Maryland Health Benefit Exchange

What Maryland Health Benefit Exchange does

Maryland Health Benefit Exchange (MHBE) is a state government public corporation and independent unit of Maryland state government, established in 2011 under the Affordable Care Act. It operates Maryland Health Connection, the state's health insurance marketplace, serving individual consumers, families, and small businesses (under 50 employees) seeking qualified health plans. The platform enables plan comparison, eligibility determination for federal tax credits and cost-sharing reductions, and integrated enrollment with Medicaid and the Maryland Children's Health Insurance Program through a 'no wrong door' architecture that links the Maryland Department of Health, Department of Human Services, and Maryland Insurance Administration.

The technology platform supports multiple distribution channels: an online self-service portal at marylandhealthconnection.gov, a mobile application, a Consumer Support Center (call center staffed by contractor Maximus), eight regional Connector Entities providing free in-person navigator assistance, 50+ Application Counselor Program partner organizations (including Johns Hopkins Health System, Chase Brexton, LifeBridge Health, and University of Maryland Medical System), authorized brokers using a Producer Portal, and a small business SHOP portal. Core technology differentiators are interoperability/integration with state systems and ease-of-use accessibility, including Spanish-language content and Relay/interpreter services.

MHBE's operating model is funded by Maryland state appropriations, federal grants, and carrier participation fees tied to premium revenue thresholds (over $20M small group or $10M individual market). The agency does not generate commercial revenue; its FY25 administrative costs totaled $14,611,889.51, of which approximately $12.7M is salary/wages/benefits. Additional state-funded programs include a State Reinsurance Program (under Section 1332 waiver), a Young Adult Subsidy Program, and an Easy Enrollment Program integrated with state tax filings. The agency is governed by a nine-member Board of Trustees that includes the Maryland Department of Health Secretary, the Maryland Insurance Administration Commissioner, and the Maryland Health Care Commission Executive Director.

Name

Maryland Health Benefit Exchange

Legal name

Maryland Health Benefit Exchange

Website

https://marylandhbe.com

Company type

Private

Founded year

2011

Operating status

Operating

Headcount range

101–250 employees

Short description

Maryland Health Benefit Exchange is a state government public corporation that operates Maryland Health Connection, the state's ACA health insurance marketplace serving individual consumers, families, and small businesses in Maryland through online, mobile, call center, and in-person navigator channels.

Ownership category

akta.pro rank

Product category

State Health Insurance Marketplace

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Direct Health and Medical Insurance Carriers (524114)

SIC

Insurance Agents, Brokers & Service (6411), Accident & Health Insurance (6321)

akta.pro primary industry

Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)

akta.pro secondary industry

Patient Financial Engagement (Estimates, Billing Presentment, Payments) (HLACAEAI)

Keywords

• State health insurance marketplace
• ACA exchange platform
• Health plan enrollment
• Medicaid eligibility determination
• Small business health options

Headquarters

HQ city

Baltimore

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Technology or R&D, Marketing or Sales

Revenue model

1. Government Appropriations: State government funding for operations. FY25 total administrative costs were $14,611,889.51.
2. Carrier Participation Fees: Insurance carriers required to participate in the state-based exchange based on premium revenue thresholds (over $20M in small group, $10M in individual market) or if offering catastrophic plans.
3. Federal Grants: Initial establishment funded through federal Early Innovator, Planning and Level One Establishment grants. Ongoing federal funding for exchange operations.

Pricing tiers

Go-to-market motion3 records

Distribution channels7 records

Marketing channels6 records

Core offering

Maryland Health Benefit Exchange operates Maryland Health Connection, the state-based health insurance marketplace established under the Affordable Care Act. The platform enables Maryland residents to explore health insurance plans, compare rates, determine eligibility for tax credits and cost-sharing reductions, and enroll in public assistance programs such as Medicaid and the Maryland Children's Health Insurance Program. It also offers Maryland Health Connection for Small Business (SHOP) for small employers, supported by Connector Entity navigators, Application Counselor Program partners, and authorized brokers.

Product overview

Maryland Health Benefit Exchange operates Maryland Health Connection, a state-based health insurance marketplace established under the ACA. The platform consists of the core Maryland Health Connection for individuals and families, Maryland Health Connection for Small Business (SHOP), and multiple辅助 programs including the Connector Entity Program with navigators, Application Counselor Program, State Reinsurance Program, Young Adult Subsidy Program, and Easy Enrollment Program. Insurance carriers offer Qualified Health Plans and stand-alone dental plans through the exchange. The ecosystem also includes a Producer Portal for brokers and authorized producers to manage enrollments.

Differentiator

Problem solved

Functional benefit

Products and services

• Maryland Health Connection Maryland's state health insurance marketplace operating under the Affordable Care Act, providing a one-stop shop for residents to explore health insurance plans, compare rates, determine eligibility for tax credits and cost-sharing reductions, and enroll in public assistance programs such as Medicaid and the Maryland Children's Health Insurance Program.
• Maryland Health Connection for Small Business (SHOP) Small Business Health Options Program (SHOP) enabling Maryland small businesses to find health plans for employees, offer an employee choice model, and qualify for the Small Business Health Care Tax Credit through authorized brokers.
• Connector Entity Program (Navigator Services) Free in-person consumer assistance program with trained navigators in eight regions across Maryland providing education, eligibility determination, and enrollment help with health coverage.
• Application Counselor Program

Quantifiable outcome

• Nearly 250,000 Marylanders enrolled in 2025, seventh consecutive year of enrollment increases
• +3 more outcomes

Named customers7 records

Segments5 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

14 partnerships are on record, tiered core and secondary.

• Maryland Department of HealthcoreStrategic or Co-development PartnerMaryland's state health department. MHBE works with MDH on integrated eligibility and enrollment, Medicaid coordination, and health policy implementation. The Secretary of Maryland Department of Health serves on the MHBE Board of Trustees.
• Maryland Insurance AdministrationcoreStrategic or Co-development PartnerState insurance regulator. MHBE coordinates with MIA on plan certification, market rules, and carrier oversight. The Commissioner of MIA serves on the MHBE Board of Trustees.
• Department of Human ServicescoreStrategic or Co-development PartnerMaryland's human services agency. MHBE works with DHS on integrated eligibility systems supporting the 'no wrong door' approach for benefits enrollment.
• CareFirst BlueCross BlueShieldcoreChannel Partner/ Reseller/ DistributorMajor health insurance carrier participating in Maryland Health Connection marketplace. Carriers sell qualified health plans through the exchange and are subject to MHBE certification standards.
• Kaiser PermanentecoreChannel Partner/ Reseller/ DistributorHealth insurance carrier participating in Maryland Health Connection marketplace offering qualified health plans.
• UnitedHealthcarecoreChannel Partner/ Reseller/ DistributorHealth insurance carrier participating in Maryland Health Connection marketplace offering qualified health plans.
• Healthcare Access MarylandcoreImplementation/ SI/ Consulting PartnerPrimary Connector Entity and Application Counselor Program partner providing navigator services in Baltimore, Anne Arundel, Howard, and Prince George's counties.
• SEEDCOcoreImplementation/ SI/ Consulting PartnerConnector Entity partner serving Calvert, Caroline, Cecil, Charles, Dorchester, Harford, Kent, Queen Anne's, Somerset, St. Mary's, and Talbot counties.
• Area Health Education Center (AHEC) WestcoreImplementation/ SI/ Consulting PartnerConnector Entity serving Western Maryland regions including Allegany, Carroll, Frederick, Garrett, Washington, Wicomico, and Worcester counties.
• Montgomery County Health ConnectcoreImplementation/ SI/ Consulting PartnerConnector Entity serving Montgomery County residents with navigator services.
• Johns Hopkins Health SystemsecondaryImplementation/ SI/ Consulting PartnerApplication Counselor Program partner with multiple hospital locations (Johns Hopkins Hospital, Johns Hopkins Bayview, Howard County General, Suburban Hospital, Johns Hopkins Community Physicians) providing in-person enrollment assistance.
• Chase Brexton Health ServicessecondaryImplementation/ SI/ Consulting PartnerApplication Counselor Program partner since 2014, providing health coverage enrollment assistance as a healthcare provider organization.
• MaximussecondaryImplementation/ SI/ Consulting PartnerExternal contractor providing Consumer Support Center worker staffing for call center operations.
• Maryland Health Care CommissionsecondaryStrategic or Co-development PartnerThe Executive Director of MHCC serves on the MHBE Board of Trustees, providing health system planning and quality reporting coordination.

Scale indicators6 records

Recent moves5 records

Expansion highlights5 records

Broad incumbents

• Healthcare.gov: The federal health insurance marketplace serving states that do not operate their own exchange. Functions as a fallback/benchmark for state exchange functionality and competes with MHBE for federal policy attention.

Direct peers

• Covered California: California's state-based health insurance marketplace established under the ACA. Both are state-operated ACA exchanges with active advertising, navigator/assister programs, and SHOP offerings for small businesses.
• Connect for Health Colorado: Colorado's state-based health insurance marketplace. Comparable state ACA exchange with financial assistance, broker network, and SHOP offerings.
• Massachusetts Health Connector: Massachusetts' state-based health insurance exchange. Both are state-run ACA marketplaces with Connector-style navigator programs and subsidized coverage offerings.
• DC Health Link: Washington D.C.'s health insurance marketplace. Comparable state-level ACA marketplace with integrated eligibility and small business offerings.
• Washington Healthplanfinder: Washington's state-based health insurance marketplace. Comparable ACA state exchange with online portal, mobile app, and in-person enrollment assistance.
• MNsure: Minnesota's state-based health insurance marketplace. Comparable state ACA exchange with broker and navigator support.
• NY State of Health: New York's official health plan marketplace. Both operate state-based individual marketplaces with integrated Medicaid eligibility, navigator programs, and small business options.
• Access Health CT: Connecticut's state-based health insurance marketplace. Directly comparable state exchange with individual and small business enrollment.
• Vermont Health Connect: Vermont's state-based health insurance marketplace. Comparable state ACA exchange with integrated eligibility and individual enrollment.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/MarylandConnect
• YouTubeyoutube.com/user/MarylandConnect
• Facebookfacebook.com/MarylandConnect
• LinkedInlinkedin.com/company/maryland-health-benefit-exchange
• Instagraminstagram.com/MarylandConnect

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Maryland Health Benefit Exchange