Code of Maryland Regulations
Title 14 - INDEPENDENT AGENCIES
Subtitle 35 - MARYLAND HEALTH BENEFIT EXCHANGE
Chapter 14.35.15 - Carrier Certification Standards
Section 14.35.15.10 - Waiver Authority

Universal Citation: MD Code Reg 14.35.15.10

Current through Register Vol. 51, No. 6, March 22, 2024

A. The Exchange, with the approval of the Exchange Board of Trustees, and for reasons solely within the discretion of the Exchange, may grant a waiver to a specific provision of the application for certification, with or without conditions.

B. A waiver may only be granted to the extent it does not conflict with the provisions of Insurance Article, Annotated Code of Maryland, or applicable federal and State law.

C. A carrier may submit a request for a waiver on a form developed by the Exchange.

D. Carriers who are newly seeking accreditation from outside entities and have not yet received such accreditation by the Exchange's application deadline should use the waiver process to seek waiver or modification of this condition.

E. The request shall state:

(1) The provision from which a waiver is sought;

(2) The reason the carrier is unable to comply with the provision; and

(3) The reason that compliance with the provision will impose a substantial hardship.

F. The Exchange may grant a waiver if:

(1) The Exchange determines that compliance with the provision from which the waiver is sought cannot be accomplished without substantial hardship;

(2) The waiver will not conflict with applicable State and federal law; and

(3) The waiver is in the best interests of the State.

G. Final Written Decisions on Requests for Waivers.

(1) The Exchange shall issue a final written decision on a request for a waiver that is submitted under §A of this regulation within 45 days from receipt of the request and all supporting information for the waiver by the Exchange.

(2) If the Exchange grants a waiver, the decision shall include:
(a) The duration of the waiver; and

(b) Any conditions imposed by the Exchange.

(3) A request for a waiver may be denied if:
(a) The Exchange determines that the conditions of §D of this regulation are not satisfied;

(b) A waiver is not in the best interests of the State; or

(c) The waiver will conflict with applicable State or federal laws.

(4) A denial may not be appealed.

(5) The Exchange shall notify the carrier of the decision by mail or electronically.

H. The Exchange may revoke a waiver if it appears that the reasons for granting the waiver have ceased to exist.

I. The Exchange's decision and the request for waiver shall be subject to public disclosure.

Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.