§ 11-1. Definitions.

(a) In general.

In this subtitle, the following words have the meanings indicated.

(b) Director.

"Director" means the Director of the Department of Finance.

"Exclusive employee organization" means an employee organization designated as an exclusive representative, as described under subtitle 4 of the Municipal Labor Relations Article {"Certification and Recognition of Employee Organizations"}.

(d) Fund.

"Fund" means the Premium Stabilization Fund created under this subtitle.

(e) Generally Accepted Accounting Principles.

"Generally Accepted Accounting Principles" or "GAAP" means the accounting principles, standards, and procedures of the Financial Accounting Standards Board.

(f) Government Standards Accounting Board.

"Government Accounting Standards Board" or "GASB" means the organization that promulgates accounting and financial reporting standards for U.S. state and local governments that follow GAAP.

(g) Health benefit option.

"Health benefit option" means the type and components of a health benefit plan offered to:

(1) an employee;

(2) a retiree;

(3) an employee or retiree's spouse; and

(4) an employee or retiree's dependent.

(h) Health benefit option – Inclusions

"Health benefit option" includes:

(1) the structure of a health plan, including:

(i) a health maintenance organization;

(ii) a participating provider organization;

(iii) a point-of-service plan;

(iv) a fee-for-service plan; and

(v) a consumer-directed plan;

(2) covered benefits, including:

(i) medical benefits;

(ii) dental benefits;

(iii) prescription drug benefits; and

(iv) vision benefits;

(3) the manner in which benefits are covered, including:

(i) group health plans; and

(ii) health insurance exchanges;

(4) cost-sharing plan features, including:

(i) deductibles;

(ii) co-pays;

(iii) coinsurance; and

(iv) out-of-pocket maximums; and

(5) cost-controlling plan features, including:

(i) prior approval requirements;

(ii) prescription formularies; and

(iii) management of investigative or trial treatments and services.

(i) Health benefit plan.

"Health benefit plan" means the health benefits and other options available to a participant under an insured plan or a self-insured plan offered by Baltimore City under the Program.

(j) Health Insurance Committee: HIC.

"Health Insurance Committee" or "HIC" means the labor management committee established by action of the City Board of Estimates on November 7, 2012.

(k) Participant.

"Participant" means any individual who is or may be eligible to receive benefits under the Program, including a:

(1) City employee;

(2) retired City employee;

(3) spouse of a City employee or retired City employee; and

(4) dependent of a City employee or retired City employee.

(l) Plan year.

"Plan year" means the calendar or fiscal year of each benefit plan offered under the Program.

(m) Program.

"Program" means the City Employee and Retiree Health Benefits Program.

(n) Retiree: retired City employee.

"Retiree" or "retired City employee" means a former City employee who receives or is entitled to receive a defined benefit pension under City Code Article 22 {"Retirement Systems"}.

(o) Retiree health plan.

"Retiree health plan" means any health benefit plan, including any Medicare Advantage Plan, offered by or through the City to its retirees, their spouses, and their dependents.