STM Plans and SEP

[yankee466]

Had a broker tell me he was advised by Humana rep to simply put people on a 30 day STM plan with someone like UHC, and then since the plan involuntarily terminates at the end of 30 days, you qualify for a SEP.

You call the CSRs at the Marketplace, and they say ABSOLUTELY......no problem!!!! Loss of coverage.....we'll sign you right up. The script does not care about the prior plan at all......just that it was a plan that expired.

Sounds odd to me if you understand the law.....but apparently it works just fine. No idea how it works off the exchange, but on the exchange seems like a piece of cake.

Any takers on this? I would not touch it with a 10 foot pole. My googling all says it does not apply to STM plans.

 

[Yagents]

HC.gov reps don't understand the difference between MEC and STM. Nor do they ask for proof. It's like Mac daddy is handing out the sugar.

OFF exchange, some carriers are accepting loss of STM as an SEP.

https://www.healthcare.gov/how-can-...-of-open-enrollment/special-enrollment-period

Losing other health coverage—due to losing job-based coverage, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent's plan, losing eligibility for Medicaid or CHIP, and similar circumstances. Important: Voluntarily ending coverage doesn't qualify you for a Special Enrollment Period. Neither does losing coverage that doesn't qualify as minimum essential coverage.

 

[somarco]

I specifically asked Humana about this several months ago. They said maybe, maybe not.

Maybe, if the STM originated prior to 1/1/14

Probably not if the STM was written on 1/1/14 or later.

hc.gov is a different matter. They make $hit up as they go.

 

[RayNY]

HC.gov/exchange reps just don't care. They're not paid to care.

You don't even need to lose coverage or have proof. Just complain until they "escalate" you to "resolutions",they just give the client whatever they request and make us look like idiots for saying it's not allowed.