2023 End of Session Wrap-Up: Employee Benefits and Relations

The segments below provide a brief overview of MACo’s work in the area of employee benefits and relations in the 2023 General Assembly. 

MACo advocates for fair state laws governing employment practices, labor representation, and employer-employee relationships. MACo becomes particularly engaged when a proposal has a disproportionate or unique effect on public sector employees – frequently those affecting public safety employees or other public workers who engage in sensitive and essential functions.

In addition to the swearing-in of a new governor, the 445th legislative session kicked off with more relaxed health and safety measures compared to the turbulence of the last few years. This enabled MACo’s policy team to dynamically engage with private-sector stakeholders, legislators, and representatives from all divisions of government. Under these more conventional circumstances, MACo’s advocacy led to a plethora of favorable outcomes for its members.

Follow these links for more coverage on our Conduit Street blog and Legislative Database


Hiring and Retention

MACo supported with amendments SB 413 – Apprenticeship 2030 Commission establishing a commission to examine and make recommendations to expand access to apprenticeships state-wide and to reduce the current shortage of skilled practitioners in high-demand occupations. Counties support these efforts, and simply asked for representation on the Commission to ensure the findings are sensitive to the needs of local government. The bill did not pass in the 2023 session.

Bill Information | MACo Coverage


Paid Family and Medical Leave

MACo supported SB 828/HB 988 – Family and Medical Leave Insurance Program – Modifications with amendments to delay implementation of the Family Medical Leave Insurance (FAMLI) program and to clarify the private plan equal benefit application process. The Department of Labor offered similar amendments, delaying regulation publication until January 2024 and contributions until October 1, 2024. The bill also made adjustments to several other aspects of the benefits program. Ultimately, the bill was passed with the Department amendments, satisfying MACo’s request, and is now awaiting the Governor’s signature.

Bill Information | MACo Coverage

Pharmacy Benefits

MACo opposed HB 382/SB 895 – Maryland Department of Health and Prescription Drug Affordability Board – Managed Care Organizations and Prescription Drug Claims – Study as originally drafted. As drafted and introduced, would have imposed an additional fee on pharmacy prescriptions negotiated by pharmacy benefits managers (PBMs) on behalf of Medicaid. While counties were not the target of the bill as drafted, they have grave concerns with this shift in policy and its eventual effect on all employee health care coverage. Ultimately, the bill passed after it was amended striking any changes to existing pharmaceutical benefits policy and instead to study similar policies nationwide.

Bill Information

MACo opposed HB 357/SB 898 – Pharmacy Benefits Managers – Definition of Purchaser and Alteration of Application of Law. The bill sought to limit the tools Pharmacy Benefits Managers (PBMs) can use to negotiate pharmaceutical prices on behalf of their clients, including county governments. In doing so, it would have greatly disrupted counties’ ability to provide our staff with the best and most fiscally responsible benefits for their public service.  

The bill would have done so in several ways, including by restricting the abilities to design all aspects of benefits plans, to have full management over contracting with vendors to provide benefits, and to create the checks and balances employers deem necessary to protect staff and their financial contributions to the plan.  In practice, HB 357 would substantially limit, if not negate, PBMs’ ability to leverage certain cost-saving tools critical to negotiating the best and fairest prescription drug prices for counties and our staff, like requiring 90-day supplies of certain drugs or requiring mail orders to fill certain prescriptions. The bill did not pass in the 2023 session.

Bill Information


Workers’ Compensation 

MACo opposed SB 406/HB 335 – Workers’ Compensation – Occupational Disease Presumptions – First Responders to classify post-traumatic stress disorder diagnosed in first responders a presumed occupational disease that was suffered in the line of duty or course of employment and therefore compensable under the workers’ compensation law. The bill did not pass in the 2023 session.

Bill InformationMACo Coverage

MACo opposed SB 377/HB 590 – Workers’ Compensation – Benefits – Offset and Study expanding hearing benefits compensated under workers’ compensation and eliminating offsets for plans that offer service-based injury retirement benefits. Working with the Finance committee and other stakeholders, MACo secured amendments striking hearing benefits from the bill and requiring a study to analyze the impact of changes to offsets to county sponsored benefit plans. The bill passed the 2023 session as amended and is awaiting the Governor’s signature.

Bill Information | MACo Coverage

MACo sent a letter of information on HB 919/SB 538 – Workers’ Compensation – Occupational Disease Presumptions – Hypertension, which would have greatly altered existing workers’ compensation benefits for volunteer and paid firefighters experiencing hypertension, by expanding eligibility and minimizing current requirements. Current law grants volunteer and professional firefighters hypertension as a presumption for worker’s compensation, eligible by death or disability. HB 919 would remove that death and disability eligibility requirement and instead grants the benefit even if the claimant is still able to work and even if they choose to continue doing so – a dramatic rethinking of the core notion of workers’ compensation. 

Furthermore, the bill would only require a basic physical examination to qualify for the benefit, negating the existing presumption that a diagnosis of hypertension is related to the claimant’s line of work in firefighting. In doing so, the bill essentially changes the current statute of limitations to claim benefits, making it near impossible to determine when hypertension started and whether it is attributable to firefighting or other factors like genetics and diet, as growing scientific evidence suggests. The bill did not pass in the 2023 session.

Bill Information


More information on employee benefits and relations-related legislation tracked by MACo during the 2023 legislative session.