PARRIS N. GLENDENING, Governor

Ch. 294

(E) A CARRIER MAY ELECT NOT TO RENEW ALL INDIVIDUAL HEALTH
BENEFIT PLANS IN THE STATE

(F) WHEN A CARRIER ELECTS NOT TO RENEW ALL INDIVIDUAL HEALTH
BENEFIT PLANS IN THE STATE, THE CARRIER:

(1) SHALL GIVE NOTICE OF ITS DECISION TO THE AFFECTED
INDIVIDUALS AT LEAST 180 DAYS BEFORE THE EFFECTIVE DATE OF NONRENEWAL;

(2) AT LEAST 30 WORKING DAYS BEFORE THAT NOTICE, SHALL GIVE
NOTICE TO THE COMMISSIONER; AND

(3) MAY NOT WRITE NEW BUSINESS FOR INDIVIDUALS IN THE STATE
FOR A 5-YEAR PERIOD BEGINNING ON THE DATE OF NOTICE TO THE
COMMISSIONER.

(G) A HEALTH MAINTENANCE ORGANIZATION NEED NOT OFFER COVERAGE
TO AN INDIVIDUAL WHO DOES NOT LIVE, RESIDE, OR WORK WITHIN THE HEALTH
MAINTENANCE ORGANIZATION'S APPROVED SERVICE AREAS.

760,

(A) EXCEPT AS PROVIDED IN SUBSECTION (B) OF THIS SECTION, A CARRIER
SHALL RENEW AN INDIVIDUAL HEALTH BENEFIT PLAN AT THE OPTION OF THE
ELIGIBLE INDIVIDUAL

(B) A CARRIER MAY NOT CANCEL OR REFUSE TO RENEW AN INDIVIDUAL
HEALTH BENEFIT PLAN EXCEPT:

(1) FOR NONPAYMENT OF THE REQUIRED PREMIUMS;

(2) WHERE THE INDIVIDUAL HAS PERFORMED AN ACT OR PRACTICE
THAT CONSTITUTES FRAUD;

(3) WHERE THE INDIVIDUAL HAS MADE AN INTENTIONAL
MISREPRESENTATION OF MATERIAL FACT UNDER THE TERMS OF THE COVERAGE;

(4) WHERE THE CARRIER ELECTS NOT TO RENEW ALL OF ITS
INDIVIDUAL HEALTH BENEFIT PLANS IN THE STATE;

(5) WHERE THE ELIGIBLE INDIVIDUAL NO LONGER RESIDES, LIVES, OR
WORKS IN THE SERVICE AREA PROVIDED THAT THE COVERAGE IS TERMINATED
UNDER THIS PROVISION UNIFORMLY WITHOUT REGARD TO ANY HEALTH
STATUS-RELATED FACTOR OF COVERED INDIVIDUALS; OR

(6) WHERE, IN THE CASE OF HEALTH INSURANCE COVERAGE THAT IS
MADE AVAILABLE IN THE INDIVIDUAL MARKET ONLY THROUGH ONE OR MORE
BONA FIDE ASSOCIATIONS, THE MEMBERSHIP OF THE ELIGIBLE INDIVIDUAL IN THE
ASSOCIATION CEASES BUT ONLY IF SUCH COVERAGE IS TERMINATED UNDER THIS
PARAGRAPH UNIFORMLY WITHOUT REGARD TO ANY HEALTH STATUS-RELATED
FACTOR OF COVERED INDIVIDUALS.

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