§ 435.551 Applicable individual.

An applicable individual is an individual who is not a specified excluded individual as defined at § 435.554 and who is— (a) Eligible to enroll or is enrolled under the State plan under § 435.119; or (b) Otherwise eligible to enroll or is enrolled in a demonstration project under section 1115(a)(2) of the Act that provides coverage that meets minimum essential coverage requirements as defined under § 435.4, and who is: (1) At least 19 and under 65 years of age; (2) Not pregnant; (3) Not entitled to or enrolled for benefits under part A of title XVIII or enrolled for benefits under part B of title XVIII; and (4) Not otherwise eligible to enroll under the State plan.