News to Me, Up to July 1 Marketplace SEP for Dropping COBRA

[yorkriver1]

Just checked today to be sure I was not incorrectly turning down my friend who wants a quote for Marketplace coverage.

Her former employer's plan is 7/1 to 7/1 plan year. She wants to check Marketplace before making the choice to stay on COBRA during group renewal time. I think otherwise she has another 6-9 months of COBRA.

I was surprised to see that now, HC.gov says anyone on COBRA can have a SEP if they enroll before 7/1/14.

"Important: If you currently have COBRA continuation coverage, you may qualify for a Special Enrollment Period for a limited time only. This allows you to enroll in a Marketplace plan instead. In order to take advantage of this one-time Special Enrollment Period, you must enroll in a new plan by July 1, 2014."

Up until this popped up, all training classes have said, it's over once they opt for COBRA until open enrollment or COBRA ends.

https://www.healthcare.gov/what-if-i-currently-have-cobra-coverage/

After looking further down list of posts, I noticed Duaine posted this and a couple other exceptions on May 7, under "Feds Change Rules Again". Good info. there.

 

[Lakshmi]

Thank you. That is good to know. I would have thought they would not let that happen and that they would make people exhaust their COBRA first.

Good info.

 

[somarco]

I would have thought they would not let that happen and that they would make people exhaust their COBRA first.

Do you really believe the govt is benevolent?

 

[yorkriver1]

All recent carrier workshops, including last week, have mentioned that if someone took COBRA after losing employer coverage they are locked in until open enrollment. I am glad I checked on HC.gov and found this exception, not mentioned in carrier workshops.

This may help folks on COBRA who missed the cue to sign up on Marketplace during open enrollment or didn't/couldn't avoid taking COBRA in the first place when they lost employer coverage.

Seems that carriers and HC.gov are leaning gradually towards more ways to create SEP's, perhaps seeking more premium/enrollees.

 

[Lakshmi]

Absolutely not!! Hence, why I permanently departed from the health insurance sales scene, effective Mar. 31, 2014.

Should've made this move much sooner.

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Well, I suppose that's not entirely true. I am still taking a referrals. I feel like I have an obligation sometimes.

It's seems so futile to even bother with the exchange or ACA. I still haven't been paid a dime on what I've put through from January to March.

It is good to keep up on what's going on...I still fantasize about things going back to how it used to be. Although, I know it will not happen. lol

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Re: benevolent. I increasingly sense that both HC.gov and carriers are leaning towards ways to get more people enrolled through SEP's. It's premium in, however, most likely, not generosity.



Exactly!!

I equate it to UH always saying they would not except a business check if the policy holder was the business owner. This was awhile ago...but, we did it all the time anyway. They never turned it down. It's all about getting people to enroll.

I recently enrolled someone who lost their coverage due to non payment. She forgot. This wasn't in the Marketplace, but she went through on SEP through an off exchange company. They told me I could do it when I called underwriting.

However, it also states that non-payment is not sufficient to qualify for SEP.

Just noting internally, there are almost always loop holes to get more numbers signed up. ugh. never ending.

 

[Yagents]

I've called the marketplace twice in the past week since this news came out. Twice they spoke to a supervisor. Twice they've said they have not heard anything about this new rule.

Par for the course

 

[yorkriver1]

Yes, I guess we can refer them to their own website, which is where I found the information--see link to their site in my OP--.

This morning, I asked a front line rep to please check with the supervisor when I was told that folks enrolling during a SEP have to sign up before the 15th for 1st of following month…..not…..but that has been discussed elsewhere here.

 

[RayNY]

York, I had the same problem today, 3 times (4/30 terms applied this week for 5/1 effective, denied b/c "past submission date", and offered 6/1). I eventually had to quote the federal law, and the carrier's own SEP guidance, for them to properly process.

http://www.cms.gov/CCIIO/Resources/...e/Downloads/SEP-and-hardship-FAQ-5-1-2014.pdf <CMS full text, if you want to read it.

I called my state's exchange today (NY, a SBM, not FFM). They were unaware of the guidance, but thanked me for bringing it to their attention and providing a reference to the document in question.

Does not apply in NY, as per the supervisor. If you're dealing with an SBM, I suggest you call in and see if they followed CMS's encouragement to "adopt similar special enrollment periods". Chances are, they didn't even know.

 

[somarco]

Wondering out loud here . . . .

What happened to the guy (Matt Vick) that worked for one of the exchanges? He had a lot of really good info. Anyone know how to contact him?

 

[Quotebroker]

Got this email last night. State specific, though.

COVERED CALIFORNIA CREATES LIMITED SPECIAL-ENROLLMENT PERIOD FOR THOSE
COVERED BY COBRA
COBRA Enrollees Have 60 Days to Switch to an Exchange Plan; Move Is Expected to Save California Consumers Money on Health Insurance

SACRAMENTO, Calif. — Beginning Thursday, May 15, Covered California will launch a limited-time special-enrollment period for people who have COBRA health insurance, either Federal COBRA or Cal-COBRA, and would like to switch to an exchange plan.
People who have health coverage through COBRA (the Consolidated Omnibus Budget Reconciliation Act) will be eligible to shop for and buy coverage through Covered California from May 15 through July 15. The two-month window mirrors a U.S. Department of Health and Human Services (HHS) ruling announced May 2 that allows COBRA enrollees to buy plans through the federal exchange up to July 1.
The federal policy for the COBRA special-enrollment period was approved amid concerns that notifications did not give consumers clear information about options in the new marketplace. HHS encouraged state exchanges to follow suit.
“COBRA coverage has given vital protection for nearly three decades to people who lost coverage from their employers, especially those who couldn’t get affordable insurance because of their age or a pre-existing condition,” said Covered California Executive Director Peter V. Lee. “Since the passage of the Affordable Care Act, plans in the individual market could be preferable to COBRA coverage because of premium assistance and cost-sharing reductions, available only through the exchanges. For some people who have COBRA coverage, purchasing a plan in the Covered California marketplace during this special-enrollment period could save thousands of dollars a year.”
Under COBRA, individuals who experience a job loss can purchase the coverage they had through their employer but are responsible to pay the full cost. In some cases, individuals and families can purchase more affordable coverage in the health benefit exchanges.
“COBRA will continue to be a cornerstone of coverage for workers after a job loss, but it’s important for employees to know that there are options in the marketplace that could save them money,” Lee said.
This newest category of special enrollment joins a host of “qualifying life events” under the federal Patient Protection and Affordable Care Act that allow consumers to get exchange coverage during a time when open enrollment is not available. Other events include losing coverage, having a child, getting married and moving.
COBRA enrollees, either on Federal COBRA or Cal-COBRA, who would like to take advantage of this limited special-enrollment period can apply at the Covered California website and select “Other Qualifying Event” during the special-enrollment application process.