Code of Massachusetts Regulations
958 CMR - HEALTH POLICY COMMISSION
Title 958 CMR 4.000 - Health Insurance Open Enrollment Waivers
Section 4.030 - Eligibility for Enrollment Waivers

Universal Citation: 958 MA Code of Regs 958.4

Current through Register 1518, March 29, 2024

(1) An eligible individual may apply for an enrollment waiver within 30 calendar days of receipt of notice by a carrier in accordance with regulatory guidance issued by the Division of Insurance that such individual is not eligible to enroll in a health benefit plan outside of open enrollment pursuant to 211 CMR 66.00: Small Group Health Insurance, or pursuant to applicable federal law including the Patient Protection and Affordable Care Act, Public Law 111-148, and any rules, regulations or guidance issued thereunder.

(2) The following individuals are not eligible to apply for an enrollment waiver:

(a) A person who does not meet the definition of "eligible individual" set forth in 958 CMR 4.020.

(b) An individual who has not first applied to a carrier for enrollment in a health plan and been notified that he or she is not eligible to enroll outside of the open enrollment period.

(3) The Office of Patient Protection is not required to review any request for an enrollment waiver that is received within 30 days of the next open enrollment period.

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