Starting in 2007, all employers with 10,000 or more employees would be required to attest to the amount of money they spend on all health expenditures for workers, dependents and retirees:

• Eligible expenses include only those deductible for federal tax purposes, as defined by the Internal Revenue Service (IRS).
• Earnings per employee would be assessed up to the median family income in Maryland (currently $55,213) but the assessment would not apply to wages for workers eligible for Medicare.
• Expenditures would be reported in gross dollars and in % of payroll.
• Sworn statements submitted by companies would be subject to random state audit for verification.
• Employers must also submit information on the number of part/full time employees and whether their uncovered employees receive health care through another source.

Private employers who spend less than 8% of payroll would pay the State the difference between what they spend on benefits and the 8% payroll amount. Non-profit employers who spend less than 6% of payroll would pay the State the difference between what they spend on benefits and the 6% payroll amount.

• Companies not doing their "fair share" could choose whether to increase their spending on health care benefits or pay into a special fund to help expand Medicaid eligibility.