What is a Special Enrollment Period?

A Special Enrollment Period or SEP is a time period outside of the Open Enrollment period during which an individual or family, due to certain Qualifying Life Event, would have the option to sign up for health care through a Job-based or Marketplace (Health Care Reform) plan. Examples of a Qualifying Life Events are:

  • Marriage
  • Having a baby, adopting a child or placing a child for adoption or foster care
  • Moving your residence
  • Losing other health coverage—due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances.
    • Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.

Job-based plans must provide a SEP of 30 days following a qualifying life event.  Marketplace plans can provide a SEP up to 60 days following the qualifying life event.

 

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The information provided is for informational purposes only and does not constitute legal advice. The information above contains only a summary of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation or requirement. Depending on the specific facts of any situation, there may be additional or different requirements. This is to be used only as a guide and not as a definitive description of your compliance obligations.