Special Election Period Available to Members Affected by a Weather Related Emergency or Major Disaster

Special Election Period Available to Members Affected by a Weather Related Emergency or Major Disaster

As you know, hurricanes Harvey, Irma, and Maria caused disruption in Texas, Louisiana, Florida, Georgia, South Carolina, Puerto Rico and the U.S. Virgin Islands. The Centers for Medicare & Medicaid Services (CMS) have extended a Special Election Period (SEP) to Medicare beneficiaries affected by the hurricane and flooding that followed. The SEP will run from the start of the incident through Dec. 31, 2017.

Who is eligible?
Any beneficiary who resides in, or resided in, an area for which the Federal Emergency Management Agency (FEMA) has declared an emergency or major disaster (see www.fema.gov/disasters) is eligible for the SEP, if the beneficiary was unable to enroll in a plan during another qualifying election period. In addition, beneficiaries who do not live in the impacted areas but receive assistance from someone living in one of the affected areas also qualify for this SEP.

What does this mean for beneficiaries?

  • Eligible beneficiaries who are unable to make a plan selection during the Annual Enrollment Period (AEP) have until Dec. 31, 2017, to enroll in a 2018 Plan. Eligible beneficiaries who wish to change their health and/or prescription drug plan, but are unable to do so during the Annual Enrollment Period (Oct. 15, 2017-Dec. 7, 2017), will now have until Dec. 31, 2017 to enroll in a 2018 plan. Enrollments taken between Dec. 8 and Dec. 31, 2017, are effective Jan. 1, 2018. You must submit a paper application. Use the SEP enrollment type code on the application, and write in Weather Related Emergency, for any enrollments taken between Dec. 8 and Dec. 31.
  • Eligible beneficiaries who were eligible for a different SEP, or aged into Medicare, but were unable to enroll during the allotted time period, will have their election period extended. Eligible beneficiaries who had/have a qualifying election period (e.g., aged into Medicare, are aging into Medicare or are qualified for a different SEP) but were unable to enroll in a plan during the allotted time, have until Dec. 31, 2017 to enroll. Enrollments received are effective the first day of the following month. For example, if a beneficiary aged into Medicare and had until Aug. 31, 2017, to enroll but was unable to complete the enrollment process, the beneficiary can enroll now. If the beneficiary enrolls Oct. 10, 2017, the beneficiary’s plan will be effective Nov. 1, 2017. Use the SEP enrollment code on the paper application, and write in Weather Related Emergency.

Agent action
If a consumer contacts you as a result of this SEP, you may help them enroll in one of our plans and earn a commission. You must:

  1. Ask the beneficiary for proof that the beneficiary resided in an affected area (e.g., driver’s license or utility bill reflecting the beneficiary’s address).
  2. If the beneficiary is unable to provide proof, ask the beneficiary if they attest that they lived/live in an area impacted by the hurricanes.
  3. Once you verify eligibility, you can proceed with the application.
  4. You must use a paper application. Use the SEP election type code on the application, and write in Weather Related Emergency.

Annual Enrollment Period (AEP)

Please note that this Special Election Period is in addition to the Annual Enrollment Period. If beneficiaries in the impacted areas want to enroll in a plan, or change plans during AEP, with a Jan. 1, 2018, effective date, use the AEP election code, NOT the SEP enrollment code.

Contact
If you have any questions, please contact the Producer Help Desk at phd@uhc.com. If you have compliance questions, please email compliance_questions@uhc.com and be sure to include your full name, contact information and writing number.

October 5, 2017.Confidential and proprietary. For internal/agent use only. Do not distribute.
Posted in Uncategorized.