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CBPP Webinar: Beyond the Basics of Exemptions, Penalties and Special Enrollment Periods

[Please Note: We presented an updated version of this webinar on May 7, 2014.] 

In the fourteenth in the Center on Budget and Policy Priorities’ “Beyond the Basics” series of webinars titled “Beyond the Basics of Exemptions, Penalties and Special Enrollment Periods,” we focus on triggers and timing for special enrollment periods, how people can qualify for exemptions from the individual responsibility requirement, and how the penalties for not having coverage are calculated.  We review information from past webinars as well as address new developments and updates.

Watch the Webinar

PART I: Special Enrollment Periods (Watch here)

Presented by Sarah Lueck, Senior Health Policy Analyst

    • When can someone enroll or switch Marketplace plans (or QHPs) outside of open enrollment? (watch here)
    • Special enrollment period (SEP) triggers (watch here)
    • SEP timing (watch here)
    • Examples of SEP triggers and coverage effective dates:

Life changes (watch here)

Loss of minimum essential coverage (MEC) (watch here)

Other situations (watch here)

    • What does not trigger an SEP? (watch here)
    • Watch Q&A

PART II: Exemptions from the Individual Responsibility Requirement (Watch here)

Presented by Tara Straw, Senior Health Policy Analyst

    • Types of exemptions from the penalty (watch here)
    • Marketplace exemptions: Hardship

Financial or domestic circumstances (watch here)

Lack of affordable coverage (>8% of household income) (watch here)

Ineligible for Medicaid based on state decision not to expand (watch here)

    • Exemptions granted by the IRS

Income below filing threshold (watch here)

Lack of affordable coverage (>8% of household income) (watch here)

Certain noncitizens (nonresident aliens or undocumented residents) (watch here)

Short coverage gap (< 3 months) (watch here)

Open enrollment coverage gap (watch here)

PART III: Penalties (Watch here)

Presented by Dave Chandra, Senior Health Policy Analyst

    • What is the individual shared responsibility penalty? (watch here)
    • Countable income for the penalty (watch here)
    • Calculating the penalty (watch here)
    • Calculating the penalty for partial year coverage (watch here)
    • Watch Q&A

Additional Resources

    • Slide Deck (Please note that slides 8, 21, 31, and 39 in this slide deck have been updated for clarification, but the video has not been updated.)
    • Resources