Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Employer/Employee Interaction and Special Enrollment Periods (SEPs)
Program Area: Small Business Health Options Program (SHOP)
Question: What is the length of special enrollment periods in the SHOPs?
Answer: In a March 11, 2013 proposed rule (78 FR 15553), we proposed aligning the length of special enrollment periods in the SHOPs with those set forth under HIPAA. Special enrollment periods in group markets, as provided for in rules implementing HIPAA, last for 30 days after loss of eligibility for other private insurance coverage or after a person becomes a dependent through marriage, birth, adoption, or placement for adoption. The proposed rule also would clarify that, consistent with HIPAA, there would be a 60-day special enrollment period for any qualified employee or dependent of a qualified employee who has become ineligible for Medicaid or CHIP or who has become eligible for state premium assistance under a Medicaid or CHIP program. These regulations were finalized as proposed.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 02, 2013
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