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14.35.14.00.htm 14.35.14.00. Title 14 INDEPENDENT AGENCIES Subtitle 35 MARYLAND HEALTH BENEFIT EXCHANGE Chapter 14 Eligibility Standards for Enrollment in Qualified Health Plans, Advance Payments of the Premium Tax Credit, and Cost-Sharing Reductions Authority: Insurance Article, §31-106 and 31-108, Annotated Code of Maryland
14.35.14.01.htm 14.35.14.01. 01 Scope.. This chapter sets forth the eligibility standards for enrollment in qualified health plans, advance payments of the premium tax credit, and cost-sharing reductions.
14.35.14.02.htm 14.35.14.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) “Advance payments of the premium tax credit” means payment of the federal tax credits specified in §36B of the Internal Revenue Code (as added by §1401 of the Affordable Care Act) which are provided on an advance basis to an eligible individual enrolled in a qualified health plan through an Exchange in accordance with §1412 of the Affordable Care Act.2) “Affordable Care Act”
14.35.14.03.htm 14.35.14.03. 03 Eligibility Requirements for Enrollment in a Qualified Health Plan.. The Maryland Health Benefit Exchange shall determine an applicant’s eligibility for enrollment in a qualified health plan based on the criteria set forth under 45 CFR. §155.305(a)
14.35.14.04.htm 14.35.14.04. 04 Eligibility for Qualified Health Plan Enrollment Periods.. The Exchange shall determine an applicant eligible for an enrollment period if he or she meets the criteria for an annual enrollment period, as specified in 45 CFR §155.410, or for a special enrollment period, as specified in 45 CFR §155.420 and the Maryland Health Benefit Exchange’s Procedures on Eligibility and Enrollment ― Special Enrollment Periods.
14.35.14.05.htm 14.35.14.05. 05 Eligibility Requirements for Advance Payments of the Premium Tax Credit.. The Maryland Health Benefit Exchange shall determine a tax filer’s eligibility for advance payments of the premium tax credit based on the criteria set forth under 45. CFR §155.305(f) and 26 CFR §1.36B-2.
14.35.14.06.htm 14.35.14.06. 06 Eligibility Requirements for Cost-Sharing Reductions.. A. The Maryland Health Benefit Exchange shall determine an applicant’s eligibility for cost-sharing reductions based on the criteria set forth under 45 CFR §155.305(g)B. Where an applicant is an Indian, the Maryland Health Benefit Exchange shall determine the applicant’s eligibility for any cost-sharing reductions based on the criteria set forth under 45 CFR §155.350.
14.35.14.07.htm 14.35.14.07. 07 Eligibility Requirements for Enrollment in a Catastrophic Plan.. The Maryland Health Benefit Exchange shall determine an applicant’s eligibility for enrollment in a catastrophic plan based on the criteria set forth under 45 CFR §155.305(h)
14.35.14.9999.htm 14.35.14.9999. Administrative History Effective date: June 8, 2015 (42:11 Md. R. 726).
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