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Larry Gross has been preparing for Tuesday for quite awhile.

That day marks the opening of Maryland’s new health care exchange system, a key part of the federal Affordable Care Act. Individuals and families can start shopping for health insurance Tuesday, while small businesses with from two to 50 full-time employees in Maryland can start applying Jan. 1.

“We’ve actually been preparing for this for a couple of years now,” said Gross, executive director of market development for Rockville-based Kaiser Permanente of the Mid-Atlantic States.

Kaiser is one of several health care companies offering plans through the exchange, called Maryland Health Connection. With the system being new, Gross expects a few bugs and delays, though it’s hard to know what to expect.

“We don’t know how many people will sign up when open enrollment begins [Tuesday],” Gross said. “The coverage won’t begin until Jan. 1. … We hope people will evaluate the options and make sure they make the right choices of what is best for them.”

Maryland has been ahead of the curve in many ways in building its own health insurance exchange and preparing for open enrollment, Gross said. Maryland is one of 16 states, along with Washington, D.C., operating their own exchanges. Others such as Virginia are allowing the federal government to run their exchanges.

“The idea for us is to keep it as simple as possible,” Gross said. “Maryland is limiting the plans to make them as simple as possible, so people can understand what they are getting and compare choices.”

While many employers limit health plans to one or two choices, the idea for the exchange is to increase the pool of plans and perhaps the costs will drop. For a 50-year-old nonsmoker in Maryland, premiums run from $278 a month to $470, depending on which plan is selected. Tax credits and other assistance are available based on income.

Kaiser has trained customer service employees in case they are called about the exchanges, Gross said. Individuals can sign up for plans directly with Kaiser, but won’t be able to get the credits and assistance in most cases unless they apply through an exchange, he said.

The system will allow for more choices for employers as well as employees, Gross said.

“Rather than have an employer pick the plan, employees get to select the carrier they want,” he said. “We think that is a great idea, both for individuals and small-group employers.”

Eric Feldstein, business banking market manager for Greater Washington, Central Maryland and Virginia with M&T Bank, said small-business clients he deals with in seeking loans are still uncertain about aspects of the law.

“It’s a top-of-the-line issue with clients,” Feldstein said. “There is not a great deal of clarity on the law.”

Pregnancy protection takes effect Tuesday

Several new state laws passed by the General Assembly earlier this year that impact businesses take effect Tuesday.

One will give pregnant employees the same rights in many cases as disabled workers if their condition is considered a disability.

Maryland employers who employ 15 workers or more must make “reasonable accommodations” to a woman who experiences limitations due to her pregnancy, said Glendora Hughes, general counsel for the Maryland Commission on Civil Rights.

Those accommodations can be as simple as being able to get more bathroom breaks, or can lead to a change to less strenuous job duties, she said.

“It’s up to a negotiation between the employer and the employee as to what is reasonable,” Hughes said. “The law provides suggestions. … The intent was to provide as much guidance as possible.”

Employers can require certification from a medical physician to the same extent as any temporary disability, she said.

The ban on more semi-automatic handguns and rifles also takes effect Tuesday. A driver holding a cellphone in his or her hand in a vehicle also will become a primary offense in which a police officer can stop a driver.



kshay@gazette.net