Code of Maryland Regulations
Title 14 - INDEPENDENT AGENCIES
Subtitle 35 - MARYLAND HEALTH BENEFIT EXCHANGE
Chapter 14.35.07 - Eligibility Standards for Enrollment in a Qualified Health Plan, Eligibility Standards for APTC and CSR, and Eligibility Standards for Enrollment in a Catastrophic Qualified Health Plan in the Individual Exchange
Section 14.35.07.16 - Special Enrollment Period-Violation of Material Provision Through the Individual Exchange
Current through Register Vol. 51, No. 6, March 22, 2024
A. Prior to January 1, 2020, an enrollee or an enrollee's dependent shall be eligible for a special enrollment period set forth in 45 CFR § 155.420(c)(3) if the triggering event set forth in 45 CFR § 155.420(d)(5) occurs.
B. Effective January 1, 2020, an enrollee or an enrollee's dependent is eligible for a special enrollment period if the enrollee or the enrollee's dependent:
C. Notification to the Individual Exchange under §B(2) of this regulation shall be satisfied if the enrollee or the enrollee's dependent provides notice:
D. Notification to the Maryland Insurance Administration under §B(2) of this regulation shall be satisfied if the enrollee or enrollee's dependent files a complaint with the Maryland Insurance Administration.
E. Effective January 1, 2020, the length of the special enrollment period shall be 30 days from the date that the Individual Exchange notifies the enrollee or the enrollee's dependent that the enrollee or enrollee's dependent is eligible for a special enrollment period under this regulation.
F. The effective date of coverage for an enrollee or an enrollee's dependent who is determined eligible for a special enrollment period under this regulation and selects a QHP during the special enrollment period under §E of this regulation:
G. The Individual Exchange's determination that an individual is eligible for a special enrollment period under this regulation may be made prior to the completion of the Maryland Insurance Administration's review of the alleged violation of a material provision of the contract in relation to the enrollee or the enrollee's dependent.