New Special Enrollment Confirmation Process

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Due to concerns about whether current federal Health Insurance Marketplace rules and procedures are sufficient to ensure that only those who are eligible enroll through special enrollment periods, the Centers for Medicare & Medicaid Services (CMS) has created a new verification process for individuals to apply.

How Special Enrollment Confirmation Works
Beginning in the next several months, all consumers who enroll or change plans using a special enrollment period for any of the following triggering events will be directed to submit documentation to verify their eligibility:

  • Loss of minimum essential coverage;
  • Permanent move;
  • Birth, adoption, placement for adoption, placement for foster care or child support or other court order; or
  • Marriage.

CMS will provide consumers with lists of qualifying documents, such as a birth or marriage certificate. Consumers will be able to upload documents to their HealthCare.gov accounts or mail them in.

For more information about implementation of the new process, please review the CMS announcement and Fact Sheet.

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