§147.128. Rules regarding rescissions. — Inbound Citations

(i) An adverse benefit determination means an adverse benefit determination as defined in 29 CFR 2560.503-1, as well as any rescission of coverage, as described in § 147.128 (whether or not, in connection with the rescission, there is an adverse effect on any particular benefit at that time).

(2) Situations allowing for a rescission as specified in 45 CFR 147.128.

(iii) The enrollee's coverage is rescinded in accordance with § 147.128 of this subchapter, after a QHP issuer demonstrates, to the reasonable satisfaction of the Exchange, if required by the Exchange, that the rescission is appropriate;

(v) The enrollee's coverage is rescinded in accordance with § 147.128 of this subtitle.