Does that count for state run exchanges too or just the federal?
Just the federal so far. If anything changes i'll update.
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Does that count for state run exchanges too or just the federal?
We here at the FFM have been instructed we cannot deny ANYONE an SEP.
How many of you considering writing business as a SEP have thought about the possibility of an insurance company issuing the policy and then, after claims are filed in excess of expectations, suddenly deciding to investigate the validity of the SEP and possibly cancel the policy based on the lack of a true qualifying event?
If you don't think that will happen particularly with a company like Florida Blue, then you are proceeding blindly-every insurance company will do whatever possible to keep from paying claims out in this new era of healthcare and health insurance.
If the consumer does NOT have an application:
1) Complete an application on behalf of the consumer and review eligibility results, if the consumer qualifies for SEP, enroll them in coverage.
2) There may be times when you will need to add an SEP.
3) If the consumer does not qualifiy for a listed SEP, but they INSIST that they should, perform these steps:
* Add an SEP
* Enroll the consumer in coverage
* Complete the HICS escalation to CMS
"If the consumer insists they qualify you CANNOT deny them"
I cannot copy and paste the documents as they are property of GDIT.