In accordance with an Executive Order issued on January 28th by President Biden, CMS announced a Special Enrollment Period (SEP) for individuals and families for coverage in response to the COVID-19 Public Health Emergency. This SEP will allow individuals and families to enroll in 2021 health insurance coverage. Beginning February 15, 2021 and through May 15, 2021, consumers will be able to submit a new application or update an existing application. As a State-based Exchange on the federal platform, this SEP will be available on Healthcare.gov in Virginia. To promote the SEP and ensure consumers are aware of this implementation, CMS plans to conduct an outreach campaign in cooperation with community and stakeholder organizations focused on education and awareness of this new opportunity to enroll in English, Spanish and other languages.
In Virginia, the Health Benefit Exchange and Bureau of Insurance will work together to support this effort. Staff will stand ready to answer questions and direct callers to assisters and healthcare.gov. The HBE website and FAQs will be updated to provide direction.
Additional details from CMS:
- Consumers who are eligible and enroll under this SEP will be able to select a plan with coverage that starts prospectively the first of the month after plan selection.
- Consumers will have 30 days after they submit their application to choose a plan.
- Current enrollees will be able to change to any available plan in their area without restriction to the same level of coverage as their current plan. In order to use this SEP, current enrollees will need to step through their application and make any changes if needed to their current information and submit their application in order to receive an updated eligibility result that provides the SEP before continuing on to enrollment. Important – it is our understanding that deductible and out-of-pocket maximum accumulations are not required to be transferred to the new plan chosen; and will start over.
- This SEP opportunity will not involve any new application questions or require consumers or enrollment partners to provide any new information not otherwise required to determine eligibility and enroll in coverage. In addition, consumers won’t need to provide any documentation of a qualifying event (e.g., loss of a job or birth of a child), which is typically required for SEP eligibility.
- Consumers found eligible for Medicaid or FAMIS will be transferred for enrollment in those programs.
White House fact sheet: https://www.whitehouse.gov/briefing-room/statements-releases/2021/01/28/fact-sheet-president-biden-to-sign-executive-orders-strengthening-americans-access-to-quality-affordable-health-care/
Please let us know if there are questions about this SEP. Should you wish to not be included in future communications, please provide that response.
Virginia Health Benefit Exchange