PARRIS N. GLENDENING, Governor

Ch. 294

(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.

15-1310.

(A) A CARRIER SHALL PROVIDE WRITTEN CERTIFICATION OF CREDITABLE
COVERAGE

(B) THE CERTIFICATION OF CREDITABLE COVERAGE DESCRIBED IN
SUBSECTION (A) OF THIS SECTION SHALL BE PROVIDED:

(1) AUTOMATICALLY AT THE TIME AN INDIVIDUAL CEASES TO BE
COVERED UNDER THE HEALTH BENEFITS PLAN AND WITHIN A REASONABLE
PERIOD AFTER CESSATION OF COVERAGE; AND

(2) AT THE REQUEST OF THE INDIVIDUAL, IN NO EVENT LATER THAN 21
MONTHS AFTER THE DATE OF CESSATION OF THE COURAGE.

(1) AUTOMATICALLY AT THE TIME AN INDIVIDUAL CEASES TO BE
COVERED UNDER THE HEALTH BENEFITS PLAN OR OTHERWISE BECOMES COVERED
UNDER A COBRA CONTINUATION PROVISION:

(2) IN THE CASE OF AN INDIVIDUAL WHO BECOMES COVERED UNDER A
COBRA CONTINUATION PROVISION, AT THE TIME THE INDIVIDUAL CEASES TO BE
COVERED UNDER THE PROVISION: AND

(3) ON THE REQUEST ON BEHALF OF AN INDIVIDUAL MADE NOT LATER
THAN 24 MONTHS AFTER THE DATE OF CESSATION OF THE COVERAGE DESCRIBED
IN ITEM (1) OR (2) OF THIS SUBSECTION, WHICHEVER IS LATER.

(C) THE CERTIFICATION MAY BE PROVIDED AT A TIME CONSISTENT WITH
NOTICES REQUIRED UNDER ANY APPLICABLE STATE OR FEDERAL CONTINUATION
PROVISION.

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