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Enrollment and Eligibility (ENR) FAQ

Guidance for FAQ regarding Eligibility and Special Enrollment Period (SEP)

Program Area: Enrollment and Eligibility (ENR)

Question: Assuming the enrollee pays the first month's premium by the due date, what coverage effective date should a Qualified Health Plan (QHP) Issuer send back on the 834 Confirmation/Effectuation transaction?

Answer: The QHP Issuer should send the 834 Confirmation/Effectuation transaction indicating a January 1, 2014 coverage effective date, and when applicable, a January 1, 2014 Advanced Payment of the Premium Tax Credit (APTC) start date.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 01, 2014

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