§156.290. Non-certification and decertification of QHPs.
45 C.F.R. § 156.290
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—
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;
Fulfill its obligation to cover benefits for each enrollee through the end of the plan or benefit year through the Exchange;
Fulfill data reporting obligations from the last plan or benefit year of the certification;
Provide notice to enrollees as described in paragraph (b) of this section; and
Terminate the coverage or enrollment through the Exchange of enrollees in the QHP in accordance with § 156.270, as applicable.
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.
Decertification. If a QHP is decertified by the Exchange, the QHP issuer must terminate the enrollment of enrollees through the Exchange only after:
The Exchange has made notification as described in § 155.1080 of this subchapter; and
Enrollees have an opportunity to enroll in other coverage.
Notes, amendments, and revision history
Amendments
[77 FR 18469, Mar. 27, 2012, as amended at 80 FR 10875, Feb. 27, 2015; 81 FR 94181, Dec. 22, 2016]
Source
Source: 77 FR 18469, Mar. 27, 2012, unless otherwise noted.
Authority
Authority: 42 U.S.C. 18021-18024, 18031-18032, 18041-18042, 18044, 18054, 18061, 18063, 18071, 18082, and 26 U.S.C. 36B.
Source
Source: 76 FR 77411, Dec. 13, 2011, unless otherwise noted.
Amendments
[77 FR 18469, Mar. 27, 2012, as amended at 80 FR 10875, Feb. 27, 2015; 81 FR 94181, Dec. 22, 2016]