Md. Code Regs. 14.35.14.03

Current through Register Vol. 51, No. 24, December 2, 2024

Section 14.35.14.03 - Terminations in General

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 ofAPTC, 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.

Md. Code Regs. 14.35.14.03

Regulation .03 adopted effective 42:11 Md. R. 726, eff.6/8/2015; adopted effective 46:5 Md. R. 308, eff. 3/11/2019