Sec. 14.35.07.05. Eligibility Requirements for Enrollment in a Qualified Health Plan Through the Individual Exchange

A. An applicant shall be determined eligible for enrollment in a QHP through the Individual Exchange if the applicant is:

(1) A citizen or national of the United States, a non-citizen who is lawfully present in the United States, and reasonably expected to be a citizen, national, or a non-citizen who is lawfully present for the entire period for which enrollment is sought;

(2) A resident of the Individual Exchange service area; and

(3) Not incarcerated, other than incarceration pending the disposition of charges.

B. Eligibility under this regulation is contingent upon verification of the applicant’s attestation that the applicant meets the criteria stated in §A(1) of this regulation, or upon receipt of the applicant’s attestation that the applicant meets the criteria stated in §A(2) and (3) of this regulation.

C. For the purpose of determining eligibility for enrollment in a QHP under §A(1) of this regulation, “lawfully present” means a non-citizen individual as defined in 45 CFR §152.2.