45 CFR §155.140

1. (a)Regional Exchange. A State may participate in a regional Exchange if:
   1. (1)The Exchange spans two or more States, regardless of whether the States are contiguous; and
   2. (2)The regional Exchange submits a single Exchange Blueprint and is approved to operate consistent with § 155.105(c).
2. (b)Subsidiary Exchange. A State may establish one or more subsidiary Exchanges within the State if:
   1. (1)Each such Exchange serves a geographically distinct area; and
   2. (2)The area served by each subsidiary Exchange is at least as large as a rating area described in section 2701(a) of the PHS Act.
3. (c)Exchange standards. Each regional or subsidiary Exchange must:
   1. (1)Otherwise meet the requirements of an Exchange consistent with this part; and
   2. (2)Meet the following standards for SHOP:
      1. (i)Perform the functions of a SHOP for its service area in accordance with subpart H of this part; and
      2. (ii)Encompass the same geographic area for its regional or subsidiary SHOP and its regional or subsidiary Exchange except:
         1. (A)In the case of a regional Exchange established pursuant to § 155.100(a)(2), the regional SHOP must encompass a geographic area that matches the combined geographic areas of the individual market Exchanges established to serve the same set of States establishing the regional SHOP; and
         2. (B)In the case of a subsidiary Exchange established pursuant to § 155.100(a)(2), the combined geographic area of all subsidiary SHOPs established in the State must encompass the geographic area of the individual market Exchange established to serve the State.