Section 4500.110  Compliance Reviews of QHP Issuers

The Exchange adopts the requirements for compliance reviews of QHP issuers provided in 45 CFR 156.715 (Dec. 22, 2016) (no later editions or amendments), except that:

a)         references to "a Federally-facilitated Exchange" are substituted with "the Illinois Exchange";

b)         references to "HHS" are substituted with "the Department";

c)         the reference to "subpart I of this part" is substituted with "this Part"; and

d)         until the Exchange operates as a State-based Exchange, the Exchange will enforce 45 CFR 156.715 in the manner required under 45 CFR 156.350(a)(3).  When the Exchange operates as a State-based Exchange, the limitation in 45 CFR 156.350(a)(3) does not apply. Nothing in this Section affects the Department's authority, scope, or procedures available for market analysis or market conduct actions performed under Section 132 of the Code.

(Source:  Amended at 49 Ill. Reg. 14672, effective October 28, 2025)