§ 11-13. Retained duties and powers of City.

(a) In general.

The Director of the Department of Human Resources shall have the general duty to administer the Program.

(b) Powers.

Subject to the provisions of this subtitle, the Director of the Department of Human Resources or the Director's designee may:

(1) propose the health benefit options and design the health benefits plans, which may include a wellness program made available to participants;

(2) prepare forms and establish procedures to be followed in order to obtain health benefits under the Program;

(3) determine the eligibility of persons to participate in the Program and its health benefit plans and other plans by applying the provisions of the Program governing such eligibility subject to the right of persons to appeal adverse decisions on eligibility through grievance and arbitration procedures established under this subtitle;

(4) approve or supervise the approval of the payment of claims for health and other benefits;

(5) establish a process for internal appeals and external review of decisions on claims that complies with the federal Affordable Care Act and subsequent statutes;

(6) review the payment of claims for health insurance benefits and seek recovery of any overpayment of benefits;

(7) establish through the processes of collective bargaining available under this subtitle health care flexible spending accounts or health savings accounts as part of the Program; and

(8) subject to Title 4 {"Administrative Procedure Act – Regulations"} of the City General Provisions Article, may adopt rules and regulations to carry out this subtitle, provided that, at least 60 prior to taking effect, the rules and regulations are published and delivered to:

(i) each exclusive employee organization;

(ii) MAPS;

(iii) retirees; and

(iv) their consultant.