Special Enrollment Period for Individuals

The Centers for Medicare and Medicaid Services (CMS) announced a new Individual Health Insurance Marketplace Special Enrollment Opportunity beginning on March 15 through April 30. This Special Enrollment Opportunity is for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment” when they file their 2014 taxes in a Federally Facilitated Marketplace (FFM) states.

Who is Eligible
Your clients who live in a FFM state are eligible for this Special Enrollment Opportunity if they:

  • Are not currently enrolled in health coverage through the FFM for 2015,
  • Attest that they paid the fee for not having health coverage in 2014, and
  • Attest that they first became aware of, or understood the implications of, the penalty or shared responsibility payment after Feb. 15, 2015, when Open Enrollment ended, in connection with preparing their 2014 taxes.

State-based Exchanges (SBE) have the flexibility to determine whether they will establish a similar special enrollment period. Check specific SBE websites for additional information.

What This Means
Your eligible clients will have the opportunity to purchase an On-Exchange Individual Health Plan from March 15 through April 30.

  • Enrollments made by the 15th of the month will have coverage effective on the 1st day of the following month.
  • Enrollments made after the 15th of the month will have coverage effective on the 1st day of the second month.

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