<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 14.35.16.05" title_num="14" subtitle_num="35" chapter_num="16" heading="Qualified Health Plan Certification — Plan Service Areas.">
  <paragraph num="A.">
    <text>As part of a QHP certification application, an authorized carrier shall submit:</text>
    <paragraph num="(1)">
      <text>A description of the boundaries of the service area of any health benefit plan that is smaller than the State of Maryland; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>For any service area smaller than the State of Maryland, an explanation of the reason for the smaller service area, including a justification that the boundaries are not designed to discriminate against individuals excluded from the health benefit plan’s service area.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Carriers submitting a justification under §A(2) of this regulation are not required to submit a justification in subsequent years, after the initial justification submission, if there has been no change in the carrier’s health benefit plan service areas.</text>
  </paragraph>
  <paragraph num="C.">
    <text>After the initial data submission under Regulation .04E of this chapter, a change to a health benefit plan’s service area shall be made only by petition to the Exchange and:</text>
    <paragraph num="(1)">
      <text>Because the carrier cannot secure enough providers; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Because of an Exchange request to serve an unmet need.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>After the final data submission under Regulation .04E of this chapter, a change to the health benefit plan’s service area shall be permitted only if the change is an expansion of the health benefit plan’s service area.</text>
  </paragraph>
</regulation>