Commission to Study Health Insurance Pooling Meeting Notes
June 4, 2026
Agenda
- I. Welcome
- II. Phase 2 - Research and Analysis (April - July)
- a. Data Acquisition Plan - Segal demonstration
- b. Confirmation of Data Contacts
- III. Discussion
- IV. Assigned Tasks and Adjournment
Discussion
After committee members were welcomed, DBM representatives outlined the mandatory Data Use Agreement process for all participating entities. Next, Segal demonstrated the planned Smartsheet project management platform for data collection.
While the digital tool provides a solid foundation for the process, the committee noted two key challenges during the subsequent discussion. First, they addressed the practical logistics of handling small groups that operate entirely without digital data. Second, members raised questions about overall participation rates, discussing whether the final study results would be skewed if groups not interested in pooling choose to withhold their data. Because data contribution to the study is voluntary rather than mandated, the committee debated how to mitigate the risk of non-participation. Members agreed that if groups not interested in pooling withhold their data, the final analysis will be skewed. To address this, the committee discussed outreach strategies to convince all parties to participate. Ensuring a complete and accurate dataset was identified as a top priority, specifically to prevent the legislature from moving forward with policy decisions based on inaccurate or unrepresentative data.
The session concluded with an agreement to cancel the June 25th meeting to allow sufficient time for the data collection process.
Upcoming Meeting Schedule:
- June 4 - in-person
- June 25 - cancelled
- July 16 - in-person
- August 6 - virtual
- August 27 - in-person
- September 17 - virtual
- October 8 - in-person
- October 29 - virtual
- November 19 - in-person
Following the meeting's adjournment, additional localized data was contributed to support the committee's objective. Pamela Shaw submitted the results of the 2026 Maryland County Benefit Survey for review. Additionally, Dan Gottheimer forwarded comprehensive health rate information for Maryland public schools by county, which was tracked and compiled by the Maryland State Education Association (MSEA) for the years 2025 and 2026.
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April 23, 2026
Agenda
- I. Welcome
- II. Overview of Phase 2 Objectives
- III. Analysis of Current Plan Offerings - Data acquisition and timeline
- IV. Discussion - Structural Challenges
- V. Future Meeting Format and Schedule
Discussion
Discussion focused on data procurement methods for the evaluation of current plan offerings. Leadership from MACo, MML, and MABE committed to helping to coordinate these efforts and provided points of contact for further assistance.
Maryland's established health insurance pools include the Local Government Insurance Trust (LGIT), representing 24 participating municipalities, and the Eastern Shore of Maryland Educational Consortium (ESMEC) Health Insurance Alliance, comprising seven member school boards. Commission members provided some designated contacts for these organizations to assist with acquisition of data relating to these pooled groups.
To help facilitate the process, the DBM Deputy Secretary will coordinate with key contacts to help prepare entities for the upcoming data requests.
To meet the May 31 deadline, the Employee Benefits Division is fast-tracking the delivery of a data request template and the necessary NDAs to ensure an authorized and efficient exchange of information. Data security and integrity will be maintained via a secure file transfer portal hosted by Segal. This SFTP site will serve as the centralized repository for all claims data submissions.
Consultants from The Segal Company highlighted that health insurance pooling is a growing interest among other states. However, they cautioned that these arrangements involve multiple complex factors that require thorough analysis. Key considerations include underwriting and risk pooling mechanics, compliance with varied state and federal legal constraints, and the alignment of diverse plan designs.
There was a brief examination of the structural challenges related to a mandatory pooled insurance model including adverse selection, loss of local autonomy, actuarial complexity, geographic provider disparity and administrative hurdles.
The session concluded with an agreement on a new hybrid meeting cadence. Moving forward, sessions will alternate between in-person and virtual formats, though a remote dial-in option will remain available for all meetings. While the team acknowledged the efficiency of virtual attendance, members were encouraged to attend in person whenever possible to capitalize on the participation and collaborative energy that face-to-face interaction provides.
Upcoming Meeting Schedule:
- June 4 - in-person
- June 25 - virtual
- July 16 - in-person
- August 6 - virtual
- August 27 - in-person
- September 17 - virtual
- October 8 - in-person
- October 29 - virtual
- November 19 - in-person
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March 27, 2026
Agenda
- I. Welcome and introduction of commission members
- II. Review of SB547 of 2025 and HB1400 of 2018
- III. Questions
- IV. Future meeting plan and schedule
Discussion Questions
Please provide clarification of the $86M loss over the last 6 years for the 57 entities who currently participate in the state health plan.
Response: Claim costs for the 57 participating entities exceeded all premium and administration fees invoiced to each entity during this period. Satellites organizations are invoiced 105% of the Rates published annually.
Will there be consideration of provider access across the state?
Response: This study's focus is the impact of pooling public employee health insurance plans.
How many participants are in the state plan from the satellite groups currently?
Response: As of January 1, 2026: 6,648 employees, 3,119 enrolled
What does voluntary participation in the state plan mean?
Response: Current law permits Maryland counties, municipal corporations and county boards of education to enroll their employees in the state plan as "satellite organizations" as defined by SPP §2-503(d) (i) or §2-513. Participation is voluntary.
How many employees (non-satellite) are in the state plan currently?
Response: As of January 1, 2026:
• 75,184 - Active Employees
• 8,580 - Pre-65 Retirees
• 44,104 - Post-65 Retirees
• 244,315 Total Members (includes Satellites)
Are the benefits for retirees in the state health plan the same as the benefits for active employees?
Response: The health and dental plans offered are the same as those offered to active employees. Medicare eligible retirees aged 65+ must enroll in Medicare Parts A & B. The state plan becomes the secondary payer, acting as the Medicare Supplement. Medicare primary retirees must enroll in an individual Medicare Part D prescription plan. The state partners with Via Benefits to support our retiree's transition.
Are prescription benefits included in this study?
Response: Yes, prescription benefits are included in this study.
Please provide the detail of current health plan offerings for the State Employee and Retiree Health and Welfare Benefits Program.
Response: Here is the link to the Health Benefit Guide: https://dbm.maryland.gov/benefits/Documents/2026-health-benefits-guide.pdf
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