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Special Enrollment Period (SEP)

Assister resources to help consumers apply for SEP.

COVID-19 SEP

MNsure has announced a three-month special enrollment period (SEP) beginning Tuesday, February 16, and ending on Monday, May 17. 

This SEP is for individuals determined eligible to purchase a QHP through MNsure and do not currently have QHP coverage through MNsure. 

Consumers who enroll during the SEP will have coverage beginning on the first day of the month following sign-up date. Consumers do not have a choice of effectuation date with this SEP. For example, Minnesotans who sign up for coverage in February will have a March 1 start date, sign-ups in April will have a May 1 start date, and those who sign up by May 17 will have a June 1 coverage start date. 

Process for New Applications

  • After submitting a new online application, if a consumer is found eligible for a QHP, the consumer must click on the “Enroll in Plans” button.
  • On their enrollment dashboard, under “Next Steps,” they should click on the “Confirm Event” button. 
  • In the dropdown list of qualifying life events, the consumer should select “COVID-19 SEP.”
  • No event date or verifications are required. The consumer will immediately proceed to shopping after clicking continue. 
  • Once the consumer selects a plan, their shopping window will close. Consumers CANNOT re-shop and select a different plan during the SEP. If a consumer wants to enroll in medical and dental, they should select both plans at the same time.

Process for Existing Applications

  • Consumers who have already submitted an application, are eligible for a QHP, but are NOT enrolled will not need to confirm a qualifying life event. 
  • When these consumers go to their enrollment dashboard, the SEP shopping option will automatically be available, and they can shop and enroll. 
  • Once the consumer selects a plan, their shopping window will close. Consumers CANNOT re-shop and select a different plan during the SEP. If a consumer wants to enroll in medical and dental, they should select both plans at the same time.

Special Circumstances

The consumer will need to call to enroll in the following situations (brokers can call the Broker Service Line and navigators and CAC can call the ARC with the consumer present):

  • Partially enrolled households that are seeking to enroll unenrolled household members.
  • Households that applied between December 23, 2020, and February 15, 2021.
  • If the online SEP process does not work as expected (for example, if a consumer completed a paper application).
  • If the consumer wants to enroll using a different qualifying life event/special enrollment period.

Additional Information

  • Consumers currently enrolled through MNsure cannot use this SEP to change plans.
  • A consumer can switch from an off-exchange plan to a MNsure plan using this SEP but should be aware of negative consequences such as restarting their annual deductible. 
  • Eligibility rules for tax credits still apply: if a consumer was not eligible for tax credits because they were enrolled in ESI that was determined affordable, they cannot drop ESI coverage and use this SEP to get tax credits. 

Qualified Dental Plans (QDPs)

  • Consumers not enrolled in a qualified health plan (QHP) through MNsure can use this SEP to enroll in dental-only coverage.
  • Consumers currently enrolled in a QHP through MNsure cannot use this SEP to add dental coverage.

SEP for New Consumers

MNsure.org has examples of qualifying life events that allow new consumers to enroll outside of open enrollment and instructions for consumers on how to apply for a special enrollment period.

  1. A new consumer will need to create an account/complete an application to determine if they qualify for a qualified health plan (QHP) with or without financial assistance AND if they qualify to shop and enrollment in health care plans through MNsure outside of the open enrollment period.
  2. If a consumer receives eligibility for a QHP, select the Enroll in Plans button from the eligibility results screen to launch the shopping and enrollment platform.
  3. Select the Confirm Event button on the consumer’s dashboard in the shopping and enrollment platform.
  4. Select the qualifying life event and enter the date the qualifying life event occurred.
  5. If the event can be confirmed, instructions will be provided from the shopping and enrollment platform to submit SEP verification documentation either by mail or the upload tool. Additional information about verifications.

SEP for Current Consumers

MNsure.org has examples of qualifying life events that allow consumers with an existing application to change plans or enroll in new plans outside of open enrollment. There are also instructions for consumers on how to apply for a special enrollment period.

  1. Assisters will need to notify MNsure if a consumer has experienced a qualifying life event using the Report a Change process.
  2. After reporting a change, if the consumer is eligible to enroll in a QHP during a special enrollment period:
  • The consumer will be contacted and assisters will receive a secure email confirming next steps.
  • The assister may need to log in to the shopping and enrollment platform and select the Confirm Event button on the consumer’s dashboard in the shopping and enrollment platform.
  • Select the qualifying life event and enter the date the event occurred.
  • Once the event is confirmed plan shopping and enrollment will be available to the consumer.

SEP for Decrease in Household Income

Consumers looking to enroll utilizing the SEP for decrease in household income will need to follow these steps:

If the consumer already has an application through MNsure, they can follow the SEP Process for Current Consumer section below.

If the consumer is new to MNsure, they will first need to create an account and complete an application to determine if they are eligible for a qualified health plan (QHP).

  1. If the consumer receives eligibility for a QHP, navigate to mnsure.org and enter the phrase "enrollment upload" into the search bar.
  2. Select the link to "send documents to verify your life event."
  3. Upload the following:
    • Documents that support a decrease in household income.
    • Document that proves the household had minimum essential coverage (MEC) at least 1 day in the past 60 days.
  4. Wait at least 10 minutes after uploading documents.
  5. Contact the ARC or Broker Service Line (BSL) to complete the remainder of the SEP reporting process.
  6. Tell the ARC/BSL agent that the call is to confirm the consumer’s eligibility for the SEP for decrease in household income.
  7. The ARC/BSL agent will ask questions necessary to complete the SEP questionnaire in the shopping and enrollment platform.
  8. The ARC/BSL agent will then review the uploaded documents to confirm that they support the eligibility criteria for this SEP.
    • If approved, while on the call, the ARC/BSL agent will open shopping to allow the consumer to enroll.
    • If not approved, the ARC/BSL agent will provide guidance on what is needed to confirm eligibility for the SEP.

More information on this qualifying life event (QLE) can be found on MNsure.org.

If the consumer already has an application through MNsure, they should follow the SEP Process for Current Consumer section below.

SEP Notices

Any notices sent to consumers that were not manually created by MNsure can be viewed in the consumer’s inbox in the shopping and enrollment platform.

SEP Tips

Most SEPs require some kind of proof (verification). See Verifications for more information.

SEP eligibility: See Qualifying Life Events for questions about what kinds of life events may provide eligibility for a SEP. For MNsure to determine whether a consumer’s situation qualifies for a SEP, we must complete a full SEP application, which requires complete information.

Manage your calls to the ARC / Broker Service Line. Remember to use the Case Status Request (CSR) form whenever possible.

Remind Consumers to report ALL changes: Consumers should report application changes even if they are not applying for a SEP. Changes could change their eligibility.

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