The Universal SEP

[TxOnline]

So far this year, on-Exchange SEP applications have auto back-dated to the 1st of the month after the month in which the coverage was lost. Off-Exchange have behaved the same way.

This "rule" caused me much grief with one client who HAD to pay 60 days premiums in arrears. Took 6 weeks of calls/letters to get this changed to the 1st of the month in which the enrollment took place, which is what she wanted.
ac

It hasn't ALWAYS worked like this for me.

Recent example:
On-X application submitted October 7th.
Lost group coverage at work on Sept 30th.
I expected effective date to be Oct 1st (backdated).
He WANTED an effective date of Oct 1st.
He got an effective date of Nov 1st.
They would NOT change to Oct 1st (after several calls to hc.gov).

Carrier confirmed that OFF-X app would have auto-assigned eff date of 10/1.
But, that they MUST accept the effective date assigned by the govt for ON-x apps. And, that I should keep calling for a correction.
We just gave up...and he accepted effective date of Nov 1st.

No logic to this madness!

 

[houcoogster]

It hasn't ALWAYS worked like this for me.

Recent example:
On-X application submitted October 7th.
Lost group coverage at work on Sept 30th.
I expected effective date to be Oct 1st (backdated).
He WANTED an effective date of Oct 1st.
He got an effective date of Nov 1st.
They would NOT change to Oct 1st (after several calls to hc.gov).

Carrier confirmed that OFF-X app would have auto-assigned eff date of 10/1.
But, that they MUST accept the effective date assigned by the govt for ON-x apps. And, that I should keep calling for a correction.
We just gave up...and he accepted effective date of Nov 1st.

No logic to this madness!

This has been my recent experience too....no rhyme nor reason....

 

[kgmom219]

I can only get this to work if I call in for the app. I've never gotten it to work online.

 

[dorado]

Today I wanted to use the SEP for my clients whose income decreased and change plans for 12/1.
I called in (he had me as authorized rep.), and they did get a higher subsidy, but couldn't change the plan. The H.C.gov rep double checked, and then confirmed that the plan couldn't be changed, so they (clients) didn't really have a SEP. I only mentioned that income for 2014 would decrease, maybe I should have mentioned that the wife lost her job...

 

[yorkriver1]

I went online, HC.gov yesterday and completed an app with client; job loss 10/31/2014. Went very well, app is redesigned, simpler, quicker. Went through by saying loss of coverage 10/31/14. Effective date 12/1/14 showed up, as client wanted.

We'll see how things are Saturday!

 

[RayNY]

Today I wanted to use the SEP for my clients whose income decreased and change plans for 12/1.
I called in (he had me as authorized rep.), and they did get a higher subsidy, but couldn't change the plan.

For change of income, they have to A) newly qualify for subsidy, B) newly not qualify for subsidy or C) cross a CSR threshold that would qualify them for a different CSR plan. Argument's sake, an individual going from $40k to $30k is not an SEP, just a subsidy adjustment. $29,200 to $29,100 would be an SEP (new CSR eligibility).

York,

Did they force the 12/1 effective? I know it's what your client wants, but as we know, the law says it should be effective "the first day of the month after the qualifying event", or 11/1. I've had my exchange do the same thing, I'm just curious if you had the option to follow the law.

 

[yorkriver1]

Ray,
No, it just defaulted to 12/1/14. Maybe if I called them, but we know many of them don't have full awareness of those laws.
Update: Yesterday, same scenario as 11/13/14, enrollment got all the way to full app submitted with 12/1/14 eligibility, wouldn't process fully. Rep acknowledged app is in, call back when system cleared. Probably down last night to prep for today.
Bumpy ride today? We'll see very soon.

 

[TxOnline]

I don't know how to post a link to this thread (in the other recent SEP thread).

But, here are examples of HC.gov assigning the wrong effective dates to SEP apps.

Anyone else have different results?
Or, maybe the system is working correctly now?

 

[AllenChicago]

I don't know how to post a link to this thread (in the other recent SEP thread).

But, here are examples of HC.gov assigning the wrong effective dates to SEP apps.

Anyone else have different results?
Or, maybe the system is working correctly now?

NOPE...IT ISN'T. HC.gov is not assigning a 12/1/14 effective date, even though current client's plan is being terminated on 11/30/2014.

Why does HC.flub ask those SEP questions near the end of the application and then have the gall to put in the eligibility letter than a SEP is granted, but shows a 1/1/2015 effective date on the "Pick/Buy Your Plan" screen. Gruber designed this system? He's the STUPID one!
ac

 

[Post Quartermaster]

NOPE...IT ISN'T. HC.gov is not assigning a 12/1/14 effective date, even though current client's plan is being terminated on 11/30/2014.

Why does HC.flub ask those SEP questions near the end of the application and then have the gall to put in the eligibility letter than a SEP is granted, but shows a 1/1/2015 effective date on the "Pick/Buy Your Plan" screen. Gruber designed this system? He's the STUPID one!
ac

I ran 2 different 12/1 effective SEPs last Friday. Did you not select that you are applying for 2014 perhaps?