C.F.R. » Title 45 » SUBCHAPTER B—REQUIREMENTS RELATING TO HEALTH CARE ACCESS › PART 155—EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT › Subpart K—Exchange Functions: Certification of Qualified Health Plans

45 C.F.R. § 155.1010

Certification process for QHPs

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(a) Certification procedures. The Exchange must establish procedures for the certification of QHPs consistent with § 155.1000(c).

(1) Completion date. The Exchange must complete the certification of the QHPs that will be offered during the open enrollment period prior to the beginning of such period, as outlined in § 155.410.

(2) Ongoing compliance. The Exchange must monitor the QHP issuers for demonstration of ongoing compliance with the certification requirements in § 155.1000(c).

(b) Exchange recognition of plans deemed certified for participation in an Exchange. Notwithstanding paragraph (a) of this section, an Exchange must recognize as certified QHPs:

(1) A multi-State plan certified by and under contract with the U.S. Office of Personnel Management.

(2) A CO-OP QHP as described in subpart F of part 156 and deemed as certified under § 156.520(e).

Notes of Decisions
Cited in 1 case (1 in the last 5 years), 2021–2021 · leading case: Texas Med. Resources, LLP Texas Physician Resources, LLP & Pediatric Emergency Med. Grp., LLP v. Molina Healthcare of Texas, Inc. (Tex. App. 2021).
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Texas Med. Resources, LLP Texas Physician Resources, LLP & Pediatric Emergency Med. Grp., LLP v. Molina Healthcare of Texas, Inc. (Tex. App. 2021). · cites it 2× “071; 45 C.F.R. § 155.1010 . The ACA strives to provide affordable insurance for underserved citizens.”
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