4123-6-52 Employer participation in the QHP system - bureau recertification of QHPs.

(A) The bureau shall initiate the recertification process by sending certified QHPs a recertification application, which must be completed, signed and submitted to the bureau if the QHP wishes to be considered for recertification.

(B) Except as otherwise provided in paragraph (E) of this rule, if the bureau receives a completed and signed recertification application from a QHP, the QHP's certification shall remain in effect until the bureau issues a final order approving or denying the QHP's application for recertification.

(C) If the bureau does not receive a completed and signed recertification application from the QHP within sixty days from the date of the notice sent in accordance with paragraph (A) of this rule, the bureau shall send a second notice to the QHP stating that the QHP has thirty days from the date of the second notice to complete, sign and submit the recertification application to the bureau if the QHP wishes to be considered for recertification.

(D) If the bureau does not receive a completed and signed recertification application from the QHP within thirty days from the date of the notice sent in accordance with paragraph (C) of this rule, the QHP's certification shall lapse. Such lapse of certification is not an adjudication order and is not subject to appeal pursuant to rule 4123-6-17 of the Administrative Code.

(E) If the bureau receives a completed and signed recertification application from a QHP after the QHP's certification has lapsed pursuant to paragraph (D) of this rule, the QHP's certification shall remain lapsed until the bureau issues a final order approving or denying the QHP's application for recertification.

Effective: 11/13/2015
Five Year Review (FYR) Dates: 08/25/2020
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4121.44, 4121.441, 4121.442, 4121.31, 4123.05
Rule Amplifies: 4121.12, 4121.121, 4121.44, 4121.441, 4121.442