<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 14.35.14.07" title_num="14" subtitle_num="35" chapter_num="14" heading="Termination by Carrier.">
  <paragraph num="A.">
    <text>A carrier may only terminate an individual’s coverage in a QHP before receiving an instruction from the Exchange to terminate coverage:</text>
    <paragraph num="(1)">
      <text>If the enrollee requests termination of the enrollee’s enrollment to the carrier, and the termination follows the procedures in Regulation .04 of this chapter;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the enrollee’s coverage is rescinded under 45 CFR §147.128;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If the carrier is decertified by the Exchange under COMAR 14.35.16.11;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>If the carrier ceases to offer the QHP that an enrollee is enrolled in through the Exchange under 45 CFR §147.106(b)(4) and the carrier follows the requirements under 45 CFR §147.106(c);</text>
    </paragraph>
    <paragraph num="(5)">
      <text>If the carrier ceases to offer any QHPs through the Exchange under 45 CFR §147.106(b)(4) and the carrier follows the requirements under 45 CFR §147.106(d);</text>
    </paragraph>
    <paragraph num="(6)">
      <text>If the enrollee has performed an act or practice that constitutes fraud or intentional misrepresentation of material fact in connection with the coverage under 45 CFR §147.106(b)(2); or</text>
    </paragraph>
    <paragraph num="(7)">
      <text>For nonpayment of premiums as specified in §B of this regulation.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Termination for Nonpayment.</text>
    <paragraph num="(1)">
      <text>A carrier may terminate coverage for nonpayment of premium if the enrollee has not made applicable premium payments and at the time the enrollee first fails to pay premiums:</text>
      <paragraph num="(a)">
        <text>The enrollee is receiving APTC, and the 3-month grace period under Insurance Article, §15-1315(c)—(e), Annotated Code of Maryland, has been exhausted; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The enrollee is not receiving APTC and all other applicable grace periods under State law have been exhausted.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>A carrier may not terminate coverage for failure to make a premium payment if:</text>
      <paragraph num="(a)">
        <text>Through a renewal of the plan under 45 CFR §155.335, the enrollee maintains coverage in the same QHP or same product that is a uniform modification of coverage under Insurance Article, §15-1309(a)(4), Annotated Code of Maryland; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The applicable grace period has not been exhausted under:</text>
        <paragraph num="(i)">
          <text>Insurance Article, §15-1315(c)—(e), Annotated Code of Maryland; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Another applicable grace period under State law if the enrollee is not receiving APTC.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>The last day of coverage is:</text>
      <paragraph num="(a)">
        <text>The last day of the first month of the 3-month grace period when terminating an individual after exhaustion of the 3-month grace period for individuals receiving APTC; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>31 days after the missed premium payment was due when terminating an individual after the exhaustion of any other applicable grace period.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Notice of Non-Payment of Premiums. If an enrollee is delinquent on premium payment, the carrier shall provide the enrollee with notice of such payment delinquency. A carrier shall provide such notices promptly and without undue delay, within 10 business days of the date the issuer should have discovered the delinquency.</text>
  </paragraph>
</regulation>