---
kind: "section"
citation: "45 C.F.R. § 155.140"
title: "45"
number: "155.140"
heading: "Establishment of a regional Exchange or subsidiary Exchange."
url: "https://uscodex.org/cfr/45/155.140"
---

# §155.140. Establishment of a regional Exchange or subsidiary Exchange.

- (a) **Regional Exchange.** A State may participate in a regional Exchange if:
  - (1) The Exchange spans two or more States, regardless of whether the States are contiguous; and
  - (2) The regional Exchange submits a single Exchange Blueprint and is approved to operate consistent with [§ 155.105(c)](/cfr/45/155.105.md?p=c).
- (b) **Subsidiary Exchange.** A State may establish one or more subsidiary Exchanges within the State if:
  - (1) Each such Exchange serves a geographically distinct area; and
  - (2) The area served by each subsidiary Exchange is at least as large as a rating area described in [section 2701(a)](/cfr/45/2701.md?p=a) of the PHS Act.
- (c) **Exchange standards.** Each regional or subsidiary Exchange must:
  - (1) Otherwise meet the requirements of an Exchange consistent with this part; and
  - (2) **Meet the following standards for SHOP—**
    - (i) Perform the functions of a SHOP for its service area in accordance with subpart H of this part; and
    - (ii) Encompass the same geographic area for its regional or subsidiary SHOP and its regional or subsidiary Exchange except:
      - (A) In the case of a regional Exchange established pursuant to [§ 155.100(a)(2)](/cfr/45/155.100.md?p=a-2), the regional SHOP must encompass a geographic area that matches the combined geographic areas of the individual market Exchanges established to serve the same set of States establishing the regional SHOP; and
      - (B) In the case of a subsidiary Exchange established pursuant to [§ 155.100(a)(2)](/cfr/45/155.100.md?p=a-2), the combined geographic area of all subsidiary SHOPs established in the State must encompass the geographic area of the individual market Exchange established to serve the State.

## Notes

### Amendments

[77 FR 18444, Mar. 27, 2012, as amended at 78 FR 54134, Aug. 30, 2013]

### Authority

Authority: 42 U.S.C. 18021-18024, 18031-18033, 18041-18042, 18051, 18054, 18071, and 18081-18083.

### Source

Source: 77 FR 11718, Feb. 27, 2012, unless otherwise noted.

### Amendments

[77 FR 18444, Mar. 27, 2012, as amended at 78 FR 54134, Aug. 30, 2013]