In addition, when exchanges grant special enrollment periods based on «exceptional circumstances»
those special enrollment periods apply within the exchanges; off - exchange, it's up to the carriers as to whether or not they want to implement similar special enrollment periods.
The special enrollment period applies even if you have the option to continue your employer - sponsored plan under COBRA.
A few commenters requested that we further define material plan or benefit display errors and expressed concern about
this special enrollment period applying off - Exchange.
Not exact matches
If so, look into the
special enrollment period, as you will not need to
apply for Medicare's Plan B coverage right away.
Under § 147.104, this
special enrollment period also
applies to individuals who seek to enroll in individual market coverage off the Exchange.
Regardless of whether you purchase insurance through the exchange or off - exchange, the annual open
enrollment window
applies, and
special enrollment periods are necessary in order to enroll at any other time of the year.
Another commenter requested that no
special enrollment period be given for death as other
special enrollment periods likely
apply.
The same open
enrollment dates
apply outside the exchange, and most of the
special enrollment period rules also
apply to plans purchased outside the exchange.
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.
Section 147.104 (b)(2)(i) extends several of the
special enrollment periods that
apply to issuers on the Exchange, to all issuers in the individual market.
Response: With the exception of certain triggering events specified in § 147.104 (b)(2), which are only relevant to
enrollment in a QHP through the Exchange, the same
special enrollment periods (also referred to as limited open
enrollment periods)
apply throughout the individual market, both inside and outside of the Exchange.
Comment: One commenter suggested HHS clarify how the
special enrollment period provisions in the Exchange regulations at § 155.420
apply in the individual market outside the Exchange.
If you
apply outside of
enrollment, you must have a Special Enrollment Period to qualify for
enrollment, you must have a
Special Enrollment Period to qualify for
Enrollment Period to qualify for coverage.
Paragraph (d)(10) for the
special enrollment period for victims of domestic abuse or spousal abandonment and their dependents who seek to
apply for coverage apart from the perpetrator of the abuse or abandonment;
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.
This is important to ensure that they continue to be available, are equitably
applied across Exchanges, and that consumers, assisters, issuers, and other stakeholders have a common understanding of the parameters and coverage effective dates associated with each of these
special enrollment periods.
Paragraph (d)(11) for the
special enrollment period for consumers and their dependents who
apply for coverage and are later determined ineligible for Medicaid or CHIP;
By codifying these, we seek to ensure that these existing
special enrollment periods are
applied consistently across Exchanges, and to provide both issuers and consumers with greater certainty in how these
special enrollment periods are
applied.
We noted that certain
special enrollment periods in § 155.420 are incorporated into the individual market guaranteed availability regulations at § 147.104 (b) and
apply to all issuers offering non-grandfathered individual market coverage, whether through or outside of an Exchange.
Enrollment is limited to the annual open enrollment window that starts each fall on November 1, or a special enrollment period triggered by a qualifying event, but insurers no longer ask about medical history when you apply for
Enrollment is limited to the annual open
enrollment window that starts each fall on November 1, or a special enrollment period triggered by a qualifying event, but insurers no longer ask about medical history when you apply for
enrollment window that starts each fall on November 1, or a
special enrollment period triggered by a qualifying event, but insurers no longer ask about medical history when you apply for
enrollment period triggered by a qualifying event, but insurers no longer ask about medical history when you
apply for coverage.
When you
apply for Marketplace coverage and qualify for a
Special Enrollment Period, you may be asked to provide documents to confirm the events that make you eligible.
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.
Learn more about how to
apply with a
Special Enrollment Period.
These
special enrollment periods also
apply in the individual market, so if you lose your job - based health insurance in the middle of the year, you're eligible to enroll in a plan through the exchange or directly through a health insurance company, despite the fact that open
enrollment for the year has already ended.
The 2014 plan data
applies only to plans offered during 2014, including those purchased after March 31, 2014 with a
Special Enrollment Period.
You may qualify for a
Special Enrollment Period regardless of whether you
applied through:
If you'd like to change your plan, you can do so now only if you experience a qualifying life event — like losing other coverage, having a baby, or getting married — and
apply with a
Special Enrollment Period.
If all of these
apply to you, you're eligible for a
Special Enrollment Period that allows you to enroll in a 2015 plan.
If you
applied for Marketplace coverage through a
Special Enrollment Period because you moved or lost other health coverage, you may be asked to submit documents to confirm you qualify.
If you lost or will lose coverage from any of these sources, you may be eligible to
apply through a
Special Enrollment Period:
This
special enrollment period (December 16 - December 31)
applies to people who reside in (or who resided in when the hurricane hit) one of the counties that FEMA deemed eligible for «individual assistance» or «public assistance» following Hurricanes Irma and Harvey.
If you're
applying for 2014 coverage with a
Special Enrollment Period, you can learn more about the process here.
For example, if you
applied for a 2018 Obamacare plan during open
enrollment in the fall of 2017, OR if you're
applying for 2018 coverage in mid-2018 using a
special enrollment period (triggered by a qualifying event), you'll use the FPL figures from 2017.
Learn how to
apply for a
Special Enrollment Period.
If you lose your COBRA health insurance because your COBRA eligibility
period of 18 - 36 months expired, you're eligible for a 60 - day
special enrollment period on the Marketplace (the same as the eligibility
period that
applied when you were initially eligible for COBRA).
Important: If your state runs its own Marketplace, visit your state's website to
apply for a
Special Enrollment Period.
Because they all
apply on the same Marketplace application, they're all eligible for a
Special Enrollment Period.
We also proposed to explicitly state that the requirement for Exchanges to ensure appropriate actions are taken in connection with retroactive terminations, currently set forth in paragraph (d)(6) regarding
special enrollment periods,
applies to all retroactive terminations, including valid cancellations of coverage under a «free look» law.