Important News: ​Special Enrollment Period Changes for Individual/Family Insurance

For people who use the marketplace (healthcare.gov) for their insurance coverage, the new administration changed the rules for Special Enrollment Periods on June 19th. This article applies to anyone who loses coverage mid-year, such as the loss of a job, retirement, move from another state or county, and loss of Badgercare. 

The new rules are even more stringent and require people to act even more quickly when they find out they are going to lose coverage. People will also need to be prepared to have at least one month of no coverage while the new Special Enrollment Period Verification processes.
 
What you need to know
When you lose other coverage, such as from an employer or BadgerCare, you have 60 days to enroll in a marketplace plan or risk going uninsured for the rest of the year. This is known as a Special Enrollment Period (SEP). If you miss your SEP, you will have to wait until Open Enrollment (November 1st - December 15th) to enroll into a plan for the next year. It is important to act fast, and I highly recommend getting help or using an online enrollment tool like this one to make the process as easy as can be. Acting before you lose coverage is still important, but it has gotten trickier.
 
What you need to do now that’s different
The new rules make it so you must prove you lost other coverage before your new coverage can start. This means that at the time you apply, you should have your termination letter in hand so you can submit it right away. Realistically, however, most COBRA notices don’t go out until 10 days after coverage has ended. This means you are likely to face at least a month gap in insurance coverage.
 
What to do if you’re waiting for a COBRA notice
Contact your former employer and ask them to write a letter saying what day your insurance ended/ends. If you’re losing BadgerCare, you will get a notice 10 days before your loss.

How to prove loss of other insurance
You’ll have to upload the document to your account on healthcare.gov and check back in a few days to see if you’ve been approved so you can pay your first month’s premium (you will have already selected a plan that is “pending”). I help people in Wisconsin with the enrollment process and I always help my clients submit verifications. Contact me before you apply on your own if you would like help, at no cost to you.