Skip to main content


Updated 03/12/2020

Frequently Asked Questions

  • 45 CFR 147.104 of the new guaranteed issue regulation does not allow you to base a member's eligibility upon not having another major medical policy. The only limitations on guaranteed issue are listed in 45 CFR 147.104. The regulation does not address coordination of benefits. The preamble to the final regulation points out that "Section 2724(a)(1) of the Public Health Services Act (PHS Act) provides that nothing in part A or part C of Title XXVII of the PHS Act should be construed to preempt any state law that does not prevent the application of a federal requirement." So Michigan's Coordination of Benefits Act and the coordination of benefits language in each contract would determine which coverage is primary.

  • Plans may be offered only off the Marketplace, but if a plan is offered on the Marketplace it must also be available off the Marketplace.