What is the Low Income Special Enrollment Period?
There is now a Special Enrollment Period available for low-income consumers. The Special Enrollment Period provides them an opportunity to sign up for health care coverage with little to no monthly premiums! This is available for those with an income less than 150% of the federal poverty level and will be available year-round. Through this Special Enrollment Period, new members who fit the eligibility criteria can enroll in a plan and members who already have coverage can change their plan. A great thing about this change is that the deductible will change and the out-of-pocket maximum will reset.
When does this Special Enrollment period start?
This Special enrollment period began on March 18, 2022, and will continue through December 31, 2022. All consumers who are eligible for an advanced premium tax credit (APTC) with expected household incomes at or below 150% of the federal poverty level can participate in this new election period.
Who qualifies for this Special Enrollment period?
The 150% SEP– unlike most other life event-based enrollment periods– does not have a deadline, so consumers qualify as long as they’re eligible for the advance premium tax credit. Throughout the year, consumers eligible for this SEP are also generally eligible for free or low-cost plans with very low deductibles and out-of-pocket costs. State-based marketplaces that operate their own eligibility and enrollment platforms also have the option to offer this SEP. Consumers can use the SEP screener tool at healthcare.gov/screener for help determining if they are eligible for the 150% SEP.
How can my clients apply for this Special Enrollment period?
Once you have selected a new plan with your clients, you will be able to skip the “SEP Reasons” step in the application process. This is due in part to the application automatically detecting the SEP for clients with the proper qualifying income and there would be nothing needed to mark on the “Upcoming/Recent Changes” part of the application. After submitting the application, you will be able to confirm the SEP as “due to estimated household income” on the eligibility results page. It’s that easy!
We hope that this information on the Low Income Special Enrollment Period is useful to you.
Empower Brokerage is dedicated to helping you make informed decisions about your health and finances. Whether it’s through webinar training, one-on-one calls, seminars, or marketing plans, we want you to be successful!
Give us a call at 888-539-1633 or leave a comment below if you have any questions.
Jose has been a career agent working with Empower Brokerage since 2021 helping clients from all walks of life find tailored solutions for their healthcare needs.