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Monday, July 11, 2016

Special Enrollment for Permanent Moves, Marriages, and More

Jessica Kendall

Director of State Partnerships

Nygel Williams

Villers Fellow

Consumers have opportunities to enroll in health coverage 365 days a year, but many don’t know about it. Summer is an ideal time to find consumers who qualify for special enrollment periods (SEPs). Wedding season is in full swing, grad caps have been tossed, diplomas are in hand, and those all-nighters in the library finally paid off.

Newlyweds and recent graduates are just two examples of demographics that enrollment assisters can focus on when conducting outreach and forming strategic partnerships.

It’s important for advocacy groups and others helping consumers complete their health insurance applications to spread the word that coverage is available for people now, as their lives change. These groups can help consumers navigate the new process that the Centers for Medicare and Medicaid Services (CMS) just enacted for enrolling in coverage through certain SEPs.

Recent changes to the permanent move SEP

Recently, CMS made changes to the rules surrounding the permanent move SEP that go into effect starting July 11. Here are some of the major changes:

  • In order to qualify, most consumers must have minimum essential coverage for at least one of the 60 days before they move.
  • If consumers are aware of the move and can provide documentation, they can apply through the SEP up to 60 days prior to a move.

Read on for tips and updates about changes to the SEP process. Our infographic highlights which life events qualify consumers to get health insurance through a special enrollment period. And our June webinar offers creative ideas to help enrollment assisters find consumers who may be eligible to sign up for health insurance due to a recent life change that qualifies them to enroll through an SEP.

Prior to this policy change, consumers who moved could be eligible for the SEP regardless of whether they had prior coverage. This new requirement makes it harder for people to get coverage, and we’ve been concerned about how this will negatively affect consumers.

New requirements to verify eligibility for certain SEPs

There have also been some recent changes to the verification process for the other common SEPs (loss of minimum essential coverage; having a child; gaining a dependent through adoption, placement for adoptions, placement in foster care, or child support; and marriage). As of June 17, consumers were required to provide documentation to enroll through any of these SEPs. It’s important to note these policy changes as they will affect consumers you work with, especially in between open enrollment periods.

Using SEPs to your outreach advantage

Although the new guidelines may make it more difficult for consumers to get enrolled into coverage, the biggest challenge is that people don’t know they are able to get coverage in the first place. That’s where enrollment assisters come in.

Oh the Places You’ll Go: Moving and Marriage

It’s summer, and three major life changes are happening: people are getting married, graduating from college (and losing their school-sponsored insurance), and moving.

An estimated 2.3 million people will get married, and more than 3.7 million students will be getting degrees this year and (hopefully) jobs that will take them all over the country. While many will receive health coverage through their workplace, others will not have that same opportunity. That’s when enrollment assisters can forge new relationships and partnerships to help consumers get covered.

Make Your Presence Known

Knowing coverage is available is the first step, and by forging new partnerships, assisters can make sure having health insurance is one less thing for consumers to worry about.

What to do when people:

  • Get to college—Consider working proactively with universities and colleges in your area to reach out to students before they lose their coverage. Events like career fairs are great opportunities to interact.
  • Move—People may need a moving company, an official “change of address” form, or answers from their rental company. Think about the touch points that intersect with those people. Local rental agencies, moving companies, and the post office are a good start.
  • Get married—People usually want a venue (where do people get married in your town?), a certificate (check the county clerk’s office), a dress (bridal stores, consignments stores), and perhaps a person of faith to perform the ceremony.
  • Have or adopt a baby— People may visit parenting blogs, baby-focused stores, and working with local providers. Think, where can you interact with new parents?

As we think through 365 days of enrollment, let’s also think through how we can reach consumers through targeted outreach and enroll them in coverage when they experience qualifying life-changing events.

If you have questions or want to share success stories about your efforts to enroll people who experience a life-changing event, email us at