Regulation .03 Opportunity for a Fair Hearing.
Regulation .03 Opportunity for a Fair Hearing.LinkCopy Citation
A.
An opportunity for a fair hearing shall be granted if an applicant claims that:
(1)
The determination or redetermination received from the Exchange of the applicant’s eligibility for enrollment in a qualified health plan is incorrect;
(2)
The determination or redetermination received from the Exchange of the applicant’s eligibility for an insurance affordability program is incorrect; or
(3)
The determination or redetermination received from the Exchange of the applicant’s eligibility for enrollment in a qualified health plan or an insurance affordability program is untimely as set forth in applicable law.
B.
The administrative law judge need not grant a fair hearing if the sole issue is a federal or State law requiring an automatic change adversely affecting some or all applicants.