Additional Resources
Webinar:
In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on May 12, 2022, Sarah Lueck provides an overview of special enrollment periods (SEPs), including the qualifying events that trigger a SEP, eligibility criteria for various SEPs, and the timing of coverage effective dates for SEPs.
↓ View Presentation Slides (PDF)
Note: Slides were updated after the webinar to reflect a recent policy change to coverage effective dates.
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Overview of Special Enrollment Periods (SEPs)
- Events that trigger a SEP
- Timing of SEPs
- Requirement of prior coverage
- New SEP for people with income under 150% FPL
Common Events That Trigger a SEP
- Loss of coverage
- Changes in household size
- Change in primary place of living
- Changes in eligibility for financial help
Less Common Events That Trigger a SEP
- Enrollment or plan error
- Determined ineligible for Medicaid
- Resolving a data matching issue
- Other exceptional circumstances
- Events that don’t trigger a SEP
- Overview
- Reporting changes
- Changes to verification policy in 2022
- Loss of coverage verification
- Coverage effective date after SVI is resolved
- Difference between SEP verification, DMI, and ID proofing
Restrictions on Plan Choice for Current Enrollees
- Overview
- SEPs exempt from restrictions on plan selection