News & Updates
May 10, 2016
The U.S. Department of Health and Human Services (HHS) has announced an interim final rule which tightens the requirements for certain special enrollment periods (SEPs). Separate guidance also makes clear that SEPs in the Health Insurance Marketplace are only available in six defined and limited types of circumstances.
Special Enrollment Periods
The new guidance clarifies that SEPs are only available in the following circumstances:
Availability of SEPs
The interim final rule also removes a January 1, 2017 implementation deadline by which Marketplaces would otherwise have had to provide advance availability (which provides qualified individuals with 60 days before or after a triggering event to select a qualified health plan) of the residency SEP. The rule also removes the requirement that SEPs for the loss of a dependent or for no longer being considered a dependent due to divorce, legal separation, or death be offered by January 1, 2017. Marketplaces can still provide either SEP, but implementation and the timing of that implementation are now at the option of the Marketplace.
For more information about the new guidance, please review the HHS Fact Sheet.
Be sure to check out our section on Health Insurance Exchanges for information regarding employer eligibility requirements to participate in the federal SHOP Marketplace.