End of AEP

[WCMason]

For most companies, yes. In FL, Simply and Freedom want documentation of a hardship.
I did an Aetna mapd on 12/8 and everything seems to be smooth

Thanks. Not being contracted with them I haven’t seen their memos. I am puzzled by carriers who spent huge amounts in marketing to acquire members and then impose additional barriers beyond what CMS requires to enroll those members. You’d think these two, and any others who do the same, would celebrate the extra time and be as liberal applying the rules as CMS would allow them.

 

[bluediamond]

In everything I’ve seen – – and I’ve looked carefully at each carrier email I’ve gotten about this – – it appears the beneficiary only needs to show proof of residency in the affected county but requires no attestation they were personally affected or in anyway unable to complete an enrollment due to that weather-related emergency. If anyone has seen anything different with any carrier I would like to see that too.

You're right.

 

[DS4]

Look at bullet #3,

What Does This Mean To Agents
If you are contacted by someone who was impacted by these hurricanes or wildfires, field agents should follow our normal compliant sales process:

• Execute a Scope of Appointment (SOA) prior to the appointment.
• At that meeting, attempt to obtain proof that the beneficiary resided in an affected county (e.g., driver’s license, utility bills, etc.). Remember to check the FEMA website for the areas affected: https://www.fema.gov/disasters
• If the beneficiary is unable to provide such proof, accept the beneficiary’s verbal attestation that he/she resided in an affected county. Agents should make every effort to verify that the beneficiary qualifies for this SEP, but do not have to collect proof from the beneficiary.
• Conduct a full and compliant sales presentation and when they are ready to enroll complete the application and indicate “ SEP-OTH ” with “ Weather incident ” as the reason.

 

[WCMason]

Look at bullet #3,

What Does This Mean To Agents
If you are contacted by someone who was impacted by these hurricanes or wildfires, field agents should follow our normal compliant sales process:

• Execute a Scope of Appointment (SOA) prior to the appointment.
• At that meeting, attempt to obtain proof that the beneficiary resided in an affected county (e.g., driver’s license, utility bills, etc.). Remember to check the FEMA website for the areas affected: https://www.fema.gov/disasters
• If the beneficiary is unable to provide such proof, accept the beneficiary’s verbal attestation that he/she resided in an affected county. Agents should make every effort to verify that the beneficiary qualifies for this SEP, but do not have to collect proof from the beneficiary.
• Conduct a full and compliant sales presentation and when they are ready to enroll complete the application and indicate “ SEP-OTH ” with “ Weather incident ” as the reason.

Bullet #3 has been in all of the carrier memos. The “such proof” it’s looking for is only proof that the applicant lived in the affected county.

The question is whether any carriers are requiring proof or attestation that they were personally affected by the weather or wildfires and as a result were unable to meet the AEP deadline. Apparently there are at least two that are (named in an earlier post) requiring more than proof of residency.

From what I’ve seen every major carrier is requiring only residence in the affected county without any other requirement.

 

[Todd King]

Bullet #3 has been in all of the carrier memos. The “such proof” it’s looking for is only proof that the applicant lived in the affected county.

The question is whether any carriers are requiring proof or attestation that they were personally affected by the weather or wildfires and as a result were unable to meet the AEP deadline. Apparently there are at least two that are (named in an earlier post) requiring more than proof of residency.

From what I’ve seen every major carrier is requiring only residence in the affected county without any other requirement.

And the thing about that is the 2 companies should HAVE TO accept what CMS says whether they like it or not.

 

[WCMason]

And the thing about that is the 2 companies should HAVE TO accept what CMS says whether they like it or not.

Agree. And I wish someone would. Get their denial and file a grievance. People are reluctant to do that, unfortunately.

 

[policywunk]

In everything I’ve seen – – and I’ve looked carefully at each carrier email I’ve gotten about this – – it appears the beneficiary only needs to show proof of residency in the affected county but requires no attestation they were personally affected or in anyway unable to complete an enrollment due to that weather-related emergency. If anyone has seen anything different with any carrier I would like to see that too.

CMS has now extended the SEP through 3/31/18 for affected areas.With a large book of business in Florida to protect I am not really happy about it.

 

[WCMason]

CMS has now extended the SEP through 3/31/18 for affected areas.With a large book of business in Florida to protect I am not really happy about it.

Your Florida clients may be safe. The new CMS memo extends the weather-related SEP to 3/31/18 for Puerto Rico, Virgin Islands, and the wildfire-affected counties in California. The gulf states, including Florida and Texas, do not appear to have been extended, at least not by the most recent memo (thought it’s possible I missed an earlier memo, as I’m on a post-AEP recovery vacation).

 

[Chazm]

Yeah I haven’t seen anything yet about an extension in FL