651 CMR, § 15.13 - Termination

(1) Voluntary Termination of Enrollment. A Member or his or her authorized representative may request in writing at any time that his or her enrollment in the Plan be terminated. Such termination shall be effective as of the first calendar day of the month following receipt by the Plan of the written request. The Plan shall mail written confirmation to the Member or his or her authorized representative regarding such termination from the Plan.

(2) Involuntary Termination of Enrollment. The Plan may terminate the enrollment of a Member and render a written determination which sets forth the legal, regulatory and/or policy basis for such determination, for any of the following reasons:

(a) a determination that a Member no longer meets the eligibility standards set forth in 651 CMR 15.04;

(b) non-payment of Enrollment Fees pursuant to 651 CMR 15.07(2), if applicable;

(c) failure to comply with requirements under 651 CMR 15.11;

(d) failure to submit re-determination information under 651 CMR 15.12;

(e) a finding that a Member has committed fraud under 651 CMR 15.16 (such Member is prohibited from re-enrolling into the Plan);

(f) mail sent to a Member or his or her authorized representative is returned as undeliverable with no forwarding address and other reasonable attempts to locate the Member have failed.

Notes

651 CMR, § 15.13

Amended by Mass Register Issue 1327, eff. 12/2/2016.