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

Current through Register 2024 Notice Reg. No. 28, July 12, 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.
1. New section
				  filed 9-30-2013 as a deemed emergency pursuant to Government Code section
				  100504(a)(6);
				  operative 9-30-2013 (Register 2013, No. 40). A Certificate of Compliance must
				  be transmitted to OAL by 4-1-2014 or emergency language will be repealed by
				  operation of law on the following day.
2. New section, including
				  amendment of subsection (b), refiled 4-1-2014 as a deemed emergency pursuant to
				  Government Code section
				  100504(a)(6);
				  operative 4-1-2014 (Register 2014, No. 14). A Certificate of Compliance must be
				  transmitted to OAL by 6-30-2014 or emergency language will be repealed by
				  operation of law on the following day.
3. Refiling of 4-1-2014
				  action on 6-30-2014 as a deemed emergency pursuant to Government Code section
				  100504(a)(6);
				  operative 6-30-2014 (Register 2014, No. 27). A Certificate of Compliance must
				  be transmitted to OAL by 9-29-2014 or emergency language will be repealed by
				  operation of law on the following day.
4. New section refiled
				  9-30-2014 as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 9-30-2014
				  (Register 2014, No. 40). A Certificate of Compliance must be transmitted to OAL
				  by 9-30-2015 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
5. Editorial correction of HISTORY 4 (Register 2014, No.
				  45).
6. Editorial correction of HISTORY 4 (Register 2014, No.
				  50).
7. New section refiled 12-12-2014 as an emergency pursuant to
				  Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 12-12-2014
				  (Register 2014, No. 50). A Certificate of Compliance must be transmitted to OAL
				  by 9-30-2015 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
8. Refiling of 12-12-2014 action on 5-11-2015, including
				  amendment of subsection (b), as an emergency pursuant to Government Code
				  section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 5-11-2015
				  (Register 2015, No. 20). A Certificate of Compliance must be transmitted to OAL
				  by 9-30-2015 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
9. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 9-30-2016 or the language in the
				  emergency order of 5-11-2015 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
10. New section refiled
				  9-17-2015 as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31) and Senate Bill 75 (Stats.
				  2015, Ch. 18); operative 9-17-2015 (Register 2015, No. 38). A Certificate of
				  Compliance must be transmitted to OAL by 9-30-2016 pursuant to Government Code
				  section
				  100504 or
				  the language in the emergency order of 9-17-2015 will be repealed by operation
				  of law on the following day.
11. New section refiled 12-14-2015 as
				  an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31) and Senate Bill 75 (Stats.
				  2015, Ch. 18); operative 12-14-2015 (Register 2015, No. 51). A Certificate of
				  Compliance must be transmitted to OAL by 9-30-2016 pursuant to Government Code
				  section
				  100504 or
				  the language in the emergency order of 12-14-2015 will be repealed by operation
				  of law on the following day.
12. New section refiled (including
				  amendment of subsection (b)) on 6-6-2016 as an emergency pursuant to Government
				  Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31) and Senate Bill 75 (Stats.
				  2015, Ch. 18); operative 6-6-2016 (Register 2016, No. 24). A Certificate of
				  Compliance must be transmitted to OAL by 9-30-2016 pursuant to Government Code
				  section
				  100504 or
				  the language in the emergency order of 6-6-2016 will be repealed by operation
				  of law on the following day.
13. Senate Bill 833 (Stats. 2016, c.
				  30) modified Government Code section
				  100504(a)(6)
				  to extend the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Refiling of 6-6-2016 order on 9-30-2016 as a deemed emergency pursuant
				  to Government Code section
				  100504(a)(6);
				  operative 9-30-2016 (Register 2016, No. 40). A Certificate of Compliance must
				  be transmitted to OAL by 10-1-2018 pursuant to Government Code section
				  100504(a)(6)
				  or emergency language will be repealed by operation of law on the following
				  day.
14. New section refiled (including amendment of subsection (a))
				  on 2-16-2017 as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 833 (Stats. 2016, c. 30), Senate Bill 75 (Stats.
				  2015, c. 18) and Senate Bill 857 (Stats. 2014, c. 31); operative 2-16-2017
				  (Register 2017, No. 7). A Certificate of Compliance must be transmitted to OAL
				  by 10-1-2018 pursuant to Government Code section
				  100504(a)(6)
				  or the language in the emergency order of 2-16-2017 will be repealed by
				  operation of law on the following day.
15. New section refiled
				  (including subsequent amendments) on 10-26-2017 as an emergency pursuant to
				  Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 833 (Stats. 2016, c. 30), Senate Bill 75 (Stats.
				  2015, c. 18) and Senate Bill 857 (Stats. 2014, c. 31); operative 10-26-2017
				  (Register 2017, No. 43). A Certificate of Compliance must be transmitted to OAL
				  by 10-1-2018 pursuant to Government Code section
				  100504(a)(6)
				  or the language in the emergency order of 10-26-2017 will be repealed by
				  operation of law on the following day.
16. Certificate of Compliance
				  as to 10-26-2017 order, including amendment of NOTE, transmitted to OAL
				  8-10-2018 and filed 9-24-2018; amendments effective 9-24-2018 pursuant to
				  Government Code section
				  11343.4(b)(3)
				  (Register 2018, No. 39).
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.