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CMS and New Rules in Meeting Carriers Requests for Restrict Enrolling Outside Open Enrollment Period

CMS might offer some SEP (Special Enthrallment Periods), the agency has started removing some of these because of the insurance carrier requests. As an example the SEP for Tax Season which had ran March 15th to April 30th 2015. This originally was meant only for 2015. It looks that a memo in January 19 showed that an additional 6 SEP’s would be removed, including some for the following.

  • Customers enrolling with too many in advance payments for premium tax credit because this is more of a duplicate or redundant policy.
  • Customers who are affected by errors in a treatment of their Social Security Income for tax dependents.
  • Present Lawfully Non-citizens affected for system errors when determining advance payments of that premium tax credit.
  • Non-citizens lawfully present and have incomes lower that 100% FPL or Federal Poverty Level and who had certain processing delays.
  • Those who are eligible and or are enrolled in COBRA but are not sufficiently informed about the options in their coverage.
  • Customers who had previously been enrolled in a Pre-Existing Condition Program for Health Insurance.
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