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<section article="gin" article_name="Insurance" number="31-113.1" title_number="31" title_name="Maryland Health Benefit Exchange" subtitle_number="1" subtitle_name="Maryland Health Benefit Exchange">
  <level label="a">
    <text>In accordance with the requirement to operate a toll–free hotline under § 1311(d)(4) of the Affordable Care Act and § 31–108(b)(5) of this subtitle, the Exchange may establish a Consolidated Services Center.</text>
  </level>
  <level label="b">
    <level label="1">
      <text>The CSC may employ individuals to assist the SHOP Exchange.</text>
    </level>
    <level label="2">
      <text>A CSC employee authorized to assist the SHOP Exchange:</text>
      <level label="i">
        <text>may provide the services set forth in § 31–112(c)(1) of this subtitle, but may not initiate contact with a small employer for the purpose of soliciting the small employer to provide qualified plans offered by the SHOP Exchange to its employees;</text>
      </level>
      <level label="ii">
        <text>shall hold a SHOP Exchange enrollment permit;</text>
      </level>
      <level label="iii">
        <text>is not a SHOP Exchange navigator and may not hold a SHOP Exchange navigator license;</text>
      </level>
      <level label="iv">
        <text>may not be required to hold an insurance producer license; and</text>
      </level>
      <level label="v">
        <text>shall comply with the limitations set forth in § 31–112(c)(3) of this subtitle.</text>
      </level>
    </level>
    <level label="3">
      <level label="i">
        <text>The Commissioner shall issue a SHOP Exchange enrollment permit to each applicant who meets the requirements of this paragraph.</text>
      </level>
      <level label="ii">
        <text>To qualify for a SHOP Exchange enrollment permit, an applicant:</text>
        <level label="1">
          <text>shall be of good character and trustworthy;</text>
        </level>
        <level label="2">
          <text>shall be at least 18 years old;</text>
        </level>
        <level label="3">
          <text>shall pass the written examination given by the Commissioner to applicants for a SHOP navigator license under § 31–112(d)(2)(iii) of this subtitle;</text>
        </level>
        <level label="4">
          <text>shall be engaged by, and receive compensation only through, the CSC;</text>
        </level>
        <level label="5">
          <text>may not receive compensation from or otherwise be affiliated with a carrier, an insurance producer, a third–party administrator, or any other person connected to the insurance industry; and</text>
        </level>
        <level label="6">
          <text>shall complete, and comply with any ongoing requirements of, the training program established under § 31–112(h) of this subtitle.</text>
        </level>
      </level>
    </level>
    <level label="4">
      <text>The Commissioner’s duties and authority under § 31–112(d)(3) and (e) of this subtitle shall apply to CSC employees who hold a SHOP Exchange enrollment permit issued under this subsection.</text>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>The CSC may employ individuals to assist the Individual Exchange.</text>
    </level>
    <level label="2">
      <text>A CSC employee authorized to assist the Individual Exchange:</text>
      <level label="i">
        <text>may provide the services set forth in § 31–113(d) of this subtitle, but may not initiate contact with an individual for the purpose of soliciting the individual to enroll in a qualified plan offered by the Individual Exchange;</text>
      </level>
      <level label="ii">
        <text>shall hold an Individual Exchange enrollment permit;</text>
      </level>
      <level label="iii">
        <text>is not an Individual Exchange navigator and may not hold an Individual Exchange navigator certification;</text>
      </level>
      <level label="iv">
        <text>may not be required to hold an insurance producer or adviser license;</text>
      </level>
      <level label="v">
        <text>with respect to the insurance market outside the Exchange, shall comply with § 31–113(f)(8) of this subtitle;</text>
      </level>
      <level label="vi">
        <text>shall inquire whether an individual has health insurance obtained through an insurance producer and, if so, shall refer the individual to the insurance producer for information and services unless:</text>
        <level label="1">
          <text>the individual is eligible for, but has not obtained a federal premium subsidy and cost–sharing assistance, and the insurance producer is not authorized to sell qualified plans in the Individual Exchange; or</text>
        </level>
        <level label="2">
          <text>the individual would prefer not to seek further assistance from the individual’s insurance producer; and</text>
        </level>
      </level>
      <level label="vii">
        <text>shall comply with all State and federal laws, regulations, and policies governing the Maryland Medical Assistance Program and the Maryland Children’s Health Program.</text>
      </level>
    </level>
    <level label="3">
      <level label="i">
        <text>The Exchange shall issue an Individual Exchange enrollment permit to each applicant who meets the requirements of this paragraph.</text>
      </level>
      <level label="ii">
        <text>To qualify for an Individual Exchange enrollment permit, an applicant:</text>
        <level label="1">
          <text>shall be of good character and trustworthy;</text>
        </level>
        <level label="2">
          <text>shall be at least 18 years old;</text>
        </level>
        <level label="3">
          <text>shall be engaged by, and receive compensation only through, the CSC;</text>
        </level>
        <level label="4">
          <text>may not receive any compensation, directly or indirectly, from:</text>
        </level>
        <level label="A">
          <text>a carrier, an insurance producer, or a third–party administrator in connection with the enrollment of a qualified individual in a qualified health plan; or</text>
        </level>
        <level label="B">
          <text>a managed care organization that participates in the Maryland Medical Assistance Program in connection with the enrollment of an individual in the Maryland Medical Assistance Program or the Maryland Children’s Health Program; and</text>
        </level>
        <level label="5">
          <text>shall complete, and comply with any ongoing requirements of, the training program established under § 31–113(k) of this subtitle.</text>
        </level>
      </level>
    </level>
    <level label="4">
      <text>The Commissioner’s duties and authority under § 31–113(l) of this subtitle shall apply to CSC employees who hold an Individual Exchange enrollment permit issued under this subsection.</text>
    </level>
  </level>
  <level label="d">
    <text>The Exchange, the CSC, and CSC employees shall assist the Health Education and Advocacy Unit of the Office of the Attorney General in carrying out its duties to assist consumers under Title 13, Subtitle 4A of the Commercial Law Article and Title 15, Subtitles 10A and 10D of this article.</text>
  </level>
</section>
