Enrollment and Eligibility (ENR) FAQ
Guidance for FAQ regarding Eligibility and Special Enrollment Period (SEP)
Program Area: Enrollment and Eligibility (ENR)
Question: What is the purpose of this special enrollment period (SEP) process?
Answer: Marketplace regulations at 45 CFR 155.420(d)(4) specify that the Marketplace will provide a special enrollment period when enrollment or non-enrollment in a Qualified Health Plan (QHP) is unintentional, inadvertent, or erroneous and is the result of the error, misrepresentation, or inaction of the Marketplace. Marketplace regulations at 45 CFR 155.420(d)(9) specify that the Marketplace will provide a special enrollment period when an individual meets other exceptional circumstances as the Marketplace may provide. This process implements the special enrollment periods provided in Marketplace regulations at 45 CFR 155.420(d)(4) and (9), with a focus on situations in which system or process issues at the Federally-facilitated Marketplace (FFM) prevented the timely completion of an application, plan selection, or enrollment.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 01, 2014
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