45 CFR 155.1055
§ 155.1055 Service area of a QHP.
United States · 45 CFR — Public Welfare · Status: effective
Cite this
- Citation
- 45 CFR 155.1055, § 155.1055 Service area of a QHP, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/217673
- Permanent ID
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Full text
The Exchange must have a process to establish or evaluate the service areas of QHPs to ensure such service areas meet the following minimum criteria:
(a) The service area of a QHP covers a minimum geographical area that is at least the entire geographic area of a county, or a group of counties defined by the Exchange, unless the Exchange determines that serving a smaller geographic area is necessary, nondiscriminatory, and in the best interest of the qualified individuals and employers.
(b) The service area of a QHP has been established without regard to racial, ethnic, language, health status-related factors specified under section 2705(a) of the PHS Act, or other factors that exclude specific high utilizing, high cost or medically-underserved populations.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.