Current through Register Vol. 51, No. 19, September 20, 2024
A. A small
employer is eligible to receive a premium subsidy if, at the time of initial
application for the premium subsidy, the employer:
(1) Meets the requirements under Insurance
Article, §15-1203(b)(i),
Annotated Code of Maryland;
(2) Has
been in operation for at least 12 months and, if required to file quarterly
wage reports, has filed quarterly wage reports with the Maryland Department of
Labor, Licensing, and Regulation for, at a minimum, the three calendar quarters
immediately preceding initial application for the premium subsidy;
(3) Has not offered a health benefit plan to
its employees for at least 12 consecutive months immediately before initial
application for the premium subsidy;
(4) Employed at least two but not more than
nine eligible employees:
(a) At the time the
employer's subsidy application is entered into the Commission registry;
and
(b) On at least 50 percent of
its working days during the preceding calendar quarter;
(5) Has an average wage of business that does
not exceed the maximum average wage for new applications;
(6) Agrees to offer a health benefit plan to
its eligible employees that contains a wellness benefit;
(7) Commits to establish a Section 125
payroll deduction plan within 60 days of enrollment in the Premium Subsidy
Program;
(8) Completes and signs
the subsidy application; and
(9)
Complies with the other regulations of this chapter.
B. Affiliated companies are considered one
employer for purposes of this chapter.
C. An enrolled employer is eligible to
continue receiving a premium subsidy if, at the time of the renewal
application, the employer:
(1) Has filed
quarterly wage reports with the Maryland Department of Labor, Licensing, and
Regulation for, at a minimum, the three calendar quarters immediately preceding
the renewal application for the premium subsidy;
(2) Has at least two eligible employees and
the number of eligible employees is not more than the maximum eligible firm
size;
(3) Has an average wage of
business that does not exceed the maximum average wage for
participants;
(4) Continues to
offer a health benefit plan to its eligible employees that contains a wellness
benefit;
(5) Has an established
Section 125 payroll deduction plan in place for at least 10 months;
(6) Completes and signs the subsidy
application; and
(7) Complies with
the other regulations of this chapter.
D. An enrolled employer whose coverage is
terminated before the end of the policy year for any cause, including
nonpayment of premium, is required to reapply and to meet all of the
requirements for an initial application.
E. If the carrier terminates the coverage but
then reinstates the employer's coverage with the same premium and policy
expiration date, the employer shall be reinstated in the Premium Subsidy
Program without reapplication.
F.
Retroactive payments made by a small employer who is terminated and then
reinstated by a carrier during a policy year are eligible for a premium
subsidy.
