The size of the market for “special enrollment period” (SEP) individual and family health insurance may be about 20 percent to 30 percent of the size of the regular open enrollment period market.
That estimate is based on analysis of individual “qualified health plan” (QHP) activity data from the state-based exchanges in Colorado and Minnesota.
The regular Patient Protection and Affordable Care Act (PPACA) exchange open enrollment period for individual QHP coverage started Oct. 1, 2013, and ended sometime from March 31 to mid-April in most of the country. Nevada extended its open enrollment period until May 30.
Regulators, exchange managers and insurers came up with the open enrollment system to keep consumers from waiting until they get sick to pay for coverage. To avoid risk management problems, insurers in the non-exchange individual market are using the same enrollment calendar.
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To qualify for SEPs now, consumers must show that they have undergone a major life event, such as a divorce or a relocation, or qualify for an exemption from the usual calendar rules.