- § 162.1501 - Enrollment and disenrollment in a health plan transaction.
- § 162.1502 - Standards for enrollment and disenrollment in a health plan transaction.
§ 162.1501 - Enrollment and disenrollment in a health plan transaction.
The enrollment and disenrollment in a health plan transaction is the transmission of subscriber enrollment information from the sponsor of the insurance coverage, benefits, or policy, to a health plan to establish or terminate insurance coverage.
§ 162.1502 - Standards for enrollment and disenrollment in a health plan transaction.
The Secretary adopts the following standards for enrollment and disenrollment in a health plan transaction.
(a) For the period from October 16, 2003 through March 16, 2009: ASC X12N 834—Benefit Enrollment and Maintenance, Version 4010, May 2000, Washington Publishing Company, 004010X095 and Addenda to Benefit Enrollment and Maintenance, Version 4010, October 2002, Washington Publishing Company, 004010X095A1. (Incorporated by reference in § 162.920.)
(b) For the period from March 17, 2009 through December 31, 2011, both:
(1) The standard identified in paragraph (a) of this section; and
(2) The ASC X12 Standards for Electronic Data Interchange Technical Report Type 3—Benefit Enrollment and Maintenance (834), August 2006, ASC X12N/005010X220 (Incorporated by reference in § 162.920)
(c) For the period on and after January 1, 2012, the standard identified in paragraph (b)(2) of this section.