<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".23" citation="COMAR 14.35.07.23" title_num="14" subtitle_num="35" chapter_num="07" heading="QHP Re-Enrollments—In General.">
  <paragraph num="A.">
    <text>The Exchange shall redetermine the eligibility of a qualified individual on an annual basis as specified in 45 CFR §155.335.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The Exchange shall provide a qualified individual with an annual redetermination notice as specified in 45 CFR §155.335(c) that adheres to the timing specified in 45 CFR §155.335(d).</text>
  </paragraph>
  <paragraph num="C.">
    <text>If an enrollee remains eligible for enrollment in a QHP through the Exchange upon annual redetermination, the Exchange shall re-enroll the enrollee according to 45 CFR §155.335(j), except as provided for in §E of this regulation.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Consumers eligible for re-enrollment may:</text>
    <paragraph num="(1)">
      <text>Change their plan during open enrollment;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If ineligible for automatic re-enrollment, manually re-enroll coverage by:</text>
      <paragraph num="(a)">
        <text>Re-enrolling online through the Maryland Health Connection Consumer Portal;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Re-enrolling with the assistance of an Individual Exchange Navigator, certified application counselor, or insurance producer; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Calling the MHC call center; or</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Decline re-enrollment.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Re-Enrollment into Higher Value Plans.</text>
    <paragraph num="(1)">
      <text>Unless the enrollee terminates coverage, including termination of coverage in connection with voluntarily selecting a different QHP in accordance with 45 CFR §155.430, the exchange shall follow the procedure detailed in §E(2) of this regulation to re-enroll an enrollee into a plan other than the enrollee's original plan or plan identified by the carrier pursuant to §F of this regulation if the enrollee:</text>
      <paragraph num="(a)">
        <text>Remains eligible for enrollment in a QHP through the Exchange upon annual redetermination;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Is determined, upon annual redetermination, eligible for cost-sharing reductions in accordance with 45 CFR §155.305(g);</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Is currently enrolled in a bronze level QHP that is not a high deductible health plan compatible with a health savings account as defined in 26 U.S.C. §223; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Would be re-enrolled in a bronze level QHP that is not a high deductible health plan compatible with a health savings account as defined in 26 U.S.C. §223 under §B of this regulation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The Exchange shall re-enroll enrollees that meet the criteria of §E(1) of this regulation in the QHP:</text>
      <paragraph num="(a)">
        <text>With the highest actuarial value available;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Within the same product;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>With the same provider network; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Which, compared to the original bronze level QHP into which the Exchange would otherwise re-enroll the enrollee under §B of this regulation, and after the application of advance payment of the premium tax credit and young adult subsidy under COMAR 14.35.19, has a premium that is:</text>
        <paragraph num="(i)">
          <text>Lower; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Equivalent.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>For QHPs that carriers plan to discontinue, enrollees in those QHPs shall be re-enrolled into QHPs determined by carrier-submitted plan re-enrollment templates according to COMAR 14.35.15.05O.</text>
  </paragraph>
</regulation>