CEC Special Enrollment Periods & Life Events 2 — Questions and Answers
Question 1: Which type of SEP applies to a consumer who permanently moves to a new area that offers different Marketplace plans?
- Exceptional Circumstances SEP
- Loss of Coverage SEP
- Change in Residence SEP (Correct answer)
- Dependent Addition SEP
Correct answer: Change in Residence SEP
A Change in Residence SEP allows consumers who move to a new coverage area with different plan options to enroll in a new Marketplace plan.
Question 2: A consumer who gains U.S. citizenship or lawful presence qualifies for which type of Special Enrollment Period?
- Medicaid Denial SEP
- Gain of Eligible Immigration Status SEP (Correct answer)
- Income Change SEP
- Open Enrollment Extension SEP
Correct answer: Gain of Eligible Immigration Status SEP
Gaining citizenship or lawful presence makes a consumer newly eligible for Marketplace coverage, triggering a SEP.
Question 3: How long does a SEP typically last for a consumer who loses Medicaid or CHIP coverage?
- 30 days
- 60 days (Correct answer)
- 90 days
- 120 days
Correct answer: 60 days
Consumers who lose Medicaid or CHIP coverage have a 60-day SEP to enroll in Marketplace coverage.
Question 4: Which SEP allows a consumer to change plans if they were enrolled in the wrong plan due to an error?
- Exceptional Circumstances SEP (Correct answer)
- Enrollment Error SEP
- Retroactive Correction SEP
- Agent Mistake SEP
Correct answer: Exceptional Circumstances SEP
An Exceptional Circumstances SEP can be granted when a consumer was enrolled in a plan due to an error or through no fault of their own.
Question 5: What is the maximum duration of most standard SEPs on the Health Insurance Marketplace?
- 30 days
- 45 days
- 60 days (Correct answer)
- 90 days
Correct answer: 60 days
Most standard SEPs last 60 days from the date of the qualifying life event.
Question 6: Which household event qualifies a consumer for a SEP related to household size changes?
- A sibling moving to a different state
- Adoption of a child (Correct answer)
- A roommate getting a new job
- A consumer's spouse changing employers
Correct answer: Adoption of a child
Adoption of a child is a qualifying life event that changes household size and triggers a SEP for the adopting parent.
CEC Special Enrollment Periods & Life Events 2
Which type of SEP applies to a consumer who permanently moves to a new area that offers different Marketplace plans?