Exchange Responsibilities. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 C.F.R. § 155.105 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including, the California Affordable Care Act and the Affordable Care Act. The duties of the Exchange shall include those relating to: non- interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120), consultation with stakeholders (45 C.F.R. § 155.130), financial support for continued operations of the Exchange (45 C.F.R. § 155.160), oversight, financial and quality activities (45 C.F.R. § 155.200), consumer assistance tools and programs, including, but not limited to operation of a toll-free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)), navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210), participation of brokers to enroll qualified individuals or employers in Certified QHPs (45 C.F.R. § 155.220), notices to Enrollees (45 C.F.R. § 155.230), payment of premiums (45 C.F.R. § 155.240), privacy and security of personally identifiable information (45 C.F.R. § 155.260), use of standards and protocols for electronic transactions (45 C.F.R. § 155.270), eligibility and enrollment, as well as exemption determinations in the Individual Exchange and Small Business Health Options Program (“SHOP”) (45 C.F.R. Part 155, Subparts D, E, H, I), and certification of QHPs (45 C.F.R. Part 155, Subpart K). The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a health plan and benefit design in the Exchange. The Exchange shall solicit comment from the Contractor on the designs, but shall make design and presentation decisions at its sole discretion.
Appears in 5 contracts
Samples: Qualified Health Plan Contract, Qualified Health Plan Contract, Qualified Health Plan Contract
Exchange Responsibilities. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 C.F.R. § 155.105 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including, the California Affordable Care Act and the Affordable Care Act. The duties of the Exchange shall include those relating to: non- interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120), consultation with stakeholders (45 C.F.R. § 155.130), financial support for continued operations of the Exchange (45 C.F.R. § 155.160), oversight, financial and quality activities (45 C.F.R. § 155.200), consumer assistance tools and programs, including, but not limited to operation of a toll-free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)), navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210), participation of brokers to enroll qualified individuals or employers in Certified QHPs SADPs (45 C.F.R. § 155.220), notices to Enrollees (45 C.F.R. § 155.230), payment of premiums (45 C.F.R. § 155.240), privacy and security of personally identifiable information (45 C.F.R. § 155.260), use of standards and protocols for electronic transactions (45 C.F.R. § 155.270), eligibility and enrollment, as well as exemption determinations in the Individual Exchange and Small Business Health Options Program (“SHOP”) (45 C.F.R. Part 155, Subparts D, E, H, I), and certification of QHPs SADPs (45 C.F.R. Part 155, Subpart KK and 45 CFR 155.1065). The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a health plan Stand-Alone Dental Plan and benefit design in the Exchange. The Exchange shall solicit comment from the Contractor on the designs, but shall make design and presentation decisions at its sole discretion.
Appears in 2 contracts
Samples: Stand Alone Dental Plan Contract, Stand Alone Dental Plan Contract
Exchange Responsibilities. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 42 C.F.R. § 155.105 155.106 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including, the California Affordable Care Act and the Affordable Care Act. The duties of the Exchange shall include those relating to: non- interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120), consultation with stakeholders (45 C.F.R. § 155.130), financial support for continued operations of the Exchange (45 C.F.R. § 155.160), oversight, financial and quality activities (45 C.F.R. § 155.200), consumer assistance tools and programs, including, but not limited to operation of a toll-free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)), navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210155.205), participation of brokers to enroll qualified individuals or employers in Certified QHPs (45 C.F.R. § 155.220), notices to Enrollees (45 C.F.R. § 155.230), payment of premiums (45 C.F.R. § 155.240), privacy and security of personally identifiable information (45 C.F.R. § 155.260), use of standards and protocols for electronic transactions (45 C.F.R. § 155.270), eligibility and enrollment, as well as exemption determinations in the Individual Exchange and Small Business Health Options Program (“SHOP”) (45 C.F.R. Part 155, Covered California – Draft Health Plan Contract -- April 22, 2013April 298, 2013 Subparts D, E, H, I), and certification of QHPs (45 C.F.R. Part 155, Subpart K). The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a health plan and benefit design in the Exchange. The Exchange shall solicit comment from the Contractor on the designs, but shall make design and presentation decisions at its sole discretion.
Appears in 1 contract
Samples: Qualified Health Plan Contract
Exchange Responsibilities. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 C.F.R. § 155.105 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including, the California Affordable Affo rdable Care Covered California – Final HealthFinal SADP Plan Contract – May 6August 190, 2013 5 Act and the Affordable Care Act. The duties of the Exchange shall include those relating to: non- interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120), consultation with stakeholders (45 C.F.R. § 155.130), financial support for continued operations of the Exchange (45 C.F.R. § 155.160), oversight, financial and quality activities (45 C.F.R. § 155.200), consumer assistance tools and programs, including, but not limited to operation of a toll-free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)), navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210), participation of brokers to enroll qualified individuals or employers in Certified QHPs SADPs (45 C.F.R. § 155.220), notices to Enrollees (45 C.F.R. § 155.230), payment of premiums (45 C.F.R. § 155.240), privacy and security of personally identifiable information (45 C.F.R. § 155.260), use of standards and protocols for electronic transactions (45 C.F.R. § 155.270), eligibility and enrollment, as well as exemption determinations in the Individual Exchange and Small Business Health Options Program (“SHOP”) (45 C.F.R. Part 155, Subparts D, E, H, I), and certification of QHPs SADPs (45 C.F.R. Part 155, Subpart KK and 45 CFR 155.1065). The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a health plan Stand-Alone Dental Plan and benefit design in the Exchange. The Exchange shall solicit comment from the Contractor on the designs, but shall make design and presentation decisions at its sole discretion.
Appears in 1 contract
Samples: Stand Alone Dental Plan Contract
Exchange Responsibilities. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 452 C.F.R. § 155.105 155.1056 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including, the California Affordable Care Act and the Affordable Care Act. The duties of the Exchange shall include those relating to: non- interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120), consultation with stakeholders (45 C.F.R. § 155.130), financial support for continued operations of the Exchange (45 C.F.R. § 155.160), oversight, financial and quality activities (45 C.F.R. § 155.200), consumer assistance tools and programs, including, but not limited to operation of a toll-free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)), navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210155.21005), participation of brokers to enroll qualified individuals or employers in Certified QHPs (45 C.F.R. § 155.220), notices to Enrollees (45 C.F.R. § 155.230), payment of premiums (45 C.F.R. § 155.240), privacy and security of personally identifiable information (45 C.F.R. § 155.260), use of standards and protocols for electronic transactions (45 C.F.R. § 155.270), eligibility and enrollment, as well as exemption determinations in the Individual Exchange and Small Business Health Options Program (“SHOP”) (45 C.F.R. Part 155, Subparts D, E, H, I), and certification of QHPs (45 C.F.R. Part 155, Subpart K). The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a health plan and benefit design in the Exchange. The Exchange shall solicit comment from the Contractor on the designs, but shall make design and presentation decisions at its sole discretion.
Appears in 1 contract
Samples: Qualified Health Plan Contract
Exchange Responsibilities. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 C.F.R. § 155.105 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including, the California Affordable Care Act and the Affordable Care Act. The duties of the Exchange shall include those relating to: non- interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120), consultation with stakeholders (45 C.F.R. § 155.130), financial support for continued operations of the Exchange (45 C.F.R. § 155.160), oversight, financial and quality activities (45 C.F.R. § 155.200), consumer assistance tools and programs, including, but not limited to operation of a toll-free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)), navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210), participation of brokers to enroll qualified individuals or employers in Certified QHPs QDPs (45 C.F.R. § 155.220), notices to Enrollees (45 C.F.R. § 155.230), payment of premiums (45 C.F.R. § 155.240), privacy and security of personally identifiable information (45 C.F.R. § 155.260), use of standards and protocols for electronic transactions (45 C.F.R. § 155.270), eligibility and enrollment, as well as exemption determinations in the Individual Exchange and Small Business Health Options Program (“SHOP”) (45 C.F.R. Part 155, Subparts D, E, H, I), and certification of QHPs QDPs (45 C.F.R. Part 155, Subpart KK and 45 CFR 155.1065). The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a health plan Stand-Alone Dental Plan and benefit design in the Exchange. The Exchange shall solicit comment from the Contractor on the designs, but shall make design and presentation decisions at its sole discretion.
Appears in 1 contract
Samples: Qualified Dental Plan Contract
Exchange Responsibilities. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 C.F.R. § 155.105 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including, the California Affordable Care Covered California – Final HealthFinal SADP Plan Contract – May 6August 190, 2013 5 Act and the Affordable Care Act. The duties of the Exchange shall include those relating to: non- interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120), consultation with stakeholders (45 C.F.R. § 155.130), financial support for continued operations of the Exchange (45 C.F.R. § 155.160), oversight, financial and quality activities (45 C.F.R. § 155.200), consumer assistance tools and programs, including, but not limited to operation of a toll-free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)), navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210), participation of brokers to enroll qualified individuals or employers in Certified QHPs SADPs (45 C.F.R. § 155.220), notices to Enrollees (45 C.F.R. § 155.230), payment of premiums (45 C.F.R. § 155.240), privacy and security of personally identifiable information (45 C.F.R. § 155.260), use of standards and protocols for electronic transactions (45 C.F.R. § 155.270), eligibility and enrollment, as well as exemption determinations in the Individual Exchange and Small Business Health Options Program (“SHOP”) (45 C.F.R. Part 155, Subparts D, E, H, I), and certification of QHPs SADPs (45 C.F.R. Part 155, Subpart KK and 45 CFR 155.1065). The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a health plan Stand-Alone Dental Plan and benefit design in the Exchange. The Exchange shall solicit comment from the Contractor on the designs, but shall make design and presentation decisions at its sole discretion.
Appears in 1 contract
Samples: Stand Alone Dental Plan Contract
Exchange Responsibilities. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 42 C.F.R. § 155.105 155.106 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including, the California Affordable Care Act and the Affordable Care Act. The duties of the Exchange shall include those relating to: non- interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120), consultation with stakeholders (45 C.F.R. § 155.130), financial support for continued operations of the Exchange (45 C.F.R. § 155.160), oversight, financial and quality activities (45 C.F.R. § 155.200), consumer assistance tools and programs, including, but not limited to operation of a toll-free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)), navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210155.205), participation of brokers to enroll qualified individuals or employers in Certified QHPs (45 C.F.R. § 155.220), notices to Enrollees (45 C.F.R. § 155.230), payment of premiums (45 C.F.R. § 155.240), . privacy and security of personally identifiable information (45 C.F.R. § 155.260), use of standards and protocols for electronic transactions (45 C.F.R. § 155.270), eligibility and enrollment, as well as exemption determinations in the Individual Exchange and Small Business Health Options Program (“SHOP”) (45 C.F.R. Part 155, Subparts D, E, H, I), and certification of QHPs (45 C.F.R. Part 155, Subpart K). The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a health plan and benefit design in the Exchange. The Exchange shall solicit comment from the Contractor on the designs, but shall make design and presentation decisions at its sole discretion.
Appears in 1 contract
Samples: Qualified Health Plan Contract