Sentences with phrase «special enrollment periods based»

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

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.

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.

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.

Not exact matches

With respect to effective dates other than regular effective dates, meaning retroactive or accelerated coverage effective dates resulting from enrollment under certain special enrollment periods (including birth and marriage), resulting from the resolution of appeals, or resulting from amounts newly due for prior coverage based on issuer corrections of under - billing, we considered a premium payment deadline of 10 - 15 business days from when the issuer receives the enrollment transaction.

Commenters expressed concern that codifying these special enrollment periods would extend them to both State - based Exchanges and the off - Exchange market and recommended that HHS develop additional methods for handling operational issues outside of creating new special enrollment periods.

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

A special enrollment period is triggered by certain life events such as getting married or divorced, having a baby, losing your job - based health insurance, or moving out of your health plan's service area.

In the case of a qualified individual or enrollee who is eligible for a special enrollment period as described in paragraphs (d)(4), (5), or (9) of this section, the Exchange may define the length of the special enrollment period as appropriate based on the circumstances of the special enrollment period, but in no event may the length of the special enrollment period exceed 60 days.

Comment: Commenters expressed concerns about current misuse or abuse of special enrollment periods, including consumers who inappropriately obtain a special enrollment period on the basis of a loss of minimum essential coverage after being terminated from coverage due to a failure to pay premiums in violation of § 155.420 (e)(1).

(iii) In the case of a qualified individual or enrollee eligible for a special enrollment period as described in paragraph (d)(4), (5), (9), (11), (12), or (13) of this section, the Exchange must ensure that coverage is effective on an appropriate date based on the circumstances of the special enrollment period.

State - based exchanges have some flexibility in terms of some special enrollment periods, although CMS indicated that the special enrollment period for people whose plans are discontinued at year - end is available in every state, including state - based exchanges, regardless of whether the exchange mapped those enrollees to plans from different insurers or not.

More specifically, if you lose your job - based coverage, lose eligibility for Medicaid, CHIP, or Medicare, lose coverage through a family member, or lose individual coverage, you could qualify for a Special Enrollment Period.

We propose that this special enrollment period be available with respect to a qualified individual or his or her dependent who, in any year, has coverage under a group health plan or an individual plan with a plan or policy year that is not offered on a calendar year basis.

If you lose job - based coverage for any reason, you qualify for 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.

With respect to effective dates other than regular effective dates, meaning retroactive or accelerated coverage effective dates resulting from enrollment under certain special enrollment periods (including birth and marriage), resulting from the resolution of appeals, or resulting from amounts newly due for prior coverage based on issuer corrections of under - billing, we are considering a premium payment deadline of 10 - 15 business days from when the issuer receives the enrollment transaction.

Other situations may qualify you for a special enrollment period and are considered on a case - by - case basis.

If you want to enroll because you lost your job - based coverage, see our Special Enrollment Period page for more information.

If you lose your job - based health insurance, you'll qualify for a special enrollment period on your state's health insurance exchange, regardless of whether COBRA continuation is available to you.

For example, if you lose your job and thus your job - based health insurance, that would trigger a special enrollment period on your state's health insurance exchange giving you 30 - 60 days to sign up for an exchange - based health plan even though it's not open enrollment.

Losing job - based coverage qualifies you for a Special Enrollment Period.

You're eligible for a special enrollment period because you just lost your job - based health insurance due to being laid off (note that you're eligible to get a plan in the individual market — on or off - exchange — even if you also have the option to continue your job - based insurance via COBRA.You have the full 60 - day election period to pick COBRA or an individual market plan, and you're allowed to change your mind within that 60 - day window too, which wasn't the case prior to 2017).

If you have just left your job for any reason and lost your job - based health coverage, you qualify for a Special Enrollment Period.