45 CFR §155.10
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (a)Basis. This part is based on the following sections of title I of the Affordable Care Act:
- (1)1301. Qualified health plan defined
- (2)1302. Essential health benefits requirements
- (3)1303. Special rules
- (4)1304. Related definitions
- (5)1311. Affordable choices of health benefit plans.
- (6)1312. Consumer choice
- (7)1313. Financial integrity.
- (8)1321. State flexibility in operation and enforcement of Exchanges and related requirements.
- (9)1322. Federal program to assist establishment and operation of nonprofit, member-run health insurance issuers.
- (10)1331. State flexibility to establish Basic Health Programs for low-income individuals not eligible for Medicaid.
- (11)1334. Multi-State plans.
- (12)1402. Reduced cost-sharing for individuals enrolling in QHPs.
- (13)1411. Procedures for determining eligibility for Exchange participation, advance premium tax credits and reduced cost sharing, and individual responsibility exemptions.
- (14)1412. Advance determination and payment of premium tax credits and cost-sharing reductions.
- (15)1413. Streamlining of procedures for enrollment through an exchange and State Medicaid, CHIP, and health subsidy programs.
- (b)Scope. This part establishes minimum standards for the establishment of an Exchange, minimum Exchange functions, eligibility determinations, enrollment periods, minimum SHOP functions, certification of QHPs, and health plan quality improvement.