![[photo, St. Paul Plaza, 200 St. Paul Place, Baltimore, Maryland]](/msa/mdmanual/08conoff/attorney/images/i005966b.jpg)
The Maryland Insurance Administration began in 1872 as the Insurance Department under the Comptroller of the Treasury (Chapter 388, Acts of 1872). Renamed the State Insurance Department, it became an independent agency in 1878 (Chapter 106, Acts of 1878). As the Insurance Division, it moved to the Department of Licensing and Regulation in 1970 (Chapter 402, Acts of 1970). It was reorganized as the Maryland Insurance Administration, an independent agency, in 1993 (Chapter 538, Acts of 1993).
St. Paul Plaza, 200 St. Paul Place, Baltimore, Maryland, January 2001. Photo by Diane F. Evartt.
The Administration is a specially funded State agency supported entirely through fees and assessments on the insurance industry. In lieu of a State income tax on insurance company profits, the Administration collects a 2 percent tax on premiums. Up to 60 percent of the Administration's annual appropriation is funded by assessments on the insurance industry, with the remainder coming from fees.
Two separate funds support activities of the Administration: the Insurance Regulation Fund, and the Health Care Regulatory Fund. The Insurance Regulation Fund supports the administrative and regulatory activities of the Administration. The Health Care Regulatory Fund funds the costs of compalint investigations about payment denials involving medical necessity.
While the Administration does not recieve money from the State's General Fund, it does contribute to it. In FY2011, the Administration contributed $288,414,313 to the General Fund (an increase of $9 million from FY2010) and $25.9 million in Special Fund revenue (an increase of $88,000 from FY2010). Additionally, the Administration received a $1 million federal grant under the federal Patient Protection and Affordable Care Act on August 3, 2010. These funds are used to implement provisions of the federal act, and enhance the rate-review process for health insurers operating in Maryland.
The Maryland Insurance Commissioner serves on the Climate Change Commission, the Board of Trustees of the Maryland Health Benefit Exchange, the Maryland Health Care Reform Coordinating Council, and the Interstate Insurance Product Regulation Commission.
Appointed by the Governor with Senate advice and consent, the Commissioner serves a four-year term. Subject to the Governor's approval, the Commissioner appoints the Deputy Commissioner (Code Insurance Article, secs. 2-101 through 2-408).
Under the Commissioner, the Administration is organized into eight sections: Administration; Compliance and Enforcement; Consumer Education and Advocacy; Examination and Auditing; Insurance Fraud Division; Life and Health; Producer Licensing; and Property and Casualty. The Administration also is aided by the Work Group on Access to Habilitative Services Benefits.
In July 2012, the Work Group on Access to Habilitative Services Benefits was authorized (Chapters 293 & 294, Acts of 2012). The Work Group is to determine whether children who would benefit from and are entitled to habilitative services through their health insurance policies or contracts, or through their health maintenance organization, are actually receiving those services. Further, the Work Group will consider why children are not receiving habilitative benefits, and what actions should be taken to ensure their optimum use. Finally, the Work Group will study the costs and benefits of expanding coverage to habilitative services for individuals up to 26 years of age.
The Work Group submitted its interim report in November 2012. Its final report is due November 1, 2013.
Administration oversees four units: Fiscal Services, Human Resources, Management Information Systems, and Producer Licensing.
HUMAN RESOURCES
PRODUCER LICENSING
This unit licenses insurance producers and other professionals (including bail bondsmen). It conducts background investigations of applicants for agent and broker certificates of qualification. It also conducts such investigations of officers, directors, and major stockholders of insurance companies licensed in Maryland. Additionally, the unit verifies that agents and brokers meet continuing education requirements, and reviews and approves continuing education courses.
For Maryland residents applying for licenses in other states, the unit issues letters of certification or clearance.
The Compliance and Enforcement Section is responsible for the regulation in Maryland of insurance companies, insurance producers, title agents, public adjusters, and issuers of bail bonds. The Section conducts general and target market-conduct examinations, which include a review of sales practices, advertising and materials, underwriting practices, and claims handling practices. It also investigates insurance producers and other unauthorized entities for compliance with insurance laws and regulations.
The Section oversees four units: Agent Enforcement; Life and Health Market Conduct Examinations; Market Analysis; and Property and Casualty Market Conduct Examinations.
The Section investigates and resolves complaints made by insurance policyholders, claimants, beneficiaries, and providers of health care. It also provides information to consumers about their insurance coverage and helps them understand their rights and responsiblities under their policies.
The Section licenses all insurance companies conducting business in Maryland. It conducts financial analyses and examinations of licensed insurers as often as the Commissioner deems advisable, but at least every five years. In addition, the Section performs audits of the insurers' annual statements, and their quarterly and annual premium tax reports.
Under the Section are Company Licensing, Financial Analysis, and Financial Examination.
In cooperation with the Department of State Police and the Office of Attorney General, the Division investigates and prosecutes individuals and companies who commit insurance fraud. In addition, the Division reviews anti-fraud plans and annual fraud statistics submitted by insurance companies.
Under the Division are two units: Civil Investigations, and Criminal Investigations.
Under the Section are four units: Appeals and Grievances; Life and Health Complaints; Medical Director and Private Review Agent Oversight; and Rates and Forms Review.
The Section oversees two units: Complaints, and Rates and Forms.
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Human Resources started as Professional and Consumer Services and adopted its present name in 2000. The office conducts administrative services, including personnel management, training, and facility support services.
Within the Maryland Insurance Administration, Producer Licensing had organized as Company Licensing under the Examination and Auditing Section by 1996. It reformed as Licensing in 1997, and became the Producer Licensing Section in July 2001. As Producer Licensing, it transferred as a unit to Administration in September 2012.
COMPLIANCE & ENFORCEMENT SECTION
In August 2002, the Compliance and Enforcement Section formed when the Agent Enforcement and Market Conduct Examination unit of the Life and Health Section merged with the Agent Enforcement and Market Conduct Examination unit of the Property and Casualty Section.
CONSUMER EDUCATION & ADVOCACY SECTION
Origins of the Consumer Education and Advocacy Section trace to September 1997, when the Inquiry and Investigation units of the Life and Health Section and the Property and Casualty Section merged to form the Consumer Complaint Investigation Section. The Section received its present name in September 2004.
EXAMINATION & AUDITING SECTION
Functions of the Examination and Auditing Section originated with the Bureaus of Auditing and Examination in the State Insurance Department. From 1960 to 1970, these responsibilities were consolidated into the Examination and Auditing Bureau of the State Insurance Department. Under the Insurance Division of the Department of Licensing and Regulation, the Bureau reformed in 1970, as the Examination and Auditing Section. In 1985, the Section reorganized as Examination and Licensing, and in 1990 was placed under Operations and returned to its previous name as the Examination and Auditing Section. When the Maryland Insurance Administration formed in 1993, the Section was made part of the Administration.
INSURANCE FRAUD DIVISION
In 1992, the Insurance Fraud Division was established by the Governor as a unit within the Department of Licensing and Regulation (Executive Order 01.01.1992.24). The unit transferred to the Office of the Governor in 1993 (Chapter 538, Acts of 1993; Executive Order 01.01.1994.16). In July 1995, the unit joined the Maryland Insurance Administration.
LIFE & HEALTH SECTION
The Life and Health Section reviews the life, health and dental insurance policies used by Maryland insurance providers. Each annuity contract used in Maryland is reviewed by the Section, as is each health maintenance organization (HMO) subscriber and provider contract used in Maryland. To ensure that premium rates are not excessive, inadequate, or discriminatory, the Section also reviews initial rate filings by insurers.
PROPERTY & CASUALTY SECTION
For property, casualty, surety, mortgage guaranty and title insurance used in Maryland, the Property and Casualty Section reviews policy forms. To ensure the fairness of premium rates, the Section also reviews rate filings. In addition, the Section reviews nonfinancial activities of property and casualty insurers.
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e-mail: mdmanual@mdarchives.state.md.us