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Effective yesterday: The Centers for Medicare & Medicaid Services (CMS) released official guidance that details how consumers who were affected by a Federal Emergency Management Agency (FEMA)-declared emergency or natural disaster and who, as a consequence, were unable to enroll in coverage when otherwise qualified to do so, can qualify for an Exceptional Circumstances special enrollment period (SEP).
The guidance clarifies:
- Who is eligible for this SEP
- The coverage effective date
- How affected individuals can access this SEP
- The policies for termination of coverage
- Consumer payments and grace period extensions
To help clients who have authorized you to work on their behalf use this SEP, contact the Marketplace Call Center via the Direct Agent/Broker Partner Line at 1-855-788-6275. (Note: You will be asked to enter your valid National Producer Number [NPN] to access this line. Only plan year 2019-registered agents and brokers may use the Direct Agent/Broker Partner Line.) After entering your NPN, select the option for SEPs that are not common/available through the consumer application.
If your client has not filed an authorization with the Marketplace for you to work on his or her behalf, you and your client must call the Direct Agent/Broker Partner Line together.
Clients who qualify to enroll in coverage using this SEP can also contact the Marketplace Call Center directly at 1-800-318-2596 (TTY: 1-855-889-4325). Remind your clients to provide your valid NPN to the representative who assists them so you receive credit for the enrollment.
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