Employer Coverage Ends Last Day of Employment, SEP Gives 1st of Next Month Start Date

[yorkriver1]

So, loss of coverage isn't like birth/adoption/marriage, where the effective date is the date of the event?
Just had one today, loss of coverage 9/5/15, eligibility date 10/1.
I have had these before, but it's on my mind because I have an employee situation where the add/drop will be the wedding day, for the medical--going on spouses plan--, but 1st of following month for dental. I know group can be different.

 

[RayNY]

https://www.law.cornell.edu/cfr/text/45/155.420

Marriage is not effective date of event, it's first of the month after the application is received by the carrier (2)(ii).

"New dependent" is the only time coverage is effective the day of the event. For everything else, it's either "first of month after app rec'd by carrier" or "first of month if rec'd by carrier between 1st-15th, 1st of next month if rec'd between 16th-31st"

(Keep in mind, almost this entire section was re-written/ammended by 79 FR 30348 in May 2014 http://www.gpo.gov/fdsys/pkg/FR-2014-05-27/pdf/2014-11657.pdf#page=110.)

 

[yorkriver1]

Thanks, very thorough! I was thinking this way because of the recent "new dependent", like I mentioned.
You know, it says right on the Marketplace eligibility notice for the couple losing group coverage that it would be 1st of following month if enrolled by 15th.
RTM, not to mention the more colorful RT*M.

 

[RayNY]

RTM indeed, especially if they're going to change it all!

For reference, if you apply before or on the day of the loss, you can have coverage effective without lapse. If you apply after the loss, you'll have at least a 1-month lapse.

Applying before the event happens may require a call to the exchange.