Md. Code Regs. 14.35.19.04

Current through Register Vol. 51, No. 24, December 2, 2024

Section 14.35.19.04 - Calculation of Subsidies Under the Program

A. The subsidy may not exceed the enrollee's premium amount.

B. The subsidy shall be calculated for eligible enrollees in a tax household and applied to the premium for each eligible enrollee.

C. The subsidy shall be applied to the premium balance remaining after application of the Advance Premium Tax Credit.

D. Basis of Calculation.

(1) For enrollees with a greater than 0 percent premium contribution based on the payment parameters set by the Board, the subsidy shall be calculated based on, and applied only to, the portion of premium allocated to essential health benefits.

(2) For enrollees with a 0 percent premium contribution based on the payment parameters set by the Board, the subsidy shall also be applied to nonessential health benefits so that the enrollee's total premium responsibility is equal to $0.

E. For each benefit year after 2022, the Board shall set the payment parameters for the Program before December 31 of the calendar year preceding the applicable plan year.

Md. Code Regs. 14.35.19.04

Regulation .04 adopted effective 48:24 Md. R.1025, eff. 11/29/2021; amended effective 49:26 Md. R. 1081, eff. 12/26/2022