Link to an amendment published at 81 FR 94181, Dec. 22, 2016.
(a) Non-renewal of recertification. If a QHP issuer elects not to seek recertification with the Exchange, the QHP issuer, at a minimum, must -
- (1) Notify the Exchange of its decision prior to the beginning of the recertification process and adhere to the procedures adopted by the Exchange in accordance with § 155.1075 of this subchapter;
- (2) Fulfill its obligation to cover benefits for each enrollee through the end of the plan or benefit year through the Exchange;
- (3) Fulfill data reporting obligations from the last plan or benefit year of the certification;
- (4) Provide notice to enrollees as described in paragraph (b) of this section; and
- (5) Terminate the coverage or enrollment through the Exchange of enrollees in the QHP in accordance with § 156.270, as applicable.
- (b) Notice of QHP non-renewal. If a QHP issuer elects not to seek recertification with the Exchange for its QHP, the QHP issuer must provide written notice to each enrollee.
(c) Decertification. If a QHP is decertified by the Exchange, the QHP issuer must terminate the enrollment of enrollees through the Exchange only after:
- (1) The Exchange has made notification as described in § 155.1080 of this subchapter; and
- (2) Enrollees have an opportunity to enroll in other coverage.
[77 FR 18469, Mar. 27, 2012, as amended at 80 FR 10875, Feb. 27, 2015]