Special Enrollment Periods Flashcards
6 cards from real CES practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Special Enrollment Periods flashcards as text
A hardship Special Enrollment Period in the Marketplace may be granted for situations such as:
Answer: Experiencing a natural disaster that made obtaining coverage difficult
Hardship SEPs are available for extraordinary circumstances beyond the individual's control, such as natural disasters, domestic abuse, or homelessness.
If a person elects COBRA and then lets COBRA coverage lapse without paying premiums, they:
Answer: Do not qualify for a Marketplace SEP from lapsing COBRA
Voluntarily allowing COBRA to lapse by not paying premiums is not a qualifying event, so it does not trigger a Marketplace SEP.
When an employer-sponsored plan no longer meets minimum value or affordability standards, an employee may:
Answer: Qualify for a Marketplace SEP and possibly premium tax credits
If employer-sponsored coverage fails to meet minimum value or is unaffordable, the employee has a SEP to enroll in Marketplace coverage and may qualify for premium tax credits.
What documentation is typically required when claiming a SEP based on loss of prior coverage?
Answer: A termination letter or letter from prior insurer confirming coverage end date
Applicants claiming a loss-of-coverage SEP are typically required to submit a termination-of-coverage letter from their prior insurer or employer.
A dependent child who ages off a parent's employer plan at age 26 has how long to enroll in a Marketplace plan?
Answer: 60 days from the date coverage ends
Aging off a parent's plan at 26 is a qualifying event that triggers a 60-day SEP for Marketplace enrollment starting from the date coverage ends.
The 'exceptional circumstances' SEP created by CMS allows enrollment during which period?
Answer: At any point during the year when CMS determines a special circumstance warrants it
CMS has authority to grant exceptional circumstances SEPs when unusual situations outside normal qualifying events prevent enrollment during open enrollment.