CEC Special Enrollment Periods & Life Events 1 — Questions and Answers
Question 1: What is a Special Enrollment Period (SEP) in the context of the Health Insurance Marketplace?
- A time outside Open Enrollment when qualifying life events allow plan changes (Correct answer)
- A period when Medicaid enrollments are suspended
- An annual window for all consumers to compare plans
- A grace period for premium payment after termination
Correct answer: A time outside Open Enrollment when qualifying life events allow plan changes
A SEP is a window outside Open Enrollment during which consumers who experience a qualifying life event can enroll in or change Marketplace coverage.
Question 2: Which of the following is a qualifying life event that triggers a Special Enrollment Period?
- Voluntarily canceling a previous plan
- Loss of minimum essential coverage (Correct answer)
- Deciding a current plan is too expensive
- Turning 26 and remaining on a parent's plan
Correct answer: Loss of minimum essential coverage
Involuntary loss of minimum essential coverage is a qualifying life event that triggers a SEP on the Marketplace.
Question 3: How many days does a consumer typically have to enroll in a Marketplace plan after a qualifying life event?
- 15 days
- 30 days
- 60 days (Correct answer)
- 90 days
Correct answer: 60 days
Most qualifying life events give consumers a 60-day SEP window to enroll in or change a Marketplace plan.
Question 4: Which of the following does NOT qualify as a life event for a Special Enrollment Period?
- Getting married
- Having a baby
- Moving to a new coverage area
- Choosing to leave a job voluntarily without losing coverage (Correct answer)
Correct answer: Choosing to leave a job voluntarily without losing coverage
Voluntarily leaving a job without losing health coverage does not trigger a SEP because coverage was not involuntarily lost.
Question 5: What documentation may be required to verify a SEP triggered by marriage?
- W-2 form
- Marriage certificate (Correct answer)
- Prior insurance card
- Employer verification letter
Correct answer: Marriage certificate
A marriage certificate is the standard document used to verify a SEP based on a change in household due to marriage.
Question 6: During a SEP triggered by loss of job-based coverage, when can the new Marketplace coverage typically begin?
- Immediately upon application
- The first of the month after losing coverage or the date of loss (Correct answer)
- Only at the start of the next calendar year
- 90 days after enrollment is completed
Correct answer: The first of the month after losing coverage or the date of loss
Coverage can start on the first day of the month after loss of coverage, or in some cases on the actual date coverage was lost.
CEC Special Enrollment Periods & Life Events 1
What is a Special Enrollment Period (SEP) in the context of the Health Insurance Marketplace?