- A. An enrollee who is the contract holder of a QHP who terminates enrollment in a QHP also terminates the enrollment of the other enrollees in the household.
- B. Each enrollee, who is not the contract holder, may terminate enrollment in a QHP without affecting the enrollment status of the enrollee’s household or each individual member of the enrollee’s household other than the enrollee.
- C. A carrier shall process a request from the contract holder of a QHP to terminate coverage under Regulation .04 of this chapter for all enrollees promptly and without undue delay.
- D. A carrier shall process the Exchange’s termination determination under Regulation .06 of this chapter promptly and without undue delay.
- E. A carrier shall maintain records of termination of enrollment in a QHP in the format specified by the Exchange in an electronic data interchange format for a period of 10 years.
- F. A carrier shall make reasonable accommodations for all individuals with disabilities (as defined by the Americans with Disabilities Act), including head-of-household and non-head-of-household enrollees, before terminating the individual's enrollment.
- G. A carrier shall send an electronic transaction to the Exchange documenting, or acknowledging, each termination of coverage carried out under this chapter, promptly and without undue delay.
- H. In cases of retroactive termination dates, the carrier shall accept the Exchange’s adjusted calculations of APTC, and premiums and changes to the plan variation of the QHP.
- I. A carrier shall confirm the termination of an enrollee’s coverage with a notice provided to the contract holder indicating the enrollees affected by the termination and the effective date of the termination.
Authority: Insurance Article, §§31-106(c)(1)(iv) and 31-108(b)(1) and (6), Annotated Code of Maryland
Effective date: June 8, 2015 (42:11 Md. R. 726)
Regulations .01—.07 repealed and new Regulations .01—.10 adopted effective March 11, 2019 (46:5 Md. R. 308)
Regulation .04F adopted effective February 17, 2025 (52:3 Md. R. 160)
Regulation .06F adopted effective February 19, 2024 (51:3 Md. R.154)
Regulation .07C adopted effective February 19, 2024 (51:3 Md. R.154)