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Special Enrollment Periods and Triggering Events

Special enrollment periods will last for 60 days from the date of the triggering event unless the regulation specifically provides otherwise.

All requests for special enrollment periods must be evaluated by the Exchange as part of the eligibility determination process.

For purposes of special enrollment periods, a dependent is an individual who is or may become eligible for coverage under the terms of a QHP because of a relationship to an enrollee.

Triggering Events:

HHS is seeking comment on its limitation of the special enrollment period to only those who loses minimum essential coverage, as opposed to any coverage. This was done to avoid adverse selection.

HHS seeks comments as to whether States might consider expanding the special enrollment period to include gaining dependents through other life events.

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Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.

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