Sec. 14.35.11.03. Opportunity for a Fair Hearing

A. An opportunity for a fair hearing shall be granted if an applicant claims that:

(1) The determination or redetermination received from the Exchange of the applicant’s eligibility for enrollment in a qualified health plan is incorrect;

(2) The determination or redetermination received from the Exchange of the applicant’s eligibility for an insurance affordability program is incorrect; or

(3) The determination or redetermination received from the Exchange of the applicant’s eligibility for enrollment in a qualified health plan or an insurance affordability program is untimely as set forth in applicable law.

B. The administrative law judge need not grant a fair hearing if the sole issue is a federal or State law requiring an automatic change adversely affecting some or all applicants.