Webinar: Special Enrollment Periods
In this webinar presented on February 9, 2017, Shelby Gonzales, Senior Health Policy Analyst, and Halley Cloud, Heath Outreach Manager, discuss updates and changes to the circumstances that trigger a special enrollment period and the timing of coverage effective dates for different triggering events.
Please Note: Changes that the Department of Health and Human Services proposed in special enrollment periods and the dates for the upcoming open enrollment period for 2018 coverage were finalized and became effective on June 19, 2017. For more information, see Update on Changes to SEPs Effective June 19, 2017.
Presentation Slides
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Enrollment Periods
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Open enrollment
Special enrollment periods
- Coverage effective dates
Qualifying Events That Trigger an SEP
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Loss of other qualifying coverage (video section, slides):
- Loss of minimum essential coverage
- Loss of pregnancy-related or medically needy Medicaid
- Expiration of non-calendar year plan
Changes in household size (video section, slides):
- Marriage
- Birth, adoption, or placement for foster care
Changes in primary place of living (video section, slides):
- Permanent move
Changes in eligibility for financial help (video section, slides):
- Moving out of the Medicaid coverage gap
- Current employer plan no longer considered qualifying employer coverage
- Newly becoming lawfully present
- Release from incarceration
- Status as American Indian or Alaska Native
- Newly eligible or ineligible for premium tax credits
- Change in cost-sharing reduction eligibility
Enrollment or plan error (video section, slides):
- Error, misconduct or inaction by entity aiding in enrollment
- Plan or benefit display error
- Health plan violation
Other qualifying changes (video section, slides):
- Being determined ineligible for Medicaid or CHIP
- Resolving a data-matching issue
- Survivors of domestic violence or spousal abandonment
- Exceptional circumstances
Events That Do NOT Trigger an SEP
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Common events that do not trigger an SEP
Process for Accessing SEPs
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Reporting changes in Healthcare.gov
Accessing an SEP
SEP confirmation process
Pre-enrollment verification pilot program
Resources:
- Example Documents: SEP Confirmation Process
- SEP Reference Chart
- Coverage Effective Dates Cheat Sheet
- General resources
Q&A
Additional Resources
SEP Reference Chart | View resource
Webinar: Preventing and Resolving Data-Matching Issues | View webinar
Webinar: Immigrant Eligibility for Insurance Affordability Programs | View webinar
Beyond the Basics Webinar Series | View all webinars
Key Facts About Health Reform | View all key facts