Exchange Special Enrollment, Due to COVID-19

Exchange Special Enrollment, Due to COVID-19

February 11, 2021

The Centers for Medicare & Medicaid Services (CMS) announced a new special enrollment period (SEP), starting February 15, due to the coronavirus (COVID-19) pandemic through Exchanges using the federal www.HealthCare.gov platform. This SEP is for individual health insurance, for those under age 65, and does not include Medicare. States using their own Exchange platforms are strongly encouraged to make a similar SEP available in their states.

Overview of the COVID-19 SEP
Starting on Feb. 15, 2021, and continuing through May 15, 2021, Exchanges using the www.HealthCare.gov platform will make a SEP available to all Exchange-eligible consumers who are submitting a new application or updating an existing application.

Beginning on February 15, 2021, consumers seeking to take advantage of this SEP can find out if they are eligible by visiting www.HealthCare.gov. Consumers will have 30 days after they submit their application to choose a plan.

  1. Consumers who are eligible and enroll under this SEP will be able to select a plan with coverage that starts prospectively the first of the month after plan selection.
  2. Current enrollees will be able to change to any available plan in their area without restriction to the same level of coverage as their current plan.

In order to use this SEP, current enrollees will need to use their existing application, making any necessary changes, to receive an updated eligibility result that provides the SEP before continuing on to enrollment.

Consumers do not need to provide any documentation of a qualifying event (such as loss of a job or birth of a child), which is typically required for SEP eligibility. Consumers found eligible for Medicaid or CHIP will be transferred to their state Medicaid and CHIP agencies for enrollment in those programs.

Best Regards,

Denise Neuhaus, SPHR, SHRM-SCP
Director of Human Resources & Compliance
dneuhaus@bhsins.com