Rule 120-2-112-.04. Certification and Decertification of Qualified Health Plans and Stand Alone Dental Plans

1. (1) Certification. Georgia Access is authorized to certify issuers seeking QHP or SADP certification of plan(s) to be offered on Georgia Access, regardless of licensure type. Georgia Access will publish certification criteria and guidelines annually.

2. (2) Georgia Access shall publish minimum standards that comply with federal and state requirements for participation in Georgia Access.

   1. (a) Georgia Access shall certify all plans meeting the requirements of § 1311(c) of the Federal Act for participation in Georgia Access unless it is not in the interest of eligible individuals and qualified employers in the State of Georgia.
   2. (b) Certification criteria shall be applied consistently across all issuers participating in Georgia Access.
3. (3) Annual Certification Timeline. Georgia Access shall establish an annual certification process and timeline for all participating QHP and SADP issuers.
4. (4) Issuer Agreements. All QHP and SADP issuers must enter into an Issuer Agreement with Georgia Access describing the issuer's obligations regarding offering products or services on Georgia Access.

5. (5) Decertification. Georgia Access is authorized to:

   1. (a) establish a process for decertification; and
   2. (b) decertify a QHP or SADP if it is determined that it is not in the public interest to permit such plan(s) to be offered through Georgia Access.

Authority: O.C.G.A. §§ 33-1-23; 33-2-9; 50-13-21.

History. Original Rule entitled "Certification and Decertification of Qualified Health Plans and Stand Alone Dental Plans" adopted. F. July 9, 2025; eff. July 29, 2025.

Amended: F. Sept. 12, 2025; eff. Oct. 2, 2025.