California Code of Regulations
Title 10 - Investment
Chapter 12 - California Health Benefit Exchange
Article 7 - Appeals Process for the Individual Exchange
Section 6608 - Eligibility Pending Appeal

Universal Citation: 10 CA Code of Regs 6608

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) Upon receipt of a valid appeal request or notice under Section 6606(e)(2) that concerns an appeal of a redetermination under Sections 6496(h) or 6498(j) of Article 5 of this chapter or an appeal of an erroneous termination of enrollment, the Exchange shall continue to consider the appellant eligible while the appeal is pending in accordance with standards set forth in subdivision (b) of this section.

(b) If the tax filer or appellant, as applicable, accepts eligibility pending an appeal and agrees to make their premium payments, reduced by the APTC amount they are determined eligible for by the Exchange, by the applicable payment due dates, the Exchange shall continue the appellant's eligibility for enrollment in a QHP, APTC, and CSR, as applicable, in accordance with the level of eligibility immediately before the redetermination being appealed.

Note: Authority cited: Section 100504, Government Code. Reference: Sections 100503 and 100506, Government Code; 26 CFR Section 1.36B-4; and 45 CFR Section 155.525.

Note: Authority cited: Section 100504, Government Code. Reference: Sections 100503 and 100506, Government Code; 26 CFR Section 1.36B-4; and 45 CFR Section 155.525.

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