- 4,716
Well then you propose your reason why it sailed though. You don't have one.
You know I'm right but just hate to admit it.
The Universal SEP
- Thread starter FLM2
- Start date
Well then you propose your reason why it sailed though. You don't have one.
You know I'm right but just hate to admit it.
fact..... no mention of loss of coverage
fact... no mention of loss of group coverage
fact..... your theory/dream has no legs..... hole is getting deeper.
I don't care why he got the sep however I wont make up reasons as I go along, especially it the theory im using has been debunked..... remember Iraq has weapons of mass destruction... how did that work out for that guy
fact... no mention of loss of group coverage
fact..... your theory/dream has no legs..... hole is getting deeper.
I don't care why he got the sep however I wont make up reasons as I go along, especially it the theory im using has been debunked..... remember Iraq has weapons of mass destruction... how did that work out for that guy
- 4,716
You're right tater. No mention of loss of coverage....my bad...its all good.
Don't blame this one on W.
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False on the no mention of loss of coverage. Re-read the thread.
Don't blame this one on W.
I did... It's post 35..... Your turn.. How's the weather down there?... That hole is so deep you may need a Chinese passport by now
- 4,716
I'm not amused. Are you threatening me???
- Thread starter
- #47
As Yagents said, let's put this thread to bed, I had no intention of creating controversy by stating what happened when my client and I just answered the series of questions honestly and then accepted the results posted by the system.
There are no long term implications here as OEP begins in 6 weeks and my client will qualify for a similar (or same) plan without the need for the SEP.
I also appreciate all of the input, after reading through each of the posts again I've decided not to use this leniency for any other clients should one ask-my business is 90% Off Exchange anyway.
At the same time, by next year I would hope the SEP rules will be further clarified and the process for determining the validity of an SEP will match the law so there are no gray areas.
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- 8,448
THREAD SUMMARY:
A "Change of Income" qualifies any legal citizen to a Special Enrollment at HC.gov, with or without a subsidy.
Ref: https://www.healthcare.gov/screener/marketplace.html?state=Illinois&path=marketplace
Does anyone know what threshold defines a "change" in income? Could a $5 a week increase/decrease in MAGI qualify?
If ANY change in income triggers SEP eligibility, then O.E. is now 365 days a year.
-ac
A "Change of Income" qualifies any legal citizen to a Special Enrollment at HC.gov, with or without a subsidy.
Ref: https://www.healthcare.gov/screener/marketplace.html?state=Illinois&path=marketplace
Does anyone know what threshold defines a "change" in income? Could a $5 a week increase/decrease in MAGI qualify?
If ANY change in income triggers SEP eligibility, then O.E. is now 365 days a year.
-acI don't think so Mr. Allen:
1. I haven't done an online HC.gov app in months, but the "change in income" question is only under the CIC section last time I checked.
2. The reason I say this, is a "change in income" is only an SEP if they had an existing application through HC.gov as we've already discussed:
https://www.healthcare.gov/how-can-i...llment-period/
"For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions"
----------------------------------
BUT, "change of income" is listed under SEP reasons under CIC on this page:
https://www.healthcare.gov/screener/...th=marketplace
BUT, when you click "Yes", the next page it gives you this:
https://www.healthcare.gov/screener/sep-result.html
BUT, when you click apply for coverage, it gives you a dead end:
https://www.healthcare.gov/marketplace/b/welcome/
1. I haven't done an online HC.gov app in months, but the "change in income" question is only under the CIC section last time I checked.
2. The reason I say this, is a "change in income" is only an SEP if they had an existing application through HC.gov as we've already discussed:
https://www.healthcare.gov/how-can-i...llment-period/
"For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions"
----------------------------------
BUT, "change of income" is listed under SEP reasons under CIC on this page:
https://www.healthcare.gov/screener/...th=marketplace
BUT, when you click "Yes", the next page it gives you this:
https://www.healthcare.gov/screener/sep-result.html
BUT, when you click apply for coverage, it gives you a dead end:
https://www.healthcare.gov/marketplace/b/welcome/
- 8,448
YAgents,
I think you're making this simple Change In Income (CIC) SEP eligibility way too complicated.
A couple of the links in your message are now DOA. The recent HC.gov maintenance obviously shifted some things around at the website.
At any rate, the official Healthcare.gov "screener" tool at https://www.healthcare.gov/screener/ says that if you have a "change in income", you're probably eligible for a SEP.
I've been doing mostly off-exchange this Summer. If the HC.gov screener tool says "YES...you're eligible", but the insurer's website screener doesn't have this category..i.e. the "Change In Income", you check the "Other Reason" box at the insurer's website, and proceed to enroll the client.
When/If the insurer calls the new customer to verify enrollment, there is never a problem. It's approved instantly.
ac
