HealthCare.gov managers recently gave agents and brokers lists of many types of documents consumers can use to show they qualify for special enrollment periods.
Officials from the Center for Consumer Information & Insurance Oversight, the agency directly responsible for running HealthCare.gov, put the document lists in the slidedeck for a webinar explaining the new HealthCare.gov special enrollment confirmation process.
People who want to buy individual commercial health insurance outside of the official Affordable Care Act open enrollment period now have to show that they have a good excuse to be shopping for coverage. The next open enrollment period, for 2017 coverage, is set to start Nov. 1 and end Jan. 31.
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In the slidedeck, oversight office officials show, for example, that consumers can submit any of 15 types of documentation to show that they qualify for special enrollment periods, or SEPs, because of the loss of what the government classifies as solid health coverage, or “minimum essential coverage.”
A consumer can send a state’s HealthCare.gov exchange, or “Marketplace,” a letter from an employer that’s dropping health coverage, a letter from a school saying when student health coverage ends, divorce papers showing when coverage obtained through a husband or wife ends or a notice from a government health program saying when the government plan coverage runs out.
Special enrollment periods
If nothing else is available, a consumer can send the Marketplace a “letter of explanation about the coverage you had, why and when you lost or will lose it, and the reason you can’t provide any other documents,” officials say. “The Marketplaces will take your letter into consideration.”
Similarly, if consumers qualify for special enrollment periods because they’ve moved, they can use many different types of documents, including letters explaining their lack of ability to obtain documents, to justify requests for special enrollment periods, officials say.