CES Special Enrollment Periods 3

Question 1

A hardship Special Enrollment Period in the Marketplace may be granted for situations such as:

Accepted Answer

Experiencing a natural disaster that made obtaining coverage difficult

Answer

Hardship SEPs are available for extraordinary circumstances beyond the individual's control, such as natural disasters, domestic abuse, or homelessness.

Question 2

If a person elects COBRA and then lets COBRA coverage lapse without paying premiums, they:

Accepted Answer

Do not qualify for a Marketplace SEP from lapsing COBRA

Answer

Voluntarily allowing COBRA to lapse by not paying premiums is not a qualifying event, so it does not trigger a Marketplace SEP.

Question 3

When an employer-sponsored plan no longer meets minimum value or affordability standards, an employee may:

Accepted Answer

Qualify for a Marketplace SEP and possibly premium tax credits

Answer

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.

Question 4

What documentation is typically required when claiming a SEP based on loss of prior coverage?

Accepted Answer

A termination letter or letter from prior insurer confirming coverage end date

Answer

Applicants claiming a loss-of-coverage SEP are typically required to submit a termination-of-coverage letter from their prior insurer or employer.

Question 5

A dependent child who ages off a parent's employer plan at age 26 has how long to enroll in a Marketplace plan?

Accepted Answer

60 days from the date coverage ends

Answer

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.

CES - Certified Enrollment Specialist Practice Test

CES - Certified Enrollment Specialist Practice Test

CES Special Enrollment Periods 3