Ill. Admin. Code tit. 50 § 4500.80

Current through Register Vol. 48, No. 43, October 25, 2024

Section 4500.80 - Plan Suppression

The Exchange may temporarily make a QHP certified to be offered through the Exchange temporarily unavailable for enrollment through the Exchange on one or more of the following grounds (see 45 CFR 156.815(a) through (b) (Feb. 27, 2015) (no later editions or amendments)):

a) The QHP issuer notifies the Exchange of its intent to withdraw the QHP from the Exchange when one of the exceptions to guaranteed renewability of coverage related to discontinuing a particular product or discontinuing all coverage applies under 45 CFR 147.106(c) or (d) (Apr. 25, 2019) (no later editions or amendments);

b) Data submitted for the QHP is incomplete or inaccurate;

c) The QHP is in the process of being decertified as described in Section 4500.70(c) or (d), or the QHP issuer is appealing a completed decertification through a hearing in accordance with 50 Ill. Adm. Code 2402;

d) The QHP issuer offering the QHP is the subject of a pending, ongoing, or final State or HHS regulatory or enforcement action or determination that could affect the issuer's ability to enroll consumers or otherwise relates to the issuer offering QHPs in the Exchange; or

e) One of the exceptions to guaranteed availability of coverage related to special rules for network plans or financial capacity limits under 45 CFR 147.104(c) or (d) (May 6, 2022) (no later editions or amendments) applies.

Ill. Admin. Code tit. 50, § 4500.80

Added at 48 Ill. Reg. 12312, effective 8/1/2024