45 CFR §155.515
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (a)Requirement to provide notice of appeal procedures. The Exchange must provide notice of appeal procedures at the time that the—
- (1)Applicant submits an application; and
- (2)Notice of eligibility determination is sent under §§ 155.310(g), 155.330(e)(1)(ii), 155.335(h)(1)(ii), and 155.610(i).
- (b)General content on right to appeal and appeal procedures. Notices described in paragraph (a) of this section must contain—
- (1)An explanation of the applicant or enrollee's appeal rights under this subpart;
- (2)A description of the procedures by which the applicant or enrollee may request an appeal;
- (3)Information on the applicant or enrollee's right to represent himself or herself, or to be represented by legal counsel or another representative;
- (4)An explanation of the circumstances under which the appellant's eligibility may be maintained or reinstated pending an appeal decision, as described in § 155.525; and
- (5)An explanation that an appeal decision for one household member may result in a change in eligibility for other household members and that such a change will be handled as a redetermination of eligibility for all household members in accordance with the standards specified in § 155.305.