agents and brokers - selling in the healthcare dot gov marketplace

How Will the New SEP Pilot Impact You and Your Clients?

CMS is launching a new pilot program in 2017 to test a process that requires pre-enrollment verification of consumers’ special enrollment period (SEP) eligibility for Individual Marketplace coverage.

This pilot program on HealthCare.gov is intended to test how pre-enrollment verification affects compliance, enrollment, continuity of coverage, the risk pool, and other outcomes. It impacts all states served by the HealthCare.gov Individual Marketplace platform.

Your clients’ applications may be among those randomly flagged to have their plan selections held by the Marketplace until they submit documentation to prove their SEP eligibility. Review the fact sheet below for more information and be ready to answer your clients’ questions.

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