REPORT ON MARYLAND COVERED LIVES Due September 15,
The following are the most frequently asked questions concerning the Report on Maryland Covered Lives due September 15, each year. Q. Do we have to complete this report? A. Title 15, Section 15 - 1201 of the Insurance Article of the Annotated Code of Maryland Health Insurance, states in part that… “Annually by October 1 the Insurance Commissioner shall determine the number of individuals in the State who are under the age of 65 and who are covered under an insured health benefit plan issued by an insurer authorized to engage in the insurance business in the State or under a prepaid health benefit package of a health maintenance organization that operates in the State.” The Insurance Commissioner shall accept registration from public and private employers and employee groups or associations in the State that offer health benefit plans under the Employee Retirement Income Security Act or other self-insured plans and that would agree to obtain insured health benefits for their employees or groups for a minimum period of 3 years under an insurance plan issued by an insurer authorized to engage in the insurance business in the State or under a prepaid health benefit package of a health maintenance organization that operates in the State and that would be subject to Section 3 of the Act. Upon request of the insurer or HMO being considered by a registering group of up to 250 employees, the registering group shall provide claims and demographic information sufficient to assist insurers and HMOs to develop rates that are adequate, not excessive, and not unfairly discriminatory, and in accordance with Article 48A, Section 702 of the Code.” (now Insurance Article §15-1205). Apart from the Commissioner accepting voluntary registrations of self-insured plans, there is the need to accumulate data on self-insured health benefit programs in Maryland. If your company has health business in effect or administers (TPA) health business in Maryland. You are then to file the Maryland Covered Lives Report. Q. We are a property and casualty company. Do we need to file this report? A. Again, the determining factor is if your company has any health business in effect in Maryland or are administrating (TPA) health business in Maryland. You are required to file the Maryland Covered Lives Report. Q. Where can I find a definition of health coverage? A. Section 15-1201 of the Insurance Article of the Annotated Code of Maryland provides a definition of what you need to include/exclude as health coverage when filing. Q. When completing this report must we fill in each space? A. You must fill in the company name, any identifying license or NAIC number as well as the contact information. Q. We are doing business under a different name. Which name should we use? A. Provide the legal name of your company. If you are a TPA please include your TPA license number. If you are a MCO use only your complete legal name. If you are an HMO or any other company please include your NAIC identifying number in the corresponding blocks. Do not use Abbreviations or d/b/a, etc.
Q. If we have more than one company, and some companies do not have business in Maryland must we file a report for each company? A. Each company licensed in Maryland has its own NAIC or Maryland licensee number and is a separate entity. Therefore, a separate report must be filed for each company that has health business in effect or administers (TPA) health business in Maryland. Additionally, to avoid a report being missed, each report must be filed separately. Q. Can I write the data on the report? A. No. All Data/Responses whether Alpha or Numeric must be typed. Q. If I have nothing to report how should I complete the rest of the form? A. If you have no data to report and you do not want to change any of the contact information then you do not have to complete and submit the report. You can change your contact information any time during the year by completing the “Update Maryland OCA-Reports Contact Information” form and emailing the form to: OCAReports@mdinsurance.state.md.us Q. Is there a pattern to follow when completing the Report? A. Yes. Inserted numbers in required fields the numbers will be totaled for you. Please do not insert totals. This automatic totaling will avoid incorrect totals from being recorded. Q. How and to where should we send the completed form? A. All reports are to be returned by email to: OCA-Reports@mdinsurance.state.md.us Q Why do I need to complete the contact section of the report? A. Email reminders are sent as a courtesy to your company. It is your responsibility to keep the contact information we have on record up to date. Failure to keep the contact data current may result in your not receiving future courtesy reminders and possibly late reporting fines. Q. How do I update our contact information? A. There are two (2) ways to update your contact information. The first is when completing the requested report there is a contact information section at the bottom of the report. You need to complete this section to notify us of any changes. If you want to change your contact data any other time during the year please refer to the MIA web page. On the MIA web page along with the instructions and forms to file this report, you will find instructions and a form “Update Maryland OCA-Reports Contact Information” form to complete and email to us to update your contact information. Q. Can I send a scanned or altered version of the form? A. No. Scanned or altered versions of this report are not compatible with our system. To be electronically read, all OCA Reports and forms must be in their original Adobe format and submitted as an attachment to an email. Q. When is the report due? A. Be certain to email your report to arrive before September 15th.
Please note: When e mails are received their attachments are opened and copied to the data file. Do not include any additional memos or comments with your ADOBE form as it may be overlooked during the copying process. The FAQ page should address your concerns. If you have specific comments that need to be addressed submit them via a separate email. E mails are opened in the order in which they are received.