CMS Provides for COVID-19 Special Enrollment Period

In accordance with an executive order issued by President Biden on January 28, 2021, the Centers for Medicare and Medicaid Services (CMS) is opening a COVID-19-related special enrollment period (SEP) for uninsured consumers to obtain health insurance coverage through the Affordable Care Act (ACA).

The new COVID-19-related SEP is in effect from February 15 – May 15, 2021, for the 36 states that use the HealthCare.gov platform. The SEP is available to all eligible consumers who are either submitting a new application or wanting to switch to a different plan. Consumers are able to enroll during the SEP by using the HealthCare.gov website, the Marketplace call center, or by working directly with agents or brokers currently registered with the Marketplace.

In addition, many state-administered health insurance exchanges have implemented an SEP to give uninsured consumers another opportunity to enroll in coverage. As of early February, only three states have not implemented a COVID-19-related SEP: Connecticut, Idaho, and Vermont.

Consumers can determine their eligibility for the SEP by visiting HealthCare.gov; they are no longer required to call a Marketplace call center. Eligible consumers who enroll during the SEP are able to select a plan with coverage beginning the first month following plan selection. After submitting an application, consumers will have 30 days in which to select a plan. 

Those who currently have a plan in place will be able to change plans with no restrictions to the same level of coverage as their current plan. To use the SEP, current enrollees will need to review their application, make any necessary changes, and then submit the application. They will then receive an updated eligibility result that provides the SEP before enrolling. 

Consumers enrolling during the SEP are not required to provide any qualifying event documentation, which is generally required for SEP eligibility. Those found eligible for Medicaid or the Children’s Health Insurance Program (CHIP) will be directed to their state’s Medicaid and CHIP agencies for enrollment.

HBL has experience in all areas of benefits and employment law, offering a comprehensive solution to all your business benefits and HR/employment needs. We help ensure you are in compliance with the complex requirements of ERISA and the IRS code, as well as those laws that impact you and your employees. Together, we reduce your exposure to potential legal or financial penalties. Learn more by calling 678-439-6236.

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Hall Benefits Law, LLC

HBL offers employers comprehensive legal guidance on benefits in mergers and acquisitions, Employee Stock Ownership Plans (ESOPs), executive compensation, health and welfare benefits, healthcare reform, and retirement plans. We counsel a wide spectrum of clients including small, mid-sized, and large companies, 401(k) investment advisors, health insurance brokers, accountants, attorneys, and HR consultants, just to name a few. HBL is passionate about advising clients, and we are dedicated to our mission: to provide comprehensive, personalized, and practical ERISA and benefits legal solutions that exceed client expectations.

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