The short version:
This is a new kind of SEP where your clients will not need to verify a Life Change to enroll. This starts February 15 and ends Aug 15*.
So this is just like an OEP—where uninsured clients can get enrolled, and currently insured* clients can change plans**.
*Some SBM states have different dates & rules.
**See important note below about how to change plans.
The long version:
From February 15 – Aug 15, 2021, the 36 states using the Federal Marketplace (FFM), and most of the other states, will allow consumers to enroll without having to verify a Life Change (also known as a "Qualifying Life Event") as they normally would when enrolling outside of Open Enrollment.
How it works
When you enroll a client who does not have a Life Change, simply don't select a Life Change on the application. If the client does have a legitimate Life Change, you should select it—during this SEP, they will not need to provide any follow-up documentation to prove their Life Change.
If your client has a birth or adoption Life Change, be sure to select it, so that the coverage effective date will backdate to the birth/adoption date.
SBM state details
This SEP applies to all FFM states. In addition, almost all of the states which operate their own exchanges (SBMs) are also participating in this SEP. Here's the list – we've bolded states that have different date ranges or rules:
California: February 15 – December 31*
Colorado: February 8 – August 15*
Connecticut: February 16 – April 15
Idaho: March 1 – April 30*
Maryland: now – August 15*
Massachusetts: now – August 15
Minnesota: February 16 – July 16*
New Jersey: February 15 – November 30
New York: February 15 – December 31
Nevada: February 15 – August 15
Pennsylvania: February 15 – August 15
Rhode Island: February 15 – August 15*
Vermont: February 16 – May 14*
Washington: February 15 – August 15*
Washington DC: February 15 – Dec 31 or longer*
*(No life change required for uninsured people only)
How to change plans while also triggering this SEP
If you want to change plans for a currently enrolled client, while taking advantage of this SEP's removal of the Life Change requirement, follow these steps:
1. From your Client List, click the client's name or the View button:
2. You'll then be on their Client Profile page:
You may see the Change Plans button (if the client is still in the window to change plans), but do NOT use it – this particular SEP requires an application submission, and changing plans does not resubmit the application. So instead, use the Report Changes button to go through the application, then change plans, then submit the enrollment.
There will be accelerated coverage dates, meaning as long as the enrollment is submitted before the end of the month, the coverage effective date will be the 1st of the following month. The earliest effective date for this SEP is March 1st, unless the client qualifies for a retroactive effective date (e.g. due to birth or adoption).
Why is this Enrollment Period is happening
The Centers for Medicare & Medicaid Services (CMS) determined that the COVID-19 emergency presents exceptional circumstances for consumers in accessing health insurance. Because of this emergency, they’re providing a Special Enrollment Period for individuals and families to apply and enroll in the coverage they need.