(a) General requirement. Any notice required to be sent by the Exchange to individuals or employers must be written and include:
(1) An explanation of the action reflected in the notice, including the effective date of the action.
(2) Any factual findings relevant to the action.
(3) Citations to, or identification of, the relevant regulations supporting the action.
(4) Contact information for available customer service resources.
(5) An explanation of appeal rights, if applicable.
(b) Accessibility and readability requirements. All applications, forms, and notices, including the single, streamlined application described in Sec. 155.405 and notice of annual redetermination described in Sec. 155.335(c), must conform to the standards outlined in Sec. 155.205(c).
(c) Re-evaluation of appropriateness and usability. The Exchange must re-evaluate the appropriateness and usability of applications, forms, and notices.
(d) Electronic notices. (1) The individual market Exchange must provide required notices either through standard mail, or if an individual or employer elects, electronically, provided that the requirements for electronic notices in 42 CFR 435.918 are met, except that the individual market Exchange is not required to implement the process specified in 42 CFR 435.918(b)(1) for eligibility determinations for enrollment in a QHP through the Exchange and insurance affordability programs that are effective before January 1, 2015.
(1) The individual market Exchange must provide required notices either through standard mail, or if an individual or employer elects, electronically, provided that the requirements for electronic notices in 42 CFR 435.918 are met, except that the individual market Exchange is not required to implement the process specified in 42 CFR 435.918(b)(1) for eligibility determinations for enrollment in a QHP through the Exchange and insurance affordability programs that are effective before January 1, 2015.
(2) The SHOP must provide required notices either through standard mail, or if an employer or employee elects, electronically, provided that the requirements for electronic notices in 42 CFR 435.918(b)(2) through (5) are met for the employer or employee. [77 FR 11718, Feb. 27, 2012, as amended at 78 FR 42314, July 15, 2013]