Md. Code Regs. 14.35.14.08

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

Section 14.35.14.08 - Cancellation

A. An individual's enrollment in a QHP may be canceled only if:

(1) The enrollee requests voluntary cancellation of the enrollee's enrollment to the Exchange or the carrier under §C of this regulation;

(2) The enrollee's coverage is rescinded under 45 CFR § 147.128; or

(3) The enrollee does not provide the first month's premium required to effectuate an enrollment by the due dates set forth at COMAR 14.35.07.11F.

B. To request cancellation of the individual's enrollment under §A of this regulation, the individual shall notify the Exchange or the carrier of the request to cancel before or on the last day of the month prior to the date the coverage begins.

C. An enrollee may retroactively cancel the enrollee's coverage if:

(1) The enrollee attempted to cancel the enrollee's coverage and the enrollee experienced a technical error that did not allow the enrollee to cancel the enrollee's coverage;

(2) The enrollee's enrollment in a QHP through the Exchange was unintentional, inadvertent, or erroneous and was the result of the error or misconduct of an officer, employee, or agent of the Exchange, its instrumentalities, or a non-Exchange entity providing enrollment assistance or conducting enrollment activities; or

(3) The enrollee was enrolled in a QHP without the enrollee's knowledge or consent by any third party, including third parties who have no connection with the Exchange.

D. Misconduct under §C(2) of this regulation means the failure of an officer, employee, or agent of the Exchange or HHS] its instrumentalities, or a non-Exchange entity providing enrollment assistance or conducting enrollment activities to comply with applicable standards under COMAR 14.35.14 or other applicable State or federal laws as determined by the Exchange.

E. Except as specified in §F of this regulation, the enrollee shall request cancellation under §C of this regulation by notifying the Exchange of the request:

(1) Within 60 days after the enrollee discovered the technical error under §C(1) of this regulation;

(2) Within 60 days of discovering the unintentional, inadvertent, or erroneous enrollment under §C(2) of this regulation; or

(3) Within 60 days of discovering of the enrollment under §C(2) of this regulation.

F. If the enrollee discovers an enrollment under §C of this regulation in the previous calendar year, the enrollee shall request termination under §C of this regulation by notifying the Exchange of the request by the end of March in the calendar year immediately following the calendar year with the enrollment under §C of this regulation.

G. Notification to the Exchange under §§E and F of this regulation shall be satisfied if the enrollee provides notice:

(1) To an Exchange-certified navigator, an Exchange-authorized broker or an Exchange-certified consolidated service center representative; and

(2) Using any of the methods of communication listed under COMAR 14.35.07.03B.

H. The effective date of the cancellation under §C of this regulation shall be:

(1) For a retroactive cancellation under §C(1) or (2) of this regulation:

(a) The day before the original coverage effective date; or

(b) A later date, as determined appropriate by the Exchange, based on the circumstances of the cancellation; and

(2) For a retroactive cancellation under §C(3) of this regulation, the day before the original coverage effective date.

Md. Code Regs. 14.35.14.08

Regulation .08 adopted effective 46:5 Md. R. 308, eff. 3/11/2019