SEP Qualifying Question

[SamIam]

I was referred a client who has an indemnity plan which is useless for her situation. She just lost her unemployemt income but her and her husband still financially qualify for a subsidy. IMO she doesn't qualify for a special enrollment but a fellow agent is telling me she does qualify.

I'm correct she doesn't qualify or is he correct?

 

[bluediamond]

If she just became eligible for a subsidy due to the loss of her job yes this is a SEP.

 

[SamIam]

She lost her job a long time ago what she lost within the last couple of weeks was she unemployment checks.

 

[kgmom219]

She lost her job a long time ago what she lost within the last couple of weeks was she unemployment checks.

I think this is in the grey area. Protect yourself, send them to the FFM, tell them WHY you are sending them and ask if you can add them to your OEP list.

 

[Yagents]

Loss of income is not an s.e.p unless already on the exchange

 

[papercutter]

Here's a good one for you. How about someone who has entered into a Common Law Marriage in a state that recognizes them as legally valid, and this someone wants an SEP for Obamacare?

I had a lady recently who said that she knows getting married is a qualifying life event for Obamacare. She said her common law marriage is recognized by the state. I acknowledged that you have within 90 days of marriage for a special enrollment period. So I asked her for the date when she officially entered into this "state recognized marriage". And she said "I don't know. We've been living together on and off for years. But he's been shacking up at my place since February."

 

[kgmom219]

Here's a good one for you. How about someone who has entered into a Common Law Marriage in a state that recognizes them as legally valid, and this someone wants an SEP for Obamacare?

I had a lady recently who said that she knows getting married is a qualifying life event for Obamacare. She said her common law marriage is recognized by the state. I acknowledged that you have within 90 days of marriage for a special enrollment period. So I asked her for the date when she officially entered into this "state recognized marriage". And she said "I don't know. We've been living together on and off for years. But he's been shacking up at my place since February."

Why 90 days not 60?

And what state? With the exception of Texas, I think all states require a common law certificate.

In Texas, we want everyone who lives together married. You can use an enrollment form for your marriage licence.

You can also use it to get a divorce and 50%.

 

[papercutter]

Why 90 days not 60?

And what state? With the exception of Texas, I think all states require a common law certificate.

In Texas, we want everyone who lives together married. You can use an enrollment form for your marriage licence.

You can also use it to get a divorce and 50%.

Right, 60 days.

You mean in Texas, a couple can fill out an ACA health plan application and use that as evidence itself that they are hereby married?!

 

[kgmom219]

Right, 60 days.

You mean in Texas, a couple can fill out an ACA health plan application and use that as evidence itself that they are hereby married?!

Yep!

Anything that says spouse. I have been served with 2 subpoenas requesting hard copies for court.