted gross income” has the meaning stated in 42 U.S.C. § 1395r(i)(4)(A). “Poverty line” has the meaning stated in 42 U.S.C. § 1397jj(c)(5). “Premium tax credits” means the tax credits described in § 36B of the Internal Revenue Code. “Proactively contact” means an attempt by the Exchange or the Department to reach an uninsured individual by: 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. “Program” means the Maryland Easy Enrollment Health Insurance Program established under § 31–202 of this subtitle. “Uninsured individual” means an individual under the age of 65 years who is identified through a State income tax return under § 2–115 of the Tax – General Article as not having minimum essential coverage.

There is a Maryland Easy Enrollment Health Insurance Program. The purposes of the Program are to: 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: operational on or before January 1, 2020; and available for use by residents of the State when filing a State income tax return for taxable years that begin after December 31, 2018. To facilitate the most efficient implementation of the Program, the Exchange, the Comptroller, and the Department may: 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 Exchange shall establish a Maryland Easy Enrollment Health Insurance Program Advisory Workgroup to provide ongoing advice regarding the implementation of the Program. The Advisory Workgroup shall include representation from: 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. The Advisory Workgroup shall meet at least once every 6 months. This section may not be construed to prevent the Exchange from convening other formal or informal working or advisory groups to facilitate the implementation of the Program.

The Exchange or the Department, as applicable, shall determine eligibility for insurance affordability programs as soon as possible after an individual files a State income tax return on which the individual chose a checkoff box described in § 2–115(c)(3) of the Tax – General Article indicating that an uninsured individual may be interested in obtaining minimum essential coverage. To the maximum extent practicable, the Exchange or the Department, as applicable, shall verify an uninsured individual’s eligibility for an insurance affordability program: with information on a State income tax return and other data from third–party data sources, including data described in § 1413 of the Affordable Care Act or available under § 2–115(b)(2) of the Tax – General Article; and without requesting additional information or attestations from the uninsured individual. 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: proactively contacting the individual who filed the tax return or the uninsured individual; recording, by telephonic or electronic means, attestations and documentation provided by the individual who filed the tax return or the uninsured individual; and if the attestations or documentation required to determine eligibility are not obtained using the steps described in items (i) and (ii) of this paragraph, facilitating the selection of an authorized representative for the uninsured individual. 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.

The Exchange or the Department, as applicable, shall make a determination of eligibility, in accordance with § 31–204 of this subtitle, for the Maryland Medical Assistance Program and, if applicable, the Maryland Children’s Health Program under this section, before determining eligibility for any other 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: advance notice; an opportunity to select another managed care organization plan within the period of time established by the Exchange; and an opportunity to opt out of coverage.

If an uninsured individual is not determined to be eligible for the Maryland Medical Assistance Program or the Maryland Children’s Health Program under § 31–205 of this subtitle, the Exchange shall determine, in accordance with § 31–204 of this subtitle, whether the uninsured individual is eligible for premium tax credits or cost–sharing reductions as determined under this section. 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.

The Exchange shall develop a detailed set of data privacy and data security safeguards to govern the conveyance, storage, and utilization of data under the Program. The safeguards developed under subsection (a) of this section shall ensure that the conveyance, storage, and utilization of data under the Program comply with applicable requirements of federal and State law.