Webinar: Special Enrollment Periods
In this Health Reform: Beyond the Basics webinar presented on March 14, 2018, Sarah Lueck, Senior Policy Analyst, and Halley Cloud, Health Outreach Manager, review the circumstances that trigger a special enrollment period, and clarify changes and updates to the rules surrounding special enrollment periods.
Presentation Slides
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Overview
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Special enrollment period (SEP) review
- Timing
- Coverage effective dates
- Requirement of prior coverage
- Changes and updates
Events that Trigger a Special Enrollment Period
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Loss of other qualifying coverage (video section, slides)
- Loss of minimum essential coverage
- Loss of pregnancy-related Medicaid coverage
- Loss of medically needy Medicaid coverage
- Expiration of a non-calendar year plan
Changes in household size (video section, slides)
- Marriage
- Birth / adoption / placement in foster care / court order
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 coverage
- Newly gaining eligible immigration status
- Release from incarceration
- American Indian and Alaska Native (AI/AN)
- Newly eligible or ineligible for premium tax credits
- Change in cost-sharing reduction eligibility
Enrollment or plan error (video section, slides)
- Error/misconduct/inaction
- Plan or benefit display error
- Health plan violation
Other circumstances (video section, slides)
- Being determined ineligible for Medicaid or CHIP
- Resolving a data-matching issue
- Survivors of domestic violence
- Exceptional circumstances
Events that do not trigger an SEP (video section, slides)
Process for Accessing SEPs
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Reporting changes
- Accessing an SEP
SEP pre-enrollment verification (video section, slides)
- Process for verifying eligibility for SEP
- SEPs subject to pre-enrollment verification
- Documents that can be used to verify SEP eligibility
Q&A
Additional Resources
Resources | View resources links
SEP Reference Chart | View reference chart
Beyond the Basics Webinar Series | View all webinars
Key Facts About Health Reform | View all key facts
Tools and Resources | View all tools and resources
