Can They Enroll in ACA ?

[yogooglethis]

Voluntarily dropped retiree EGHP 12/31/14.M 60 and F 59 no coverage now and qualify for full subsidy.My understanding is they can't get SEP for 3/1/15 because coverage was voluntarily dropped correct?On healthcaer.gov only ask if they lost coverage in last 60 days but I assume the applicant is asked to verify this after the fact? Can they get the SEP after 3/15 or whatever they are calling it for 4/1/15 effective even if they had coverage for 2014 won't pay penalty for 2014?

 

[bluediamond]

I completed an app just the other day with same scenario, they may ask for income proof, but no one asked for loss of coverage. You may want to get the letter of coverage and keep in your possession if someone does ask (carrier) in the future. Dec 31 was during oep they certainly can drop in voluntarily. You need to write today though. Their effective date will be tomorrow March 1. You will be too late this year if you don't complete today. Only one's who have filed their taxes and know they have a penalty for last year are going to be entitled to the SEP beginning 3/15.

 

[Yagents]

Voluntary is not an s.e.p.

No subsidy with access to group

 

[bluediamond]

I think the key here is retiree group, once they drop it they do not have access and if it was the group annual enrollment they certainly can drop it, does it trigger a SEP? The mp would certainly enroll them with subsidy.

 

[yogooglethis]

Voluntary is not an s.e.p.

No subsidy with access to group

Does no subsidy still apply if they are not employed and this was retiree EGHP coverage they dropped and which that can't get back?

 

[Yagents]

I missed retiree part. Can do with m.p., they dish out everything

 

[yogooglethis]

I think the key here is retiree group, once they drop it they do not have access and if it was the group annual enrollment they certainly can drop it, does it trigger a SEP? The mp would certainly enroll them with subsidy.

If dropped 12/31/14 would the 60 SEP run through 3/2/15 or whatever is exactly 60 days there for making them eligible for a 4/1/15 effective date if application is submitted by 3/2/15 or is 3/1/15 the last effective date available?

 

[bluediamond]

Ok I should have said this is walking a fine line, I did complete an app for a SEP same circumstance's, this past week. I called the mp and asked for a supervisor and she said technically when asked will they have access to group the answer is no because it's already dropped and answer yes to "Did you lose group in last 60 days" yes they did lose coverage. It does not ask did you voluntarily drop. I think we have all found they make the rules as they go a long.

I have been told by MP that the policy has to be effective by the 60th day so no to your answer, if they let you do it then it has to be completed today for an effective date of tomorrow.

Why did these people decide to wait so long?

Like I said I think why we all have different answer's is what we initially learned apparently can be changed at the market place's whim.

On tax forms next year if they stay the same as this all it ask's is did you have health insurance coverage.

I felt I was within the confine's of the law when a mp supervisor said go ahead with it. I did get the name of supervisor and filed it with a copy of app. But I am not worried about it. I only have a couple I worry about because I knew they were lying to me and the type to forget that I advised against it.

 

[Yagents]

To me:

They can drop voluntarily during o.e.p. and pick new plan.

But that voluntary drop does not create an s.e.p reason once o.e.p ended.

That's just me, m.p. rep will manipulate to get an s.e.p. had one m.p. rep tell my client to lie and put child as dependent to get results needed. Couldn't believe what I was hearing, and then had gall to read perjury disclaimer slowly. Client wouldn't say yes.

 

[yogooglethis]

Ok I should have said this is walking a fine line, I did complete an app for a SEP same circumstance's, this past week. I called the mp and asked for a supervisor and she said technically when asked will they have access to group the answer is no because it's already dropped and answer yes to "Did you lose group in last 60 days" yes they did lose coverage. It does not ask did you voluntarily drop. I think we have all found they make the rules as they go a long.

I have been told by MP that the policy has to be effective by the 60th day so no to your answer, if they let you do it then it has to be completed today for an effective date of tomorrow.

Why did these people decide to wait so long?

Like I said I think why we all have different answer's is what we initially learned apparently can be changed at the market place's whim.

On tax forms next year if they stay the same as this all it ask's is did you have health insurance coverage.

I felt I was within the confine's of the law when a mp supervisor said go ahead with it. I did get the name of supervisor and filed it with a copy of app. But I am not worried about it. I only have a couple I worry about because I knew they were lying to me and the type to forget that I advised against it.

FYI here is what eligibility letter generated today during application process for this client says about the 60 day SEP for loss of coverage that happened 12/31/2014 so maybe they could have enrolled for 4/1/15 as well as 3/1/15 ?


"If the table above says you are eligible for a special enrollment period, March 2, 2015 is the last day to
choose a health plan. "


Now I if I can only unlock the " Select a health insurance plan " tab i could complete the application for a 3/1/15 effective date.My npr number isn't even on the application yet .I hope I will still get credit for this 1300.00 premium case.

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