Current through September 30, 2024
Section 800.10 - Basis and scope(a)Basis. This part is based on the following sections of title I of the Affordable Care Act: (1)1001. Amendments to the Public Health Service Act.(2)1302. Essential Health Benefits Requirements.(3)1311. Affordable Choices of Health Benefit Plans.(4)1324. Level Playing Field.(5)1334. Multi-State Plans.(6)1341. Transitional Reinsurance Program for Individual Market in Each State.(7)1342. Establishment of Risk Corridors for Plans in Individual and Small Group Markets.(8)1343. Risk Adjustment.(b)Scope. This part establishes standards for health insurance issuers to contract with the United States Office of Personnel Management (OPM) to offer Multi-State Plan (MSP) options to provide health insurance coverage on Exchanges for each State. It also establishes standards for appeal of a decision by OPM affecting the issuer's participation in the MSP Program and standards for an enrollee in an MSP option to appeal denials of payment or services by an MSP issuer.