50 Ill. Adm. Code 4500.60
Non-certification of QHPs
Section 4500.60
Non-certification of QHPs
a) If a
QHP issuer elects not to seek certification for a subsequent, consecutive
certification cycle within the Exchange, the QHP issuer, at a minimum, must:
1) Notify
the Exchange of its decision before the beginning of the recertification
process, and no later than the deadline specified in 215 ILCS 97/60, and adhere
to the procedures adopted by the Exchange under 45 CFR 155.1075 (Feb. 27, 2015)
(no later editions or amendments);
2) fulfill
its obligation to cover benefits for each enrollee through the end of the plan
or benefit year through the Exchange;
3) fulfill
data reporting obligations from the last plan or benefit year of the
certification;
4) provide notice to
enrollees as described in subsection (b); and
5) terminate
the coverage or enrollment through the Exchange of enrollees in the QHP in
accordance with 45 CFR 156.270 (Apr. 27, 2023) (no later editions or
amendments), as applicable (see 45 CFR 156.290(a) (Dec. 22, 2016) (no later
editions or amendments)).
b) When,
for a subsequent, consecutive certification cycle, a QHP issuer elects not to
seek certification with the Exchange, or the Exchange denies certification of a
QHP, the QHP issuer must provide written notice to each enrollee in the form
and manner specified in 50 Ill. Adm. Code 2025 (see 45 CFR 156.290(b)).