The short version: Most states are launching a “Covid SEP” where your clients will not need a Qualifying Life Event to enroll. This starts February 15th and ends May 15th.
So, this is just like an Open Enrollment Period—where unenrolled clients
can get enrolled, and currently enrolled clients can change plans.
The long version:
From February 15th – May 15th, 2021, the 36 states using the Federal Marketplace, and several 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 Covid 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.
Some of the states which operate their own exchanges (SBMs) are also participating in this Covid SEP. Here’s the list – we’ve bolded states that have different date ranges:
- California: Feb 15th – May 15th (no life change required for uninsured people only)
- Colorado: Feb 8th – March 14th (no life change required for uninsured people only)
- Connecticut: Feb 16th – May 15th (no life change required for uninsured people only)
- Maryland: Now – March 15th (no life change required for uninsured people only)
- Massachusetts: Feb 15th – May 23rd
- Minnesota: Feb 15th – May 15th
- New Jersey: Feb 15th – May 15th
- New York: Feb 15th – March 31st (no life change required for uninsured people only)
- Nevada: Feb 15th – May 15th
- Pennsylvania: Feb 15th – May 15th
- Rhode Island: Feb 15th – May 15th
- Vermont: February 16th – May 14th (no life change required for uninsured people only – and must be done over the phone, not online)
- Washington: Feb 15th – May 15th
- Washington DC: Feb 15th – May 15th
How do I change plans for a currently-enrolled client?
To change plans for a currently-enrolled client, go to their Client Profile page by clicking their name or the View button:
The Client Profile will show a “Report changes” and “Change plans” button if the client is still within their window to change plans. If not, it will only show the “Report changes” button:
If you want to change plans without updating the application – click Change Plans if it’s there. If it’s not, then click Report Changes, go through the application without changing anything, change the plan, then submit the application.
If you want to change plans and also update the application – click Report Changes, go through the application and make any changes needed, change the plan, then submit the application.
When is the effective date?
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).
Can I shop early?
You can browse plans now if you’d like to get a head start. But, if you plan to submit without a life change, then wait until February 15th to submit the application.
Why is this Enrollment Period 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.
Written by Jeff Kriege
Agility Producer Support