- 4,716
After Open Enrollment:
- Thread starter mmike160
- Start date
- 8,448
3-10-2014
I read at KaiserHealthNews.org today that if an applicant purchased a health plan outside of Open Enrollment due to an event triggering a Special Enrollment Period (SEP), he/she will have to pick a new plan, or re-enroll in the same plan during the next Open Enrollment. The reason given is to align this person with the annual O.E. going forward. Does this sound right/accurate?
ac
I read at KaiserHealthNews.org today that if an applicant purchased a health plan outside of Open Enrollment due to an event triggering a Special Enrollment Period (SEP), he/she will have to pick a new plan, or re-enroll in the same plan during the next Open Enrollment. The reason given is to align this person with the annual O.E. going forward. Does this sound right/accurate?
ac
Allen,
I've heard the same thing from a few sources-but no legal documentation was cited. I've also heard it a step further-ALL business will renew on Jan 1, and the only time to make changes is during the OEP next year. Again, nothing was cited.
That said, I just talked with a supervisor at my state's Exchange Support line. She confirmed (3 times!) the following:
-SEP plans are 12-month contracts, they DO NOT renew Jan 1.
-SEP clients WILL NOT be forced to renew during OEP
-Expiration of an existing QHP contract (not termination for cause, cancellation, or rescission) generates a new SEP.
-Because it generates a new SEP, the client may renew, or change plans, within the 60-day window a defined by law.
(Expiration of a QHP contract is not explicitly given as one of the 9 SEP generating situations according to federal guidance. The solution is applying "loss of minimum essential coverage" to this scenario, as advised by the exchange representative.)
I've heard the same thing from a few sources-but no legal documentation was cited. I've also heard it a step further-ALL business will renew on Jan 1, and the only time to make changes is during the OEP next year. Again, nothing was cited.
That said, I just talked with a supervisor at my state's Exchange Support line. She confirmed (3 times!) the following:
-SEP plans are 12-month contracts, they DO NOT renew Jan 1.
-SEP clients WILL NOT be forced to renew during OEP
-Expiration of an existing QHP contract (not termination for cause, cancellation, or rescission) generates a new SEP.
-Because it generates a new SEP, the client may renew, or change plans, within the 60-day window a defined by law.
(Expiration of a QHP contract is not explicitly given as one of the 9 SEP generating situations according to federal guidance. The solution is applying "loss of minimum essential coverage" to this scenario, as advised by the exchange representative.)
Similar threads
