Every once in awhile life hands you lemons. If you recently received notice that you are losing your health insurance plan, fret not. You have 60 days to enroll in your new plan during this Special Enrollment Period (SEP).
Additionally, you may also consider COBRA continuation coverage, which allows you to temporarily keep your current health plan, although you will be responsible for the full premium plus administrative costs.
The New Pre-enrollment process
The Centers for Medicaid and Medicare Services (CMS) have revised the action steps taken during the special enrollment period. Beginning June 23, 2017, pre-enrollment verification starts for special enrollments due to loss of coverage or a move. The new process for enrolling in health insurance during a Special Enrollment Period requires pre-enrollment verification which CMS has termed SEPV. This means that consumers will need to submit documents verifying they qualify for the Special Enrollment Period prior to receiving coverage. An SVI (SEP Verification Issue) will be created for you beginning the process for enrollment. Once the SVI is created you have 30 days to provide documentation and choose your plan before your SVI is cancelled and then you will have to wait until the next open enrollment window (Nov 1- Dec 15) before you can enroll in a health plan.
I no longer have a health plan...what do I do?
Once you know that you are losing coverage or have lost coverage you will need to act fairly quickly as you only have 60 days to enroll, you can choose to enroll either 60 days before or after the date you will lose coverage. These are the steps you will need to take.
Alternatively, if you are transitioning jobs, you could explore COBRA or consult your new employer's health coverage options to ensure continuity.
Submit an application for Special Enrollment Period (SEP). Your application will create an SVI (Verification Issue) in the system.
Select a plan. If you need help searching plans, Take Command Health can help you search the best plans in your area. Plan Enrollment is on hold until you provide further documentation. You have 30 days to complete process.
Mail in or upload documents providing proof that you have lost or will be losing coverage including the date coverage is ending. If you need to enroll multiple members of a household, you will only need to provide documentation for one of the members and this will provide proof for the entire family.
Marketplace reviews your documents and may request additional proof.
Marketplace approves the SVI and sends you plan enrollment paperwork.
Submit payment to activate and begin using your new plan!
If COBRA coverage is available through your former employer, consider it as a way to maintain your existing plan, though at a higher cost.
Click here to see what Healthcare.gov says about what qualifies as proof of loss of coverage.
Annual Enrollment Scenarios
Keep in mind that during annual enrollment, you can use tools like Take Command's HRA Hub to retain or change your health insurance plan for the upcoming year. Ensure you complete all required onboarding steps if you’re retaining the same plan.
Summary
By being proactive—whether you’re transitioning jobs, navigating an SEP, or planning during annual enrollment—you can ensure continuous health coverage. Explore all applicable options like COBRA, marketplace plans, or employer-sponsored health insurance to find the best fit for your needs.