SEPs

Back on March 23rd, I noted that while every other state-based ACA exchange has launched an official COVID-19-specific Special Enrollment Period, there are two ACA exchanges which have refused to do so. One of them is the mothership, HealthCare.Gov, which is run by the Centers for Medicare & Medicaid (CMS) and which hosts a whopping 38 states. The other one is Your Health Idaho:

I contacted the exchange last week to see what the deal was re. a COVID-19 SEP and they kicked the ball over to the state Insurance Dept:

COVID-19 (coronavirus) is not currently considered grounds for a Special Enrollment Period in Idaho. Questions around the potential offering of an SEP would be best answered by the Idaho Department of Insurance. This really falls within their regulatory authority. YHI will follow their guidance and support whatever decision is made.

I did indeed contact the Idaho DOI, but I didn't hear back from them until today. Here's what they had to say:

via HealthSource RI:

Health Coverage Special Enrollment Period (SEP) Extended through April 30, 2020

  •  Special Enrollment Period has been extended through April 30th, 2020

EAST PROVIDENCE, R.I. (April 13, 2020) — HealthSource RI has extended the limited-time Special Enrollment Period (SEP) that was established following Governor Raimondo’s State of Emergency declaration in response to the Coronavirus (COVID-19). This SEP provides an opportunity for uninsured Rhode Islanders to purchase coverage through April 30, 2020. Coverage will begin on the first of the month following the application.

Rhode Islanders who wish to obtain coverage can do so by visiting HealthSourceRI.com and enrolling online, or by contacting the HealthSource RI call center Monday-Friday, 8am-6pm at 1-855-840-4774. When completing the online enrollment form, Rhode Islanders should select the “other” SEP event and indicate COVID-19 or coronavirus as the explanation. Once approved, customers will need to choose a plan and pay for their first month of coverage.

via the Washington Healthplan Finder:

Washington Health Benefit Exchange Reminds Individuals Impacted by COVID-19 of the Health Insurance Options available now through Washington Healthplanfinder

  • Washington Health Benefit Exchange (Exchange) today is reminding uninsured individuals impacted by the Coronavirus (COVID-19) situation in Washington that the special enrollment period is extended through May 8, 2020, for coverage beginning May 1, 2020.

Washingtonians who may qualify for health and dental coverage through Washington Healthplanfinder using existing special enrollment periods include individuals who:

via MNsure, this includes their ongoing ACA exchange Special Enrollment Period but also explains other options for Minnesotans as well:

Health Insurance Options through MNsure during COVID-19

April 7, 2020

ST. PAUL, Minn.—MNsure, the state’s health insurance exchange, reminds Minnesotans who have recently lost a job, experienced a reduction in hours, or are otherwise uninsured to visit MNsure.org to get connected to health insurance. On MNsure.org, Minnesotans looking for health insurance coverage can compare plans and see if they qualify for financial help to cover the cost of insurance premiums or low-cost or no-cost health insurance either through Medical Assistance or MinnesotaCare.

Here’s what you need to know

Uninsured? Sign up now.

As I've reported before, the DC Health Link exchange is one of a dozen state-based ACA exchanges which is currently offering a COVID-19-specific Special Enrollment Period during which uninsured residents can #GetCovered. The deadline is June 15th.

A few days ago, however, they announced an interesting expansion on the COVID SEP...one specifically intended for employees of small businesses which offer ACA SHOP plans to their employees which these employees haven't enrolled in as of yet:

DC Health Link Expands Opportunities to Get Covered During Public Health Emergency

Monday, April 6, 2020

Responding to COVID-19 pandemic, DC Health Link permits uninsured employees of DC small businesses that offer health insurance through DC Health Link to get covered now

I've written a LOT lately about the dozen state-based ACA exchanges which have implemented COVID-19-specific Special Enrollment Periods for uninsured residents...as well as the two ACA exchanges (Idaho's, which is state-based, and The Big One, HealthCare.Gov, which hosts 38 states) which haven't done so as of yet.

Given how much outrage there's been at the federal government for not opening up HC.gov to a COVID SEP (Idaho has somehow managed to escape notice for making the same decision) by practically every party (even the American Enterprise Institute, which isn't exactly a lefty organization, is calling for one), it's worth taking a look at the states which do have COVID SEPs open to anyone uninsured to see just how many people are actually taking advantage of them.

Over the years, I've estimated that even during the off-season (that is, outside of the official annual ACA Open Enrollment Period window), around 7,000 - 9,000 Americans typically enroll in ACA exchange coverage each and every day via Special Enrollment Periods (SEPs).

SEPs are typically a 60-day enrollment window during which you're eligible to #GetCovered via your state's ACA exchange if you have a Qualifying Life Experience (QLE), such as losing your existing healthcare coverage; getting married or divorced (and thus losing your current coverage); giving birth or adopting a child (to add them to your policy); turning 26 and being dropped from your parents plan; moving outside of your current state or rating area; getting out of prison or the military; becoming ineligible for Medicaid due to your income increasing; and a few other reasons.

On March 16th, New York's ACA exchange, NY State of Health, announced that they'd be launching a COVID-19 Special Enrollment Period with a deadline of April 15th.

Today, on top of several other state-based exchanges bumping out their COVID SEP deadlines, it appears that NY is doing so as well. This is hardly surprising given that the state has been slammed the hardest of any in the country by the pandemic.

There's no official press release or announcement as of yet, but according to Bloomberg News, NY Governor Andrew Cuomo made the announcement at a press conference today:

12:02:30 pm - Angelica LaVito Health-Care Reporter  @angelicalavito

New York is extending open enrollment for health insurance through May 15, Cuomo says.

Update: Here's the official press release...there's some other important details included as well:

As I expected, Connect for Health Colorado, which had originally placed a deadline of April 3rd on their COVID-19-specific Special Enrollment Period, has extended that deadline out until the end of April:

Connect for Health Colorado Extends Emergency Special Enrollment Period until April 30 in Response to COVID-19 Outbreak

DENVER — Due to the growing number of coronavirus (COVID-19) cases and increased need for health coverage, Connect for Health Colorado will extend an Emergency Special Enrollment period for uninsured Coloradans until Thursday, April 30, 2020. 

Since March 20, approximately 5,200 individuals protected their health and safety by signing up for a health insurance plan through this Special Enrollment period. People who enroll during the extended timeframe will have coverage as of May 1. 

Just yesterday I noted that Access Health CT, Connecticut's ACA exchange, was reminding residents that the deadline for their COVID-19 Special Enrollment Period was coming up today.

Moments ago, as I was expecting, they bumped that deadline out by another two weeks:

Access Health CT Extends New Special Enrollment Period For The Uninsured

Back on March 10th, Washington State, which was one of the first states hit hard by the coronavirus pandemic, was also the first state with their own full ACA exchange to announce a Special Enrollment Period specifically in response to the crisis. It originally was scheduled to last about a month, with a deadline to #GetCovered of April 8th.

Today they extended that deadline by a full month, through May 8th, 2020:

Washington Healthplanfinder Extends Current Special Enrollment Period, Gives Extra Month for Uninsured to Secure Health Coverage

In response to the ongoing Coronavirus (COVID-19) situation in Washington state, the Washington Health Benefit Exchange (Exchange) today announced it is extending the current special enrollment period for individuals who are uninsured.

via Access Health CT (this is actaully the press release from a couple of weeks ago, thus the "starting today" wording):

Access Health CT Urges Uninsured CT Residents To Take Action During Two-Week New Special Enrollment Period

New Special Enrollment Period starts today and ends Thursday, April 2

Back on March 14th, the Maryland Health Connection announced a formal COVID-19 Special Enrollment Period for uninsured residents, letting them #GetCovered through April 15th.

Maryland was already offering a SEP for uninsured residents to #GetCovered when they file their state taxes by checking off a box, but that was made pretty much moot when they launched the COVID SEP as well.

Anyway, today they announced that they're extending the COVID SEP out by another full 2 months:

SPECIAL ENROLLMENT FOR CORONAVIRUS STATE OF EMERGENCY EXTENDED TO JUNE 15

The MA Health Connector has extended their COVID-19 SEP out by another month:

Administrative Information Bulletin 03-20
Amendment to Administrative Bulletin 02-20 Guidance Regarding Special Enrollment Periods Due to the Emergence of the Novel Coronavirus SARS-Cov-2, Which Causes the Disease COVID-19
March 30, 2020

For a couple of weeks now, I've been posting constant updates as one state-based ACA exchange after another has announced a COVID-19-specific Special Enrollment Period in light of the ongoing pandemic crisis. Until now, though, there's been two ACA exchanges which haven't made such an announcement. One is the Big One, HealthCare.Gov, which hosts a whopping 38 states and which is facing increasing pressure to do so.

The other...is Idaho. Specifically, Your Health Idaho, the state's ACA exchange.

This just in via MNsure...

MNsure Announces Special Enrollment Period for Uninsured Minnesotans in Response to Growing COVID-19 Concerns

ST. PAUL, Minn.—Today MNsure announced a 30-day special enrollment period (SEP) for qualified individuals who are currently without insurance, in response to the potential growth of coronavirus (COVID-19) cases. This SEP that begins Monday, March 23, and runs through April 21, will allow uninsured individuals 30 days to enroll in health insurance coverage through MNsure.org.

“As more cases of COVID-19 are diagnosed throughout the state, we want to make sure every Minnesotan has the security of health insurance to ensure they can get the care they need if they contract this serious illness,” said MNsure CEO Nate Clark. “Uninsured Minnesotans can come to MNsure.org to sign up for coverage.”

Governor Tim Walz recently declared a peacetime emergency in response to the pandemic and stressed the importance of all Minnesotans to take care to avoid the spread of COVID-19.

California Responds to COVID-19 Emergency by Providing Path to Coverage for Millions of Californians

  • Covered California Expands Special Enrollment and Medi-Cal Seeks Waivers to Encourage Coverage
  • Effective immediately, anyone uninsured and eligible to enroll in health care coverage through Covered California can sign up through the end of June.
  • The Department of Health Care Services announces new steps to help those eligible for Medi-Cal sign up easily and get immediate coverage.
  • The moves come amid widespread disruption in the lives and livelihoods of Californians as public health officials seek to reduce the spread of COVID-19.
  • All medically necessary screening and testing for COVID-19 are free of charge, and all health plans available through Medi-Cal and Covered California offer telehealth options.
  • These actions build on increased state subsidies and the implementation of a state penalty, both of which took effect in January 2020

No one has been shouting from the rooftops louder than I have for HHS Secretary Alex Azar or CMS Administrator Seema Verma to join nearly all of the state-based ACA exchanges in announcing an official Special Enrollment Period (SEP) in light of the ongoing Coronavirus pandemic, and I'm still urging them to do so as soon as possible. The federal ACA exchange, HealthCare.Gov, hosts ACA enrollment for 38 states representing around 75% of the national population, so this is a pretty big deal.

Having said that, it's important to keep in mind that even without a COVID-19-specific SEP, many people already qualify to enroll in ACA-compliant healthcare coverage anyway, whether they're currently uninsured or because they're about to be...or because their personal circumstances are about to change. And none of these have anything to do with the COVID-19 crisis, although it's certainly going to cause a whole lot more people to qualify for two of those changes:

Special Enrollment Period (SEP)

This Just In via Vermont Health Connect...

The State of Vermont has made temporary changes to assure that Vermonters have access to health insurance. Please visit https://t.co/dXz4Cd2yQm for more information

— VT Health Connect (@VTHealthConnect) March 20, 2020

OK...that's about as vague and understated as you can get. Clicking the link doesn't make it any more obvious:

Stay informed and protect your health.

via the Colorado Dept. of Regulatory Agencies Insurance Division, it looks like Connect for Health Colorado is about to go ahead and establish their own COVID-19 Special Enrollment Period after all (this is from an internal draft document...the dates could still change, and it's not 100% guaranteed that they'll go ahead with it yet):

DEPARTMENT OF REGULATORY AGENCIES Division of Insurance 3 CCR 702-4 LIFE, ACCIDENT AND HEALTH

DRAFT Emergency Regulation 20-E-02

CONCERNING ESTABLISHING A SPECIAL ENROLLMENT PERIOD FOR ENROLLMENT IN AN INDIVIDUAL HEALTH BENEFIT PLAN RELATED TO COVID-19

...This emergency regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-108(7)(a), (7)(b)(III), 10-1-109(1), 10-16-105(2)(b), 10-16-105.7(3)(a)(II)(G), 10-16-105.7(3)(b)(II)(F),10-16-108.5(8), and 10-16-109, C.R.S.

Section 2 Scope and Purpose

via Access Health CT:

Access Health CT Announces A New Special Enrollment Period For Uninsured Connecticut Residents

AS COVID-19 THREATENS PUBLIC HEALTH, ACCESS HEALTH CT ANNOUNCES A NEW SPECIAL ENROLLMENT PERIOD FOR UNINSURED CONNECTICUT RESIDENTS

New Special Enrollment Period starts Thursday, March 19 and ends Thursday, April 2

As I've noted before, Maryland is already offering a SEP for uninsured residents to #GetCovered when they file their state taxes by checking off a box, but today they went one step further and created an official Coronavirus SEP as well, which is open to any eligible uninsured residents whether they're utilizing the "check the box" tax form option or not:

Coronavirus emergency launches one-month special enrollment period

As part of the state’s overall response to the coronavirus, and in an effort to prioritize health and safety, Maryland Health Connection opened a new special enrollment period for uninsured Marylanders.

When will the special enrollment period begin?

  • The coronavirus emergency special enrollment period will begin Monday, March 16, and end Wednesday, April 15. Coverage will begin April 1, 2020, regardless of when a health plan is selected during that time period.

How do I enroll?

via HealthSource RI:

Special Enrollment Period (SEP) Available to Purchase Coverage through HealthSource RI as a Part of the State’s Response to COVID-19

  •     Special Enrollment Period will be available through April 15, 2020

EAST PROVIDENCE, R.I. (March 14, 2020) — HealthSource RI has adopted a limited-time Special Enrollment Period (SEP), following Governor Raimondo’s State of Emergency declaration in response to the potential growth of Coronavirus (COVID-19). This SEP will allow uninsured Rhode Islanders to purchase coverage through April 15, 2020. Coverage will begin on the first of the month following the application.

via the Massachusetts Health Connector:

Massachusetts Health Connector offers extended enrollment for uninsured individuals to ease coronavirus fears

BOSTON – March 11, 2020 – To ensure everyone who wants access to covered coronavirus services has it, the Massachusetts Health Connector announced today that uninsured residents can apply and get into coverage through a 45-day window running until April 25.

On March 6, the Division of Insurance announced that Massachusetts health insurers are now required to cover the cost of testing and treatment for members who may be affected by the Coronavirus (COVID-19), including not charging co-pays or deductibles for those services. The Health Connector’s decision to open enrollment to anyone without coverage ensures Massachusetts residents concerned about contracting coronavirus can access necessary services without cost barriers.

Washington becomes 1st state-based marketplace to create a special enrollment opportunity in wake of coronavirus threat. https://t.co/2bYCrboXvl @GtownCHIR

— Sabrina Corlette (@SabrinaCorlette) March 10, 2020

via the Washington Health Benefit Exchange:

Washington Healthplanfinder Announces Special Enrollment Period in Response to Growing Coronavirus Outbreak

via MNsure:

Though open enrollment through MNsure has ended, there are still opportunities to enroll through a special enrollment period (SEP). Minnesotans who experience a qualifying life event, like aging off a parent's health insurance (turning 26), getting married, or losing other health coverage, may be eligible to apply. See a complete list of qualifying life events, including coverage start dates.

PLEASE NOTE IMPORTANT UPDATES BELOW.

I just received the following from a healthcare broker, who I trust from past communication exchanges, who wishes to remain anonymous. I'm presenting it as sent, with the only changes being breaking it out into paragraphs for readability & with their state's identifying information removed.

Glossery:

 

Earlier this week I busted the Trump Administration's CMS division for releasing a misleading report which tried to understate the enrollment retention rate of ACA exchange enrollees. I'm not entirely sure why they did this, since even their "fudged" number wasn't really that much worse than previous years (they tried to make itt look like a March attrition rate of 15.4% vs. the 12.8% and 12.6% from 2015 and 2016 respectively), but for whatever reason, they did so. The short version is that they only included enrollees who paid for their January and February policies instead of also including those who paid their March premiums, as was done in previous years. As far as I can figure, the actual 3/31/17 effectuation rate closer to 11.8%, a slight improvement over 2015 and 2016, though I can't be certain about this without knowing how many of the ~500,000 people who signed up in the last 2 weeks of January paid and were effectuated for March coverage.

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