Maryland Health Benefit Exchange

The board discussed the executive director's update regarding recent CMS benefit parameters, the H.R.1 implementation, a past file transfer issue, the status of the RFA for the Connector Entity grant program, and ongoing agency recruitments. Additionally, the board approved appointments for the 2026 Standing Advisory Committee, reviewed the 2026 IT roadmap focusing on cybersecurity and innovation, approved a five-year contract for AWS services through A & T Systems, Inc., authorized an increase to the FY 2026 IT IDIQ budget for H.R.1 implementation, and reviewed the draft strategic plan for FY 2026-2028.

The board meeting focuses on several key strategic and procurement initiatives. Discussions include the review of 2027 benefit and payment parameters, including state subsidy, reinsurance, and value plan standards. Proposed regulatory changes regarding out-of-state broker fees are on the agenda. The meeting also addresses multiple consumer assistance procurements for language line services, fulfillment services, and consolidated service center operations. Additionally, the board will review Connector Entity program grant awards for the upcoming fiscal year, task orders for IT hardware and accessories, and a sole source procurement for the National Student Clearinghouse.

The board reviewed IT IDIQ contract details and discussed approval for Fiscal Year 2027 Not-To-Exceed funding amounts. Key discussion points included a status overview of the existing master contract, task orders across various functional areas, and federal versus state funding participation ratios. The meeting addressed the implementation schedule and operational scope for the HR1 project, covering both design, development, integration, and ongoing maintenance activities. A formal motion was presented to approve the exercise of Option Year 1 of the IT IDIQ contract and the associated total funding.

The board held a special session to address the rising costs of the state premium subsidy program caused by higher-than-expected enrollment. Key discussions included a presentation on enrollment projections, the impact of grace periods on fund solvency, and the potential depletion of the State Reinsurance Program fund by 2028 if current subsidy trends continued. Following deliberation on the financial risks and potential mitigation strategies, the board unanimously approved a motion to pause eligibility for the State Subsidy Program for new special enrollment period participants for the remainder of the calendar year.

This document outlines the final 2027 Plan Certification Standards, focusing on updates to Value Plans to enhance affordability, accessibility, and health equity. Key changes include modifications to Value Plan cost-sharing requirements, including increased deductibles and maximum out-of-pocket limits across various metal levels. A new requirement mandates $0 cost sharing for at least one continuous glucose monitor (CGM) and specific diabetes-related benefits. Carriers are also required to provide accessible and transparent information regarding these $0 diabetes benefits on their websites. The guiding principles for these changes emphasize maintaining consistent actuarial values, prioritizing copays over coinsurance, and maximizing pre-deductible services.