Nonrenewal of plans

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    (a)    In this section, “product” means a discrete package of health benefits that are offered using a particular product network type within a geographic service area.

    (b)    A carrier that elects not to renew all of a particular product in the State shall:

        (1)    provide notice of the nonrenewal at least 90 days before the date of the nonrenewal to each affected:

            (i)    policyholder;

            (ii)    plan sponsor;

            (iii)    participant; and

            (iv)    beneficiary;

        (2)    offer to each affected plan sponsor the option to purchase any other health insurance coverage currently being offered by the carrier; and

        (3)    act uniformly without regard to the claims experience of any affected plan sponsor, or any health status–related factor of any affected individual.

    (c)    A carrier may elect not to renew all group health benefit plans in the State.

    (d)    When a carrier elects not to renew all group 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 groups in the State for a 5–year period beginning on the date of notice to the Commissioner.

    (e)    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.

    (f)    A carrier may make a uniform modification of coverage for a product only at the time of renewal of a health benefit plan.

    (g)    A carrier will not be considered to have elected not to renew all group health benefit plans in the State if the carrier complies with 45 C.F.R. § 147.106(d)(3).


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