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  • Code of Federal Regulations
  • C.F.R. Title 45—Public Welfare
  • SUBTITLE A—Department of Health and Human Services
  • SUBCHAPTER B—REQUIREMENTS RELATING TO HEALTH CARE ACCESS
  • PART 155—EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT
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Subpart D—Exchange Functions in the Individual Market: Eligibility Determinations for Exchange Participation and Insurance Affordability Programs

  • §155.300 Definitions and general standards for eligibility determinations.
  • §155.302 Options for conducting eligibility determinations.
  • §155.305 Eligibility standards.
  • §155.310 Eligibility process.
  • §155.315 Verification process related to eligibility for enrollment in a QHP through the Exchange.
  • §155.320 Verification process related to eligibility for insurance affordability programs.
  • §155.330 Eligibility redetermination during a benefit year.
  • §155.335 Annual eligibility redetermination.
  • §155.340 Administration of advance payments of the premium tax credit and cost-sharing reductions.
  • §155.345 Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition Insurance Plan.
  • §155.350 Special eligibility standards and process for Indians.
  • §155.355 Right to appeal.

About SCCE

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The Society of Corporate Compliance and Ethics (SCCE) is a non-profit, member-based professional association. SCCE supports our members' work with education, news, and discussion forums. We are a community of leaders, defining and shaping the corporate compliance environment across a wide range of industries and geographic regions. In developing and maintaining effective ethics and compliance programs, our members strengthen and protect their companies.

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About HCCA

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The Health Care Compliance Association (HCCA), is a 501(c)6 non-profit, member-based professional association. HCCA was established in 1996 and is headquartered in Minneapolis, MN. We provide training, certification, and other resources to over 10,000 members. Our members include compliance officers and staff from a wide range of organizations, including hospitals, research facilities, clinics and technology service providers.

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