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45 CFR 156.290

§ 156.290 Non-certification and decertification of QHPs.

United States · 45 CFR — Public Welfare · Status: effective

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45 CFR 156.290, § 156.290 Non-certification and decertification of QHPs, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/217752
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(a) Non-certification for a subsequent, consecutive certification cycle. If a QHP issuer elects not to seek certification for a subsequent, consecutive certification cycle with the Exchange, the QHP issuer, at a minimum, must— (1) Notify the Exchange of its decision prior to the beginning of the recertification process and adhere to the procedures adopted by the Exchange in accordance with § 155.1075 of this subchapter; (2) Fulfill its obligation to cover benefits for each enrollee through the end of the plan or benefit year through the Exchange; (3) Fulfill data reporting obligations from the last plan or benefit year of the certification; (4) Provide notice to enrollees as described in paragraph (b) of this section; and (5) Terminate the coverage or enrollment through the Exchange of enrollees in the QHP in accordance with § 156.270, as applicable. (b) Notice of QHP non-availability. When, for a subsequent, consecutive certification cycle, a QHP issuer elects not to seek certification with the Exchange, or the Exchange denies certification of a QHP, the QHP issuer must provide written notice to each enrollee in the form and manner specified by the Secretary under § 147.106 of this subchapter. (c) Decertification. If a QHP is decertified by the Exchange, the QHP issuer must terminate the enrollment of enrollees through the Exchange only after: (1) The Exchange has made notification as described in § 155.1080 of this subchapter; and (2) Enrollees have an opportunity to enroll in other coverage.

Legislative history

This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.