<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".17" citation="COMAR 31.17.03.17" title_num="31" subtitle_num="17" chapter_num="03" heading="Termination of Coverage.">
  <paragraph num="A.">
    <text>Termination of Plan Coverage for Nonpayment of Premium. A member's coverage automatically terminates at the end of the grace period if a premium is not received before the end of the grace period.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Termination of Plan Coverage for Specified Causes.</text>
    <paragraph num="(1)">
      <text>A member's coverage under the Plan terminates at the end of the month in which any of the following occur:</text>
      <paragraph num="(a)">
        <text>For a dependent child, other than a child who is unable to self support due to physical or mental incapacity, when the dependent child reaches the limiting age found in the member's certificate of coverage; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The member ceases to be a resident of the State.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>A member's coverage shall terminate under the Plan if:</text>
      <paragraph num="(a)">
        <text>The member or the member's covered dependent has performed an act or practice that constitutes fraud;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The member has made an intentional misrepresentation of material fact in the application for Plan coverage;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The member becomes covered under other coverage that is substantially similar to the coverage of the Plan;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The member becomes eligible for employer sponsored coverage that includes benefits comparable to Plan benefits, unless the member is eligible for the tax credit for health insurance costs under §35 of the Internal Revenue Code; or</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The member becomes eligible for coverage under Medicare, the Maryland Medical Assistance Program, or the Maryland Children's Health Program.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>If a member's coverage terminates for one of the reasons described in §B(2)(a)—(e) of this regulation, coverage for the member and any of the member's dependents ends following notice from the Plan administrator on the following dates:</text>
      <paragraph num="(a)">
        <text>If the Plan administrator gives notice of termination before the 15th day of a month, at the end of that month; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If the Plan administrator gives notice of termination on or after the 15th day of a month, at the end of the following month.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Termination for Moving Out of the Service Area.</text>
    <paragraph num="(1)">
      <text>If the Board selects a health maintenance organization to be one of the standard benefit packages offered under the Plan, a member's coverage under the Plan terminates at the end of the month when the member moves out of the service area of the health maintenance organization.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If a member's coverage under the Plan terminates for the reason described in §C(1) of this regulation, the member shall be given an option to enroll immediately into one of the other standard benefit packages offered by the Plan, if the member continues to reside within the State.</text>
    </paragraph>
  </paragraph>
</regulation>