SHOP special enrollment periods would continue to be available to enrollees who experience specified qualifying events.
We sought comment on this approach to aligning the proposed amendments with the individual - market - wide and
SHOP special enrollment periods.
If an employer group member, under the approach proposed throughout this document, believed that he or she were entitled to
a SHOP special enrollment period, but was denied that special enrollment period, the employer group member could file a complaint with the SHOP and the SHOP would investigate.
Not exact matches
We continue to believe that the effective dates for
special enrollment periods should be standardized for all
SHOPs to ensure a minimum standard for
special enrollment periods.
The proposed regulations in part 147 would amend the rules regarding fair health insurance premiums and guaranteed availability to reflect proposed changes related to the
SHOPs and
special enrollment periods.
However, we propose to modify the
SHOPs» responsibilities with respect to
special enrollment periods.
We are therefore proposing to modify the requirements to reflect that the
SHOP's proposed role is not to provide
special enrollment periods, but to ensure that QHP issuers offering coverage through the
SHOP provides the
special enrollment periods set forth in regulation.
Therefore, issuers wishing to participate in such a
SHOP would be required to administer
special enrollment periods.
Additionally, certain
special enrollment periods in § 155.420 also apply in the
SHOPs and are incorporated into the
SHOP regulations at § § 155.725 (j) and 156.285 (b).
The changes made to
special enrollment periods in this rule therefore applied to the guaranteed availability and
SHOP regulations, to the extent applicable.
We propose that the
special enrollment periods specified in § 155.725 (j) would continue to be applicable in the
SHOPs for plan years beginning on or after January 1, 2018, and propose to include these in § 155.726 (c).
If the proposed changes are finalized,
SHOPs that use the new flexibilities, such as the FF -
SHOPs, would no longer have the information required to determine employer group members» eligibility for
special enrollment periods.
While Open
Enrollment wasn't until November, because I lost my health coverage after leaving my job in August I qualified for
Special Enrollment and was able to
shop for a plan early.
If you're planning on
shopping on one of the marketplaces, make sure that you're
shopping during Open
Enrollment (or that you qualify for a
Special Enrollment Period).
If it's not open
enrollment, you should also be able to qualify for a
special enrollment period to
shop on the marketplace.
If you don't sign your baby up for health insurance within 30 days — by adding them to your existing plan, changing your plan with your existing carrier, or
shopping for a new plan — you could face a penalty for not having health insurance and will pay for medical costs out of pocket, with one caveat: giving birth qualifies you for a
Special Enrollment Period under the Affordable Care Act.
If you don't qualify for a
special enrollment period, you can't
shop the marketplaces.
Palanker said anyone
shopping for health insurance, even outside of open
enrollment, should contact their state or federal exchange to see if they are eligible for
special enrollment and a a tax credit.
Special Enrollment Periods allow people like you to shop for health insurance on the marketplace outside of regularly scheduled enrollmen
Enrollment Periods allow people like you to
shop for health insurance on the marketplace outside of regularly scheduled
enrollmentenrollment periods.
However, if you don't purchase health insurance during open
enrollment, you may be eligible to
shop during a
special enrollment period.
Even though open
enrollment is over, your move to a new state qualifies you to
shop for policies under the «
special enrollment» period.
Second, we propose to amend § 155.725 (h) so that
SHOPs would need only to establish effective dates for employees enrolling in coverage during the initial group
enrollment and the employee annual open
enrollment period, rather than for
special enrollment periods, because
SHOPs must ensure that effective dates for employees enrolling during
special enrollment periods are consistent with the effective dates specified in § 155.420 (b).
During your
special enrollment period, you can
shop in the exchange, or you can go directly to a health insurance carrier and buy a plan.
However, we propose to continue to keep effective dates for
special enrollment periods standardized to ensure a minimum standard for
special enrollment periods and because there are existing mechanisms within § 155.420 (b) for a
SHOP to achieve earlier effective dates for
special enrollment periods.
If your new eligibility results show that you qualify for a
Special Enrollment Period, you can then
shop for plans and enroll in a different one.
A
Special Enrollment Period is a period outside of Open
Enrollment when you
shop for and buy health insurance.