---
kind: "section"
citation: "42 C.F.R. § 600.320"
title: "42"
number: "600.320"
heading: "Determination of eligibility for and enrollment in a standard health plan."
url: "https://uscodex.org/cfr/42/600.320"
---

# §600.320. Determination of eligibility for and enrollment in a standard health plan.

- (a) Determining eligibility to enroll in a standard health plan may be performed by a State or through delegation to a local governmental entity, including a governmental entity that determines eligibility for Medicaid or CHIP, and may be delegated by the State to an Exchange that is a government agency.
- (b) **Timely determinations.** The terms of [§ 435.912](/cfr/42/435.912.md) of this chapter (relating to timely determinations of eligibility under the Medicaid program) apply to eligibility determinations for enrollment in a standard health plan exclusive of § [435.912(c)(3)(i)](/cfr/42/435.912.md?p=c-3-i) and [(e)(3)](/cfr/42/435.912.md?p=c-e-3). The standards established by the State must be included in the BHP Blueprint.
- (c) **Effective date of eligibility.** The State must establish a uniform method of determining the effective date of eligibility for enrollment in a standard health plan which—
  - (1) Follows the Exchange effective date standards at [45 CFR 155.420(b)(1)](/cfr/45/155.420.md?p=b-1);
  - (2) Follows the Medicaid effective date standards at [§ 435.915](/cfr/42/435.915.md) of this chapter exclusive of [§ 435.915(a)](/cfr/42/435.915.md?p=a);or
  - (3) Follows an effective date of eligibility of the first day of the month following the month in which BHP eligibility is determined; or
  - (4) Follows an effective date of eligibility standard established by the State and subject to HHS approval to ensure that the effective date is:
    - (i) No later than the first day of the second month following the date that an individual has been determined BHP-eligible; and
    - (ii) **No more restrictive than paragraphs (c)(1) through (3) of this section.**
- (d) **Enrollment periods.** The State must either offer enrollment and special enrollment periods no more restrictive than those required for an Exchange at 45 CFR [155.410](/cfr/45/155.410.md) and [155.420](/cfr/45/155.420.md) or follow the Medicaid process permitting continuous open enrollment throughout the year.

## Notes

### Amendments

[79 FR 14140, Mar. 12, 2014, as amended at 89 FR 26419, Apr. 15, 2024; 91 FR 33482, June 3, 2026]

### Authority

Authority: 42 U.S.C. 300gg, 1395, and 18051.

### Source

Source: 79 FR 14140, Mar. 12, 2014, unless otherwise noted.

### Amendments

[79 FR 14140, Mar. 12, 2014, as amended at 89 FR 26419, Apr. 15, 2024; 91 FR 33482, June 3, 2026]