Sentences with phrase «for special enrollment periods»

Even though open enrollment is over for 2015, many families will qualify for special enrollment periods throughout the year.

Additionally, victims of domestic violence or spousal abandonment, along with dependent children, qualify for Special Enrollment Periods.

HealthCare.gov and many of the state - run exchanges have stepped - up eligibility verification for special enrollment periods, so be prepared to provide proof of your qualifying event.

All of those bills are aimed at specific provisions of the ACA, or the ways in which the law has been implemented via subsequent regulations (for example, HHS was tasked with establishing the specific requirements and details for special enrollment periods, and initially opted to use the honor system rather than requiring proof of qualifying events).

Although some pregnant women might be eligible for special enrollment periods due to qualifying events, pregnancy itself is not a qualifying event.

Some people may be eligible for special enrollment periods based on their employment history or other health insurance coverage they have.

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.

And while most special enrollment periods follow the same deadlines and effective dates as general open enrollment, that's not the case for special enrollment periods that are triggered by loss of other coverage.

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).

Section 147.104 (b)(2) incorporates certain triggering events for special enrollment periods described in the Exchange regulations at § 155.420 (d), and applies them to health insurance issuers offering non-grandfathered coverage in the individual market through or outside the Exchange.

We propose to revise paragraphs (b)(2)(i), (b)(2)(ii), (b)(2)(iv), and add paragraphs (b)(2)(v), (b)(2)(vi), and (b)(2)(vii), which pertain to effective dates for special enrollment periods; to amend paragraphs (c)(2)(i) and (c)(2)(ii), which pertain to availability and length of special enrollment periods, and to revise paragraphs (d)(1)(ii), (d)(1)(v), (d)(2), (d)(4), and remove paragraph (d)(10), which pertain to specific types of special enrollment periods.

Commenters also suggested that improved data collection could also be used to curb possible misuse of special enrollment periods, in addition to expanding the Exchanges» use of electronic data sources, and improving education efforts to make sure all stakeholders understand the eligibility criteria for all special enrollment periods.

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.

Other commenters suggested that the coverage of consumers who were ultimately found to be ineligible for special enrollment periods which they used to enroll in coverage or did not submit the necessary documentation in a timely manner should be canceled as of the date the enrollment became effective.

In addition, as discussed in the 2017 Payment Notice, we are conducting an assessment of QHP enrollments that were made through special enrollment periods in the FFEs to ensure that consumers» eligibility for these special enrollment periods were properly determined.

Response: We are not finalizing new qualifying events, eliminating current qualifying events, or changing the scope of current qualifying events for special enrollment periods at this time, but are continuing to study this issue.

Response: We appreciate the ideas and recommendations shared by commenters about anticipated impacts of an eligibility verification for special enrollment periods and how HHS may reduce possible misuse and abuse of special enrollment periods, while continuing to strengthen risk pools.

In 2016, we added warnings on HealthCare.gov about inappropriate use of special enrollment periods, eliminated special enrollment periods that are no longer needed as the Exchanges mature, and tightened eligibility rules for special enrollment periods.

Section 1311 (c)(6)(C) of the Affordable Care Act directs the Secretary of HHS to require an Exchange to provide for special enrollment periods specified in section 9801 of the Code and other special enrollment periods under circumstances similar to such periods under part D of title XVIII of the Act.

The proposed revisions in paragraph (b)(2)(i) align regulatory policy for special enrollment periods based on a court order with other similar special enrollment period types, and create operational efficiencies for Exchanges by streamlining effective date options across similar special enrollment period qualifying events related to a qualified individual gaining or becoming a dependent.

In response to our request for comment and data to assess whether special enrollment periods are being abused and to minimize potential misuse and abuse of special enrollment periods, commenters expressed strong support for the Exchange to take actions to verify consumer eligibility for special enrollment periods moving forward, including requesting documentation supporting consumers» eligibility for special enrollment periods.

There was no open enrollment period in the individual market before 2014, because health plans were not guaranteed issue at any time of the year in most states - so there was no need for special enrollment periods; people simply applied, and were either accepted or declined by the insurance carriers.

Some commenters supported the proposed provision to ensure effective dates for special enrollment periods are consistent with § 155.420 (b).

One commenter opposed the effective dates for special enrollment periods under § 155.725 (j) and recommended allowing States flexibility to prescribe their own effective dates for initial, annual, and special enrollment periods, because there may be other implications to the effectuation of coverage for employees and dependents with a special enrollment period.

Comment: Several commenters requested HHS provide authority for additional triggering events for special enrollment periods.

Commenters supported the proposed provision to keep effective dates for special enrollment periods standardized.

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 qualifying events that trigger special enrollment periods are the same as they were in 2017, although there's an increased focus on verifying eligibility for special enrollment periods, so be prepared to provide proof of your qualifying event.

Response: HHS has issued technical guidance, including the Standard Companion Guide Version 1.5 (issued March 22, 2013), which provides Exchanges with the information necessary to build the ability to send the reason for Special Enrollment Periods on the enrollment transaction.

Yes, but only if they qualify for a Special Enrollment Period due to a life change, like having a baby, adopting a child, or getting married.

Once you end Marketplace coverage, you can't re-enroll until the next annual Open Enrollment Period (unless you qualify for a Special Enrollment Period).

Having a baby qualifies you for a special enrollment period, so you can either re-enroll in what you currently have or you can change your policy to better suit your growing needs.

Moving to a new zip code also qualifies you for a special enrollment period.

Important: Losing individual coverage doesn't qualify for a Special Enrollment Period if you voluntarily drop coverage, if you lose coverage because you didn't pay your premiums, or if you lose Marketplace coverage because you didn't provide required documentation when the Marketplace asked for more information.

You can buy a Marketplace plan outside Open Enrollment when your grandfathered plan year ends, and you'll qualify for a Special Enrollment Period.

If your family grows during the year, you're eligible for a special enrollment period.

We note that for purposes of determining eligibility for this special enrollment period, an individual's percentage of the FPL is a function of household income, composition and size; therefore, individuals who gain eligibility because of a change in income or a change in household composition will be eligible for this special enrollment period.

If you miss the open enrollment period or lose your major mmedical insurance and do not qualify for a special enrollment period, temporary health insurance can also provide coverage until the next open enrollment period begins.

There was also a request to amend the proposed implementation effective date for this special enrollment period, which was set for January 1, 2016.

Paragraph (d)(8)(ii) for the special enrollment period for dependents of Indians who are enrolled or are enrolling in a QHP through an Exchange at the same time as an Indian;

Losing job - based coverage, even if you quit or get fired, qualifies you for a Special Enrollment Period.

Even though dependents may access special enrollment periods based on different qualifying events, when they qualify for a special enrollment period to newly enroll in Exchange coverage, regardless of whether it is a special enrollment period due to gaining or becoming a dependent or due to a loss of minimum essential coverage, we believe they should be treated alike.

We noted that, if a loss of a dependent or no longer being considered a dependent due to divorce, legal separation, or death results in a loss of minimum essential coverage, such individuals may qualify for the special enrollment period for loss of minimum essential coverage.

Therefore, HHS will provide issuers with suggested special enrollment period language that they could use in their existing consumer notices to satisfy the requirement that they notify enrollees of their eligibility for a special enrollment period.

Specifically, we made a necessary addition in paragraph (d)(7)(ii) to maintain eligibility for a special enrollment period for individuals previously living outside of the United States or in a United States territory who move to a location within the United States, so long as they seek to enroll in coverage within 60 days of completing their permanent move.

We amended the eligibility parameters for this special enrollment period by adding requirements in § 155.420 (d)(7)(i) and (ii).

They may enroll later, but only during the General Enrollment Period (GEP) which occurs January 1st through March 31st of every year (unless they qualify for a Special Enrollment Period (SEP)-RRB-; and

Individuals who become newly ineligible for APTC or who have a change in eligibility for cost - sharing reductions as described in paragraphs (d)(6)(i) and (ii) will continue to qualify for a special enrollment period to enroll in individual market coverage through or outside of an Exchange.

Anthem, Kaiser, and Aetna offer fair compensation to appointed brokers of their products across various states — sometimes even for Special Enrollment Period applications.

If you are eligible for a Special Enrollment Period, you may be able to defer enrolling in Medicare without facing late penalties when you finally do sign up.