QUESTION

Due to a hurricane/wildfire or other natural disaster, I no longer have access to documents I need to verify my eligibility for a special enrollment period, and won’t make the marketplace’s 30-day deadline to submit them. What should I do?

Individuals with no coverage | Open and Special Enrollment Periods
ANSWER

The federal marketplace is waiving the verification requirement for those individuals impacted by the hurricanes who started the special enrollment application and whose application was pended for verification. In addition, the marketplace is providing an additional sixty days for people who experienced a qualifying event between 60-days prior to the hurricane and December 31, 2017 to enroll into 2017 coverage or make changes to your existing coverage. You will be able to request retroactive coverage based on the date that you would have selected a health plan under the original SEP. Contact the Marketplace Call Center (HealthCare.gov) at 1-800-318-2596 (TTY: 1-855-889-4325) to apply.

The guidance also allows states to direct or allow insurers to provide more generous deadlines for first month’s premium payment (i.e., binder payments) to effectuate coverage. If no state guidance exists, insurers can provide up to a 60-day extension from the original binder payment deadline. (45 C.F.R. § 155.420; CMS, 2017 Hurricane Disasters - SEPs, Termination of Coverage, and Grace Period Flexibilities).

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