Geographic Rating Areas - Application to the Individual Market

BULLETIN 13-08 Date: March 7, 2013 To: Insurers, Nonprofit Health Service Plans, and Health Maintenance Organizations Planning to Offer Health Benefit Plans in the Individual Market in Maryland (“Carriers”) Re: Geographic Rating Areas – Application to the Individual Market The purpose of this bulletin is to notify carriers of allowable geographic rating areas for nongrandfathered health benefit plans with policy years that begin on or after January 1, 2014. The federal Department of Health and Human Services published final regulations regarding Market Rules and Rate Review on February 27, 2013. A part of these final rules, 45 C.F.R. § 147.102(b)(3), require rating areas for both the individual and small group markets in each State. Maryland established four geographic rating areas for the small group market in 1993 legislation as (1) the Baltimore metropolitan area; (2) the District of Columbia metropolitan area; (3) Western Maryland; and (4) Eastern and Southern Maryland.1 These geographic areas are further defined by county by COMAR 31.11.08 as: 1. "Baltimore Metropolitan Area" means Baltimore City, Baltimore County, Harford County, Howard County, and Anne Arundel County. 2. "Eastern and Southern Maryland" means St. Mary's County, Charles County, Calvert County, Cecil County, Kent County, Queen Anne's County, Talbot County, Caroline County, Dorchester County, Wicomico County, Somerset County, and Worcester County. 3. "Washington, D.C. Metropolitan area" means Montgomery County and Prince George's County. 4. "Western Maryland" means Garrett County, Allegany County, Washington County, Carroll County, and Frederick County. This is to notify carriers that the four geographic rating areas defined above will apply to not only small group health benefit plans, but also to individual non-grandfathered health plans for policy years that begin on or after January 1, 2014 and should be reflected in rate filings for non-grandfathered individual health benefit plans for 2014 and beyond. 1 Insurance Article, § 15-1205(a)(2)(ii), Annotated Code of Maryland THERESE M. GOLDSMITH Commissioner KAREN STAKEM HORNIG Deputy Commissioner MARTIN O’MALLEY Governor ANTHONY G. BROWN Lt. Governor 200 St. Paul Place, Suite 2700, Baltimore, Maryland 21202 1-800-492-6116 TTY: 1-800-735-2258 www.mdinsurance.state.md.us Questions concerning this bulletin may be directed Megan Mason, Special Assistant to the Commissioner for Health Care Reform at (410) 468-2021. Brenda A. Wilson Associate Commissioner Life and Health Signature on original