Loss of Group Coverage Creates SEP

somarco

GA Medicare Expert
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I have a small group, 2 lives. Coming up for renewal in August. If the employer (business owner) decides to terminate the group plan does this create an SEP? Or would this be viewed as a voluntary termination of coverage, denying the SEP?
 
I have a small group, 2 lives. Coming up for renewal in August. If the employer (business owner) decides to terminate the group plan does this create an SEP? Or would this be viewed as a voluntary termination of coverage, denying the SEP?

If the group plan terminates, its an SEP.

I've done 4 times in the last 2 months for 2 person groups and once for a 10 person group. No issues. Either on or off exchange.

I did have to provide the termination letter for the off exchange enrollments to the new carrier. Healthcare.gov didn't require further documentation.
 
Thx.

This guy won't go through the exchange. He wouldn't buy an Obamacrap plan if he didn't have to. He might wait until the end of the year to drop the plan.
 
Thx.

This guy won't go through the exchange. He wouldn't buy an Obamacrap plan if he didn't have to. He might wait until the end of the year to drop the plan.

Any plan for sale now, that gets you out of paying the tax penalty is an Obamacare plan.
 
I think most of us would concur that a Obama crap plan is one purchased on the exchange and taking a subsidy ( having your neighbors pay most of your premium). Off exchange plans are just healthcare reform plans.
 
Every plan issued or renewed since 1/1/14 has to comply with Obamacrap rules.
 
Every plan issued or renewed since 1/1/14 has to comply with Obamacrap rules.

Make sure to include Every MAJOR MEDICAL plan issued. I'd also like to disagree with you about "renewed since". Remember that most plans that were in place pre 2K13 carriers were allowed to continue those plans (ACA compliant or not) when Bama scrambled to contain the "keep your Dr." lie.

Also, on another note many carriers were already rolling out ACA compliant plans as of 2K10. Assurant was one of them....not going to deep here on this carrier as I see another discussion going on in another forum I'll put my 2 cents in...

As for smaller groups after you look at the cost savings from an employer standpoint and looking at overall income getting a subsidized plan just makes sense as long as you're willing to play the network game.

Forbes put a nice article out about how the employer market for health will lose up to 30% ish of it's market share with this new social law being implemented.

Loss of employer coverage = SEP even if the employer intentionally drops coverage for the above stated reason.
 
If someone asks "is this obamacare?" the answer is always "No, It's XYZ plan from ABC carrier, and it complies with all the new laws so you won't get a penalty."

Don't play that game. Use the correct terminology.

You wouldn't let them call an EPO a HMO, or call coinsurance an actuarial value, why let them mis-label anything else?

P.S. Loss of employer coverage is an SEP, even if it's a sole prop and the owner cancels their own insurance. Carriers here ask for the proof of "a letter from the employer to the employee." I literally have them write a letter to themselves, and the carriers accept it.
 
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Tater,

Maybe I am spinning it. If spinning it results in my clients buying the right plan for their needs, or a provider actually accepting the insurance I sell them, I'm happy to spin until I puke.

You think motorcycle salesmen call them "death machines" and refer to their customers as "organ donors"? You think any salesman uses pejoratives to sell their products? No, of course not, especially when it's to the ignorant detriment of their clients.
 
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