45 CFR 156.265 - Enrollment process for qualified individuals.

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There are 17 Updates appearing in the Federal Register for 45 CFR 156. View below or at eCFR (GPOAccess)
§ 156.265 Enrollment process for qualified individuals.
(a) General requirement. A QHP issuer must process enrollment in accordance with this section.
(b) Enrollment through the Exchange for the individual market.
(1) A QHP issuer must enroll a qualified individual only if the Exchange—
(i) Notifies the QHP issuer that the individual is a qualified individual; and
(ii) Transmits information to the QHP issuer as provided in § 155.400(a) of this subchapter.
(2) If an applicant initiates enrollment directly with the QHP issuer for enrollment through the Exchange, the QHP issuer must either—
(i) Direct the individual to file an application with the Exchange in accordance with § 155.310, or
(ii) Ensure the applicant received an eligibility determination for coverage through the Exchange through the Exchange Internet Web site.
(c) Acceptance of enrollment information. A QHP issuer must accept enrollment information consistent with the privacy and security requirements established by the Exchange in accordance with § 155.260 and in an electronic format that is consistent with § 155.270.
(d) Premium payment. A QHP issuer must follow the premium payment process established by the Exchange in accordance with § 155.240.
(e) Enrollment information package. A QHP issuer must provide new enrollees an enrollment information package that is compliant with accessibility and readability standards established in § 155.230(b).
(f) Enrollment reconciliation. A QHP issuer must reconcile enrollment files with the Exchange no less than once a month in accordance with § 155.400(d).
(g) Enrollment acknowledgement. A QHP issuer must acknowledge receipt of enrollment information transmitted from the Exchange in accordance with Exchange standards established in accordance with § 155.400(b)(2) of this subchapter.

Title 45 published on 2012-10-01

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.

  • 2014-09-05; vol. 79 # 172 - Friday, September 5, 2014
    1. 79 FR 52994 - Patient Protection and Affordable Care Act; Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs; Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards Related to Exchanges
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      DEPARTMENT OF HEALTH AND HUMAN SERVICES, HHS, Centers for Medicare & Medicaid Services (CMS)
      Final rule.
      These regulations are effective on October 6, 2014.
      45 CFR Parts 146, 147, 148, 155, and 156

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United States Code

Title 45 published on 2012-10-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 45 CFR 156 after this date.

  • 2014-11-26; vol. 79 # 228 - Wednesday, November 26, 2014
    1. 79 FR 70674 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2016
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, HHS, Centers for Medicare & Medicaid Services (CMS)
      Proposed rule.
      To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on December 22, 2014.
      45 CFR Parts 144, 146, 147, 148, 153, 154, 155, 156 and 158