HHS Creates A New And Limited Special Enrollment Opportunity In States With Federally-Facilitated Health Insurance Exchanges


On May 2, 2014, the Department of Health and Human Services (HHS) released guidance which creates a special enrollment opportunity in states with a federally-facilitated health insurance Marketplace (Marketplace) for individuals who are eligible for or enrolled in COBRA continuation coverage.  In prior HHS guidance, individuals eligible for COBRA already qualify for a special enrollment period in the Marketplace when they become eligible for COBRA because of loss of employer coverage or when their COBRA coverage is exhausted. However, because HHS felt that the Department of Labor’s model COBRA election notices did not adequately explain this Marketplace enrollment opportunity, HHS re-emphasized this special Marketplace enrollment opportunity and created a special Marketplace enrollment window through July 1, 2014 for all current COBRA qualified beneficiaries.  Specifically, in states covered by a federally-facilitated Marketplace, anyone eligible for or enrolled in COBRA may drop their COBRA coverage and enroll in the Marketplace through July 1, 2014.  HHS directs COBRA beneficiaries to enroll through the Marketplace by calling the marketplace call center at 1-800-318-2596 to activate the special enrollment period.  Additionally, the Department of Labor issued new model COBRA general and election notices which include more information related to the Marketplace to further increase Marketplace awareness. Plan sponsors should consider contacting their plan’s COBRA qualified beneficiaries to inform them of this special (and limited) enrollment opportunity, as well as revising their current COBRA forms to reflect the new model language.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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