(a) Beginning October 1, 2023, each employee of an employer, each employer with 15 or more employees, and each self-employed individual participating in the Program shall contribute to the Fund.

(b) On or before December 1 every 2 years, beginning in 2025, the Secretary, in consultation with State agencies and relevant stakeholders, shall conduct a cost analysis of the Program that is focused on the cost of maintaining solvency and paying benefits to covered individuals.

(c) (1) Once every 2 years, beginning in 2025, the Secretary, in consultation with State agencies and relevant stakeholders, shall study and make recommendations regarding the following:

(i) the appropriate total rate of contribution;

(ii) the appropriate cost-sharing formula between employers and employees for making contributions to fund the Program, including various formulas that range between a cost share of:

1. A. 75% paid by employers; and

B. 25% paid by employees; and

2. A. 25% paid by employers; and

B. 75% paid by employees;

(iii) the cost efficiency and benefits of the Department issuing a request for proposals seeking the services of an outside contractor for the following:

1. premium collection;

2. claims administration;

3. data management;

4. fraud control;

5. marketing and advertising; or

6. implementing any other elements of the Program.

(2) On or before April 1 each year a study is conducted under paragraph (1) of this subsection, the Secretary shall report the findings and recommendations to the Senate Finance Committee, the House Economic Matters Committee, and the Joint Committee on Administrative, Executive, and Legislative Review in accordance with § 2-1257 of the State Government Article.

(d) (1) Subject to paragraph (2) of this subsection, on or before June 1 every 2 years, beginning in 2025, the Secretary shall set the total rate of contribution and the percentage of the total rate of contribution to be paid by employees of employers and employers with 15 or more employees that will be in effect for the 24-month period beginning on the immediately following January 1.

(2) The rate and percentages set under paragraph (1) of this subsection shall be based on the study required under subsection (c) of this section.

(3) The total rate of contribution shall be applied to all wages up to and including the Social Security wage base.

(4) The percentages set under paragraph (1) of this subsection may not vary between employees or employers.

(e) (1) Except as provided in paragraph (2) of this subsection, the employer of the employee shall deduct the employee’s required contribution from the wages of the employee.

(2) If the employer of an employee elects to pay a portion of the employee’s required contribution, the employer may deduct an amount that is less than 75% of the rate of contribution required from the wages of the employee.

(f) Each self-employed individual participating in the Program shall:

(1) pay contributions during each year that the self-employed individual participates in the Program; and

(2) contribute an amount equal to the total rate of contribution set under subsection (d) of this section.