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<section article="gsp" article_name="State Personnel and Pensions" number="2-509.1" title_number="2" title_name="State Employment Generally" subtitle_number="5" subtitle_name="Health and Welfare Benefits Program">
  <level label="a">
    <level label="1">
      <text>Except as provided in subsection (b) of this section, the State shall continue to include a prescription drug benefit plan in the health insurance benefit options established under the Program and available to retirees under §§ 2–508 and 2–509 of this subtitle notwithstanding the enactment of the federal Medicare Prescription Drug, Improvement, and Modernization Act of 2003 or any other federal law permitting states to discontinue prescription drug benefit plans to retirees of a state.</text>
    </level>
    <level label="2">
      <text>Except as provided in subsection (b) of this section:</text>
      <level label="i">
        <text>a retiree may elect to cover the retiree’s spouse or dependent child under the State prescription drug benefit plan under §§ 2–508 and 2–509 of this subtitle; and</text>
      </level>
      <level label="ii">
        <text>if a surviving spouse or surviving dependent child of a retiree is eligible to enroll in the State prescription drug benefit plan under § 2–508 or § 2–509 of this subtitle, the surviving spouse or surviving dependent child may elect to enroll in the State prescription drug benefit plan.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <text>Except as provided in subsection (c) of this section, on January 1, 2019, the State shall discontinue prescription drug benefits for:</text>
    <level label="1">
      <text>a Medicare–eligible retiree;</text>
    </level>
    <level label="2">
      <text>the Medicare–eligible spouse or surviving spouse of a retiree; and</text>
    </level>
    <level label="3">
      <text>a Medicare–eligible dependent child or surviving dependent child of a retiree.</text>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>If a retiree is eligible to participate in the prescription drug benefit plan under Medicare, but the retiree’s spouse or dependent child is not eligible to participate in a Medicare prescription drug benefit plan, the retiree may elect to cover the retiree’s spouse or dependent child under the State prescription drug benefit plan.</text>
    </level>
    <level label="2">
      <text>If the surviving spouse or surviving dependent child of a retiree is eligible to enroll in the State prescription drug benefit plan under § 2–508 or § 2–509 of this subtitle, but is not eligible to participate in the prescription drug benefit plan under Medicare, the surviving spouse or surviving dependent child may elect to enroll in the State prescription drug benefit plan.</text>
    </level>
  </level>
  <level label="d">
    <level label="1">
      <text>This subsection applies only to a retiree, a retiree’s spouse or surviving spouse, and a retiree’s dependent child or surviving dependent child:</text>
      <level label="i">
        <text>who is enrolled in a prescription drug benefit plan under Medicare;</text>
      </level>
      <level label="ii">
        <text>if the retiree is retired on or before December 31, 2019; and</text>
      </level>
      <level label="iii">
        <text>if the retiree is eligible under § 2–508 or § 2–509 of this subtitle to enroll and participate in the health insurance benefit options established under the Program.</text>
      </level>
    </level>
    <level label="2">
      <level label="i">
        <text>Subject to subparagraph (ii) of this paragraph, on or before January 1, 2020, the Department shall establish a Maryland State Retiree Prescription Drug Coverage Program that reimburses a participant for out–of–pocket costs that exceed the limits established for non–Medicare–eligible retirees in § 2–508(d)(2)(iii) of this subtitle.</text>
      </level>
      <level label="ii">
        <text>The Department may establish an out–of–pocket limit higher than the limits established in subparagraph (i) of this paragraph for a retiree who qualifies for a partial State subsidy.</text>
      </level>
    </level>
    <level label="3">
      <text>The Maryland State Retiree Prescription Drug Coverage Program established under paragraph (2) of this subsection may include:</text>
      <level label="i">
        <text>a health reimbursement account established in accordance with § 105(h) of the Internal Revenue Code; or</text>
      </level>
      <level label="ii">
        <text>another program that provides assistance with prescription drug costs.</text>
      </level>
    </level>
    <level label="4">
      <text>A retiree, a retiree’s spouse or surviving spouse, and a retiree’s dependent child or surviving dependent child may enroll in the Maryland State Retiree Prescription Drug Coverage Program during the open enrollment period or any special enrollment period for retiree health insurance benefit options.</text>
    </level>
  </level>
  <level label="e">
    <level label="1">
      <text>This subsection applies only to a retiree, a retiree’s spouse or surviving spouse, and a retiree’s dependent child or surviving dependent child:</text>
      <level label="i">
        <text>who is enrolled in a prescription drug benefit plan under Medicare; and</text>
      </level>
      <level label="ii">
        <text>if the retiree:</text>
        <level label="1">
          <text>began State service on or before June 30, 2011;</text>
        </level>
        <level label="2">
          <text>retired on or after January 1, 2020; and</text>
        </level>
        <level label="3">
          <text>is eligible under § 2–508 or § 2–509 of this subtitle to enroll and participate in the health insurance benefit options established under the Program.</text>
        </level>
      </level>
    </level>
    <level label="2">
      <level label="i">
        <text>Subject to subparagraph (ii) of this paragraph, on or before January 1, 2020, the Department shall establish a Maryland State Retiree Catastrophic Prescription Drug Assistance Program that reimburses a participant for out–of–pocket costs after the participant has entered catastrophic coverage under a prescription drug benefit plan under Medicare.</text>
      </level>
      <level label="ii">
        <text>The Department may establish a maximum reimbursement amount for a retiree who qualifies for a partial State subsidy.</text>
      </level>
    </level>
    <level label="3">
      <text>The Maryland State Retiree Catastrophic Prescription Drug Assistance Program under paragraph (2) of this subsection may provide reimbursements through:</text>
      <level label="i">
        <text>a health reimbursement account established in accordance with § 105(h) of the Internal Revenue Code; or</text>
      </level>
      <level label="ii">
        <text>another program that provides assistance with prescription drug costs.</text>
      </level>
    </level>
    <level label="4">
      <text>A retiree, a retiree’s spouse or surviving spouse, and a retiree’s dependent child or surviving dependent child may enroll in the Maryland State Retiree Catastrophic Prescription Drug Assistance Program during the open enrollment period or any special enrollment period for retiree health insurance benefit options.</text>
    </level>
  </level>
  <level label="f">
    <level label="1">
      <text>This subsection applies only to a retiree, a retiree’s spouse or surviving spouse, and a retiree’s dependent child or surviving dependent child:</text>
      <level label="i">
        <text>who is enrolled in:</text>
        <level label="1">
          <text>the Maryland State Retiree Prescription Drug Coverage Program established under subsection (d) of this section; or</text>
        </level>
        <level label="2">
          <text>the Maryland State Retiree Catastrophic Prescription Drug Assistance Program established under subsection (e) of this section; and</text>
        </level>
      </level>
      <level label="ii">
        <text>if the retiree is eligible under § 2–508 or § 2–509 of this subtitle to enroll and participate in the health insurance benefit options established under the Program.</text>
      </level>
    </level>
    <level label="2">
      <level label="i">
        <text>On or before January 1, 2020, the Department shall establish a Maryland State Retiree Life–Sustaining Prescription Drug Assistance Program that reimburses a participant for out–of–pocket costs for a life–sustaining prescription drug that is:</text>
        <level label="1">
          <text>covered by the prescription drug benefit plan in the health insurance benefit options established under the Program; and</text>
        </level>
        <level label="2">
          <text>not covered by the prescription drug benefit plan under Medicare in which the participant is enrolled.</text>
        </level>
      </level>
      <level label="ii">
        <text>The Department shall develop a list of the prescription drugs that qualify for reimbursement under subparagraph (i) of this paragraph.</text>
      </level>
      <level label="iii">
        <text>The Department may establish maximum reimbursement amounts for a retiree who qualifies for a partial State subsidy.</text>
      </level>
    </level>
    <level label="3">
      <text>The Maryland State Retiree Life–Sustaining Prescription Drug Assistance Program established under paragraph (2) of this subsection may provide reimbursements through:</text>
      <level label="i">
        <text>a health reimbursement account established in accordance with § 105(h) of the Internal Revenue Code; or</text>
      </level>
      <level label="ii">
        <text>another program that provides assistance with prescription drug costs.</text>
      </level>
    </level>
    <level label="4">
      <text>A retiree, a retiree’s spouse or surviving spouse, and a retiree’s dependent child or surviving dependent child shall be automatically enrolled in the Maryland State Retiree Life–Sustaining Prescription Drug Assistance Program on enrollment in:</text>
      <level label="i">
        <text>the Maryland State Retiree Prescription Drug Coverage Program established under subsection (d) of this section; or</text>
      </level>
      <level label="ii">
        <text>the Maryland State Retiree Catastrophic Prescription Drug Assistance Program established under subsection (e) of this section.</text>
      </level>
    </level>
  </level>
  <level label="g">
    <level label="1">
      <text>Subject to paragraph (2) of this subsection, not later than July 1 of each year, the Secretary shall provide written certified notice of the change in the State prescription drug benefit plan under this section to the individuals who will become eligible in the next calendar year to enroll in the:</text>
      <level label="i">
        <text>Maryland State Retiree Prescription Drug Coverage Program;</text>
      </level>
      <level label="ii">
        <text>Maryland State Retiree Catastrophic Prescription Drug Assistance Program; or</text>
      </level>
      <level label="iii">
        <text>Maryland State Retiree Life–Sustaining Prescription Drug Assistance Program.</text>
      </level>
    </level>
    <level label="2">
      <text>The notice shall include information regarding:</text>
      <level label="i">
        <text>coverage options available in the Medicare prescription drug benefit plan, including options that are similar to the prescription drug benefit plan in the health insurance benefit options established under the Program;</text>
      </level>
      <level label="ii">
        <text>the potential for significant penalties if an individual does not promptly choose a Medicare prescription drug benefit plan immediately on termination of the individual’s participation in the State prescription drug benefit plan;</text>
      </level>
      <level label="iii">
        <text>the programs available under subsections (d), (e), and (f) of this section; and</text>
      </level>
      <level label="iv">
        <text>any additional resources made available by the Department in accordance with this section.</text>
      </level>
    </level>
  </level>
  <level label="h">
    <level label="1">
      <text>The Department shall ensure Medicare–eligible retirees have access to one–on–one counseling services to assist retirees in selecting a Medicare prescription drug benefit plan.</text>
    </level>
    <level label="2">
      <text>The Department shall develop a plan to communicate to Medicare–eligible retirees the availability of:</text>
      <level label="i">
        <text>the programs under subsections (d), (e), and (f) of this section; and</text>
      </level>
      <level label="ii">
        <text>services and information regarding prescription drug benefit plans under Medicare.</text>
      </level>
    </level>
    <level label="3">
      <text>On or before December 31, 2019, the Department shall submit a report to the Senate Budget and Taxation Committee and the House Appropriations Committee, in accordance with § 2–1257 of the State Government Article, on the plan developed under paragraph (2) of this subsection.</text>
    </level>
    <level label="4">
      <text>The report required under paragraph (3) of this subsection shall include:</text>
      <level label="i">
        <text>options for providing one–on–one counseling, including:</text>
        <level label="1">
          <text>in–person, over–the–phone, or web–based counseling;</text>
        </level>
        <level label="2">
          <text>the times at which one–on–one counseling will be available;</text>
        </level>
        <level label="3">
          <text>a plan to ensure equitable geographic access to one–on–one counseling; and</text>
        </level>
        <level label="4">
          <text>entering into a statewide contract with an employee benefits administrator or similar entity to provide one–on–one counseling services;</text>
        </level>
      </level>
      <level label="ii">
        <text>plans for holding seminars in every county of the State to provide information regarding eligibility for and available benefits under the programs established under subsections (d), (e), and (f) of this section;</text>
      </level>
      <level label="iii">
        <text>plans for providing access to a web–based overview and interactive website that provide information on:</text>
        <level label="1">
          <text>Medicare prescription drug benefit plans; and</text>
        </level>
        <level label="2">
          <text>subsidy and financial assistance programs for low–income individuals; and</text>
        </level>
      </level>
      <level label="iv">
        <text>plans for providing a toll–free hotline for reporting issues and concerns regarding the services provided in accordance with this paragraph.</text>
      </level>
    </level>
  </level>
  <level label="i">
    <text>Subject to the requirements of § 13–108 of the State Finance and Procurement Article, the Department may make an emergency procurement for:</text>
    <level label="1">
      <text>staff required to carry out the provisions of this section; and</text>
    </level>
    <level label="2">
      <text>a third party to administer health reimbursement accounts established under this section.</text>
    </level>
  </level>
  <level label="j">
    <text>The Department shall submit quarterly reports to the Governor and, in accordance with § 2–1257 of the State Government Article, the House Appropriations Committee, the Senate Budget and Taxation Committee, and the Joint Committee on Pensions, on:</text>
    <level label="1">
      <text>the status of establishing the programs under subsections (d), (e), and (f) of this section, including:</text>
      <level label="i">
        <text>the status of procuring any contracts necessary to operate the programs; and</text>
      </level>
      <level label="ii">
        <text>the prescription drugs determined to qualify for reimbursement under the Maryland State Retiree Life–Sustaining Prescription Drug Assistance Program under subsection (f) of this section;</text>
      </level>
    </level>
    <level label="2">
      <text>the availability of one–on–one counseling services required under subsection (h) of this section;</text>
    </level>
    <level label="3">
      <text>the details of the health reimbursement accounts or other programs to provide assistance with prescription drug costs for individuals enrolled in the programs under subsections (d), (e), and (f) of this section, including:</text>
      <level label="i">
        <text>the specific out–of–pocket costs eligible for reimbursement;</text>
      </level>
      <level label="ii">
        <text>the required process for receiving reimbursement;</text>
      </level>
      <level label="iii">
        <text>the method of reimbursement;</text>
      </level>
      <level label="iv">
        <text>the timing of reimbursement; and</text>
      </level>
      <level label="v">
        <text>a plan to use debit cards to process reimbursements in a convenient and efficient manner; and</text>
      </level>
    </level>
    <level label="4">
      <text>in total and by category for the previous quarter, the number of issues and concerns reported to the hotline.</text>
    </level>
  </level>
  <level label="k">
    <text>The Department shall adopt regulations to implement the provisions of this section.</text>
  </level>
</section>
