The Special Enrollment Period (SEP) is a time outside the yearly Open Enrollment Period when a client can enroll for health insurance if they’ve experienced a Qualifying Life Event (QLE).
New changes to the special enrollment period also grant year-round enrollment in ACA-compliant health insurance to applicants whose household income does not exceed 150% of the federal poverty level (FPL) starting March of 2022. Coverage takes effect the first of the following month after enrollment.
There are no restrictions on how often this special enrollment period can be used nor the type of health plan that can be chosen. A person with an eligible household income who is already enrolled in an exchange plan can utilize the SEP to switch plans, albeit the deductible and out-of-pocket expenditure for the year will be reset to $0 when the new plan begins.
A life event that “qualifies” (QLE) a client for SEP includes those who have experienced one of following in the last 60 days:
- Lost coverage through a job for any reason including retirement, being laid off, being fired, death of a spouse, death of a parent, or loss of COBRA.
- Lost Medicaid, Florida Kidcare, Medicaid Share of Cost, or premium-free Medicare.
- Moved to another country, state, or from overseas.
- Gained employment such that you now qualify for Marketplace financial assistance.
- Turned 26 and aged off your parents’ health plan.
- Lost a student health plan.
- Gave birth to a child or adopted.
- Got married or got divorced, either of which affected your health coverage.
- Had a change in immigration status that made you newly eligible for the Marketplace.
- Were released from incarceration.