211 CMR 41.08 - Discontinuing a Closed Guaranteed Issue Health Plan or a Closed Plan

Current through Register 1466, April 1, 2022

(1) A Carrier shall no longer offer, sell, or deliver a Health Plan to any person to whom it does not have such an obligation pursuant to an individual policy, contract or agreement with an employer or through a trust or association.

(2) Notwithstanding 211 CMR 41.08(1), a Closed Guaranteed Issue Health Plan or a Closed Plan shall be subject to all requirements of 211 CMR 41.06.

(3) All Closed Guaranteed Issue Health Plans and Closed Plans shall be renewable, unless such plans are discontinued.

(4) A Carrier may discontinue a Closed Guaranteed Issue Health Plan or a Closed Plan at the discretion of the Commissioner. A request to discontinue a Closed Guaranteed Issue Health Plan or a Closed Plan shall be submitted to the Commissioner in writing at least 120 days prior to the date on which the Carrier proposes to discontinue the Closed Guarantee Issue Health Plan or the Closed Plan, shall be certified by an officer of the Carrier and shall include:

(a) A list, by marketed name and/or policy form identification number, of each Closed Guaranteed Issue Health Plan or Closed Plan that the Carrier proposes to discontinue, including the date by which it proposes to discontinue each Closed Guaranteed Issue Health Plan or Closed Plan;

(b) The number of covered lives (Eligible Individuals and Eligible Dependents) in each Closed Guaranteed Issue Health Plan or Closed Plan that the Carrier proposes to discontinue;

(c) The written notice the Carrier proposes to send to affected Eligible Individuals at least 90 days prior to the date the Carrier proposes to discontinue the Closed Guaranteed Issue Health Plan or Closed Plan, which shall state in clear and unambiguous language:

1. The date on which the Carrier will discontinue coverage in the plan;

2. The Minimum Creditable Coverage requirements in the Commonwealth;

3. The ways an Eligible Individual may purchase a health benefit plan through the Connector or directly from the Carrier, if offering coverage in the market, or directly from any other Carrier offering health benefit plans for individuals in the Commonwealth; and

4. Information regarding open enrollment as applies to individual health plans, as set forth in M.G.L. c. 176J, § 4.

(5) The Commissioner may disapprove a Carrier's request to discontinue a Closed Guaranteed Issue Health Plan or a Closed Plan if the Carrier fails to comply with the requirements of 211 CMR 41.08(4), or if the Closed Guaranteed Issue Health Plan or Closed Plan originally was marketed in the Commonwealth as a guaranteed renewable product.

Notes

211 CMR 41.08