Let your clients know: CMS will allow extended "in-line" Special Enrollment Period from February 16-22 through the Federally-Facilitated Marketplace

Certain circumstances across consumer enrollment channels (such as HealthCare.gov and the Marketplace call center) leading up to the February 15, 2015 Open Enrollment deadline kept some consumers from completing the enrollment process despite their efforts to meet the deadline.

The Centers for Medicare & Medicaid Services will provide a Special Enrollment Period (SEP) to consumers who:

1. Currently are not enrolled in coverage through the FFM,
   
   
2. Have not been terminated from coverage purchased through the FFM during the 2015 Open Enrollment period, and
   
   
3. Attest that they attempted to enroll during the annual Open Enrollment period but did not complete the process (referred to hereafter as being “in line”) by February 15, 2015 because they experienced a technical issue with HealthCare.gov that prevented them from completing enrollment by February 15 or an extensive call center wait on February 13, 14 or February 15.

The SEP started on February 16, 2015, and end on February 22, 2015.  Enrollments completed during the SEP will have an effective date of March 1, 2015, to align with the coverage effective date the consumer would have received had they been able to complete the enrollment process by February 15, 2015.  Due to the “in line” SEP coverage effective date of March 1, 2015 following the end date of the SEP, February 22, 2015 so closely, the FFM expects issuers to allow consumers a reasonable amount of time to pay the first month’s premium.  Consumers will not be able to access this SEP through the direct enrollment process but instead should contact the FFM via the call center or via HealthCare.gov.

This CMS guidance applies to the Federally-facilitated Marketplace, including State Partnership Marketplaces. It does not apply to off-exchange application submissions.

Reminder: The quoting tool (post open-enrollment period) will only allow brokers to quote for off-exchange plans that meet the criteria of a Special Enrollment Period. Brokers are able to view on-exchange products from the tool via quoting but will not connect to FFM.

This information is intended for brokers only.

Aetna Health Plans for Individuals, Families and the Self-Employed are underwritten by Aetna Life Insurance Company or by Aetna Health Inc. (“Aetna” refers to Aetna Life and/or Aetna Health Inc.). In some states, individuals may qualify as a business group of one and may be eligible for guaranteed issue, small group health plans.

CoventryOne health insurance plans are underwritten by the following affiliates of Aetna Life Insurance Company: Coventry Health and Life Insurance Company, Coventry Health Care of Kansas, Coventry Health Care of Georgia, Coventry Health Care of the Carolinas, Coventry Health Care of Louisiana, Coventry Health Care of Iowa, Coventry Health Care of Nebraska, Coventry Health Care of Illinois, Coventry Health Plan of Florida, Coventry Health Care of Missouri, Coventry Health Care of Nevada, Coventry Health Care of Texas, Coventry Health Care of Virginia, Coventry Health Care of West Virginia, HealthAmerica Pennsylvania, Coventry Health Care of Delaware, or Altius Health Plans. Certain plans are underwritten by Arches Mutual Insurance Company, administered by Coventry Health Care of Utah, or Montana Health CO-OP, administered by Altius Health Plans. 2/15

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