1. A. A qualified individual, an enrollee, a qualified individual’s dependent, and an enrollee’s dependent are eligible for a special enrollment period for change in family status if the qualified individual or enrollee gains a dependent or becomes a dependent through:

   1. (1) Marriage;
   2. (2) Birth;
   3. (3) Adoption;
   4. (4) Placement for adoption;
   5. (5) Placement in foster care;
   6. (6) A child support order; or
   7. (7) Other court order.

2. B. An enrollee is eligible for a special enrollment period for change in family status if the enrollee loses a dependent or is no longer considered a dependent through:

   1. (1) Divorce;
   2. (2) Legal separation; or
   3. (3) Death.
3. C. Family status changes shall be determined in accordance with the law of the state where the change in family status occurred.
4. D. If eligible for a special enrollment period under this regulation, a qualified individual, an enrollee, a qualified individual’s dependent or an enrollee’s dependent shall select a QHP within 60 days of the change in family status under §§A and B of this regulation.

5. E. Enrollment in a QHP selected by a qualified individual, an enrollee, the qualified individual’s dependent, or the enrollee’s dependent during a special enrollment period under this regulation shall be effective:

   1. (1) For marriages, the first day of the month following the date that the Individual Exchange receives the QHP selection;

   2. (2) For birth, adoption, placement for adoption, placement in foster care, or court order, on a date chosen by the qualified individual or enrollee that is either:

      1. (a) The date of birth, adoption, placement for adoption, placement in foster care, or effective date of court order; or
      2. (b) The first day of the month following the date that the Individual Exchange receives the QHP selection;
   3. (3) In the case of death, the first day of the month following the date that the Individual Exchange receives the QHP selection; and

   4. (4) For divorces or legal separation:

      1. (a) Before January 1, 2025:

         1. (i) The first date of the following month for QHP selections received by the Individual Exchange between the first and the 15th day of the month; or
         2. (ii) The first day of the next following month for QHP selections received by the Individual Exchange between the 16th and the last day of a month; or
      2. (b) On or after January 1, 2025, the first day of the month following the date that the Individual Exchange receives the QHP selection.

Authority: Insurance Article, §31-106(c)(1)(iv), Annotated Code of Maryland

Effective date: April 15, 2013 (40:7 Md. R. 612)

Regulation .01 repealed and new Regulations .01—.21 adopted effective March 11, 2019 (46:5 Md. R. 307)

Regulation .02B amended effective November 29, 2021 (48:24 Md. R. 1025)

Regulation .08 amended effective February 19, 2024 (51:3 Md. R.154)

Regulation .08E amended effective February 17, 2025 (52:3 Md. R. 160)

Regulation .11B, D amended effective June 13, 2022 (49:12 Md. R. 642)

Regulation .11F amended effective February 17, 2025 (52:3 Md. R. 160)

Regulation .12 amended effective June 13, 2022 (49:12 Md. R. 642)

Regulation .12E amended effective February 17, 2025 (52:3 Md. R. 160)

Regulation .12E, F amended effective February 19, 2024 (51:3 Md. R.154)

Regulation .13B, E amended effective June 13, 2022 (49:12 Md. R. 642)

Regulation .13E amended effective February 17, 2025 (52:3 Md. R. 160)

Regulation .14E amended effective February 19, 2024 (51:3 Md. R.154)

Regulation .14G adopted effective February 19, 2024 (51:3 Md. R.154)

Regulation .18A, D amended effective June 13, 2022 (49:12 Md. R. 642)

Regulation .18D amended effective February 17, 2025 (52:3 Md. R. 160)

Regulation .19 amended effective June 13, 2022 (49:12 Md. R. 642)

Regulation .19M, O amended effective February 17, 2025 (52:3 Md. R. 160)

Regulation .19 N amended effective February 19, 2024 (51:3 Md. R.154)

Regulation .22 adopted as an emergency provision effective May 10, 2023 (50:11 Md. R. 444); adopted permanently effective October 16, 2023 (50:20 Md. R. 889)

Regulation .23 adopted effective August 5, 2024 (51:15 Md. R. 710)