45 CFR 155.725 - Enrollment periods under SHOP.

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There are 7 Updates appearing in the Federal Register for 45 CFR 155. View below or at eCFR (GPOAccess)
§ 155.725 Enrollment periods under SHOP.
(a) General requirements. The SHOP must—
(1) Adhere to the start of the initial open enrollment period set forth in § 155.410;
(2) Ensure that enrollment transactions are sent to QHP issuers and that such issuers adhere to coverage effective dates in accordance with § 156.260 of this subchapter; and
(3) Provide the special enrollment periods described in § 155.420 excluding paragraphs (d)(3) and (6).
(b) Rolling enrollment in the SHOP. The SHOP must permit a qualified employer to purchase coverage for its small group at any point during the year. The employer's plan year must consist of the 12-month period beginning with the qualified employer's effective date of coverage.
(c) Annual employer election period. The SHOP must provide qualified employers with a period of no less than 30 days prior to the completion of the employer's plan year and before the annual employee open enrollment period, in which the qualified employer may change its participation in the SHOP for the next plan year, including—
(1) The method by which the qualified employer makes QHPs available to qualified employees pursuant to § 155.705(b)(2) and (3);
(2) The employer contribution towards the premium cost of coverage;
(3) The level of coverage offered to qualified employees as described in § 155.705(b)(2) and (3); and
(4) The QHP or QHPs offered to qualified employees in accordance with § 155.705.
(d) Annual employer election period notice. The SHOP must provide notification to a qualified employer of the annual election period in advance of such period.
(e) Annual employee open enrollment period. The SHOP must establish a standardized annual open enrollment period of no less than 30 days for qualified employees prior to the completion of the applicable qualified employer's plan year and after that employer's annual election period.
(f) Annual employee open enrollment period notice. The SHOP must provide notification to a qualified employee of the annual open enrollment period in advance of such period.
(g) Newly qualified employees. The SHOP must provide an employee who becomes a qualified employee outside of the initial or annual open enrollment period an enrollment period to seek coverage in a QHP beginning on the first day of becoming a qualified employee.
(h) Effective dates. The SHOP must establish effective dates of coverage for qualified employees consistent with the effective dates of coverage described in § 155.720.
(i) Renewal of coverage. If a qualified employee enrolled in a QHP through the SHOP remains eligible for coverage, such employee will remain in the QHP selected the previous year unless—
(1) The qualified employee terminates coverage from such QHP in accordance with standards identified in § 155.430;
(2) The qualified employee enrolls in another QHP if such option exists; or
(3) The QHP is no longer available to the qualified employee.

Title 45 published on 2013-10-01

The following are only the Rules published in the Federal Register after the published date of Title 45.

For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.

  • 2014-07-24; vol. 79 # 142 - Thursday, July 24, 2014
    1. 79 FR 42984 - Patient Protection and Affordable Care Act; Exchange and Insurance Market Standards for 2015 and Beyond; Correction
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES
      Final rule; correction.
      These corrections are effective on July 28, 2014.
      45 CFR Parts 144, 146, 147, 148, 153, 154, 155, 156, and 158

Title 45 published on 2013-10-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 45 CFR 155 after this date.

  • 2014-07-24; vol. 79 # 142 - Thursday, July 24, 2014
    1. 79 FR 42984 - Patient Protection and Affordable Care Act; Exchange and Insurance Market Standards for 2015 and Beyond; Correction
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES
      Final rule; correction.
      These corrections are effective on July 28, 2014.
      45 CFR Parts 144, 146, 147, 148, 153, 154, 155, 156, and 158