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Title 45 Part 800

Title 45 → Subtitle B → Chapter VIII → Part 800

Electronic Code of Federal Regulations e-CFR

Title 45 Part 800

Title 45Subtitle BChapter VIIIPart 800


TITLE 45—Public Welfare

Subtitle B—REGULATIONS RELATING TO PUBLIC WELFARE (CONTINUED)

CHAPTER VIII—OFFICE OF PERSONNEL MANAGEMENT

PART 800—MULTI-STATE PLAN PROGRAM

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Subpart A—GENERAL PROVISIONS AND DEFINITIONS

§800.10
Basis and scope.
§800.20
Definitions.
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Subpart B—MULTI-STATE PLAN PROGRAM ISSUER REQUIREMENTS

§800.101
General requirements.
§800.102
Compliance with Federal law.
§800.103
Authority to contract with issuers.
§800.104
Phased expansion, etc.
§800.105
Benefits.
§800.106
Cost-sharing limits, advance payments of premium tax credits, and cost-sharing reductions.
§800.107
Levels of coverage.
§800.108
Assessments and user fees.
§800.109
Network adequacy.
§800.110
Service area.
§800.111
Accreditation requirement.
§800.112
Reporting requirements.
§800.113
Benefit plan material or information.
§800.114
Compliance with applicable State law.
§800.115
Level playing field.
§800.116
Process for dispute resolution.
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Subpart C—PREMIUMS, RATING FACTORS, MEDICAL LOSS RATIOS, AND RISK ADJUSTMENT

§800.201
General requirements.
§800.202
Rating factors.
§800.203
Medical loss ratio.
§800.204
Reinsurance, risk corridors, and risk adjustment.
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Subpart D—APPLICATION AND CONTRACTING PROCEDURES

§800.301
Application process.
§800.302
Review of applications.
§800.303
MSP Program contracting.
§800.304
Term of the contract.
§800.305
Contract renewal process.
§800.306
Nonrenewal.
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Subpart E—COMPLIANCE

§800.401
Contract performance.
§800.402
Contract quality assurance.
§800.403
Fraud and abuse.
§800.404
Compliance actions.
§800.405
Reconsideration of compliance actions.
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Subpart F—APPEALS BY ENROLLEES OF DENIALS OF CLAIMS FOR PAYMENT OR SERVICE

§800.501
General requirements.
§800.502
MSP issuer internal claims and appeals.
§800.503
External review.
§800.504
Judicial review.
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Subpart G—MISCELLANEOUS

§800.601
Reservation of authority.
§800.602
Consumer choice with respect to certain services.
§800.603
Disclosure of information.