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§ 6862. Appeals Process.

10 CA ADC § 6862Barclays Official California Code of Regulations

Barclays California Code of Regulations
Title 10. Investment
Chapter 12. California Health Benefit Exchange
Article 11. Certified Application Counselor Program
10 CCR § 6862
§ 6862. Appeals Process.
(a) Other than a determination made pursuant to Section 6858, Certified Application Counselor Fingerprinting and Criminal Record Checks, a decision that an individual or entity is not eligible or qualified to participate or continue to participate in a program under this Article may be appealed to the Exchange in accordance with the requirements of this section.
(b) The Exchange shall allow an applicant to request an appeal within 60 calendar days of the date of the notice of eligibility determination.
(c) The first phase of the Appeals Process shall include an informal review by the Exchange. The Exchange shall consider the information used to determine the appellant's eligibility as well as any additional relevant evidence presented during the course of the appeal. The Exchange shall make an informal resolution decision within 45 calendar days from the receipt of the appeal. The Exchange shall notify the appellant in writing of the decision.
(d) If the appellant is satisfied with the outcome of the informal resolution decision, the appeal may be withdrawn. If the appeal is not withdrawn, it shall be automatically escalated to the second phase of the Appeals Process. During the second phase, an independent unit within the Exchange that had no involvement in the original eligibility or qualification determination or informal resolution decision shall review the eligibility or qualification of the appellant de novo. The appellant shall be allowed to present additional evidence during the second phase. The Exchange shall consider all relevant evidence presented during the course of the appeal and notify the appellant in writing of the final decision within 60 calendar days from the receipt of the initial appeal.

Credits

Note: Authority cited: Section 100504, Government Code. Reference: Section 100502, Government Code.
History
1. New section filed 7-6-2015 as an emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 75 (Stats. 2015, c. 18); operative 7-6-2015 (Register 2015, No. 28). A Certificate of Compliance must be transmitted to OAL by 7-6-2018 pursuant to Government Code section 100504(a)(6) or emergency language will be repealed by operation of law on the following day.
2. Editorial correction of History 1 (Register 2018, No. 37).
3. New section filed 6-7-2019; operative 6-7-2019 pursuant to Government Code section 11343.4(b)(3) (Register 2019, No. 23).
4. Editorial correction of History 1 (Register 2019, No. 39).
This database is current through 4/26/24 Register 2024, No. 17.
Cal. Admin. Code tit. 10, § 6862, 10 CA ADC § 6862
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