(a) Regional Exchange. A State may participate in a regional Exchange if:
(1) The Exchange spans two or more States, regardless of whether the States are contiguous; and
(2) The regional Exchange submits a single Exchange Blueprint and is approved to operate consistent with Sec. 155.105(c).
(b) Subsidiary Exchange. A State may establish one or more subsidiary Exchanges within the State if:
(1) Each such Exchange serves a geographically distinct area; and
(2) The area served by each subsidiary Exchange is at least as large as a rating area described in section 2701(a) of the PHS Act.
(c) Exchange standards. Each regional or subsidiary Exchange must:
(1) Otherwise meet the requirements of an Exchange consistent with this part; and
(2) Meet the following standards for SHOP:
(i) Perform the functions of a SHOP for its service area in accordance with subpart H of this part; and
(ii) Encompass the same geographic area for its regional or subsidiary SHOP and its regional or subsidiary Exchange except:
(A) In the case of a regional Exchange established pursuant to Sec. 155.100(a)(2), the regional SHOP must encompass a geographic area that matches the combined geographic areas of the individual market Exchanges established to serve the same set of States establishing the regional SHOP; and
(B) In the case of a subsidiary Exchange established pursuant to Sec. 155.100(a)(2), the combined geographic area of all subsidiary SHOPs established in the State must encompass the geographic area of the individual market Exchange established to serve the State. [77 FR 18444, Mar. 27, 2012, as amended at 78 FR 54134, Aug. 30, 2013]