Time for a Tuesday Tip: job changes can be triggers for a special enrollment period (SEP)
As I have mentioned previously, special enrollment periods are times of the year that allow you to enroll in new coverage due to life changes. These can be changes such as getting married or having a new baby. Today I wanted to focus specifically on how a job change will affect the special enrollment period.
Remember, simply changing your job doesn’t necessarily trigger a special enrollment period for the Marketplace. There are certain things that have to take place in order to trigger a special enrollment period. The important thing to note is if you had health coverage before, and you’re losing the coverage you had because your new employer doesn’t offer plans, then that will trigger a special enrollment period. You will only have 60 days from your loss of coverage, also known as your status change, in order to get enrolled into a new coverage plan. When it comes to the Marketplace, they specifically ask questions relating to your change or loss in coverage. We have to select when your coverage is either going to be lost or if you have already lost it because that’s what will determine the starting date of your 60 day period.
Remember, just changing jobs is not necessarily a trigger for special enrollment. An example of this is if you had a job that you did not have coverage for, and your new job does not offer coverage, then there’s no special enrollment period that applies to you. That’s one of the rules. However, there are ways to qualify for special enrollment in other ways. Sometimes a job change will result in you moving as well, which is a zip code change, which does potentially qualify you for a special enrollment period.
Another trigger for a special enrollment period would be if your employer decides to drop your group coverage. If they drop group coverage, and you don’t have a chance to get your own coverage, this circumstance does trigger special enrollment because you’re losing coverage. And because you’re losing coverage, you now have 60 days to get new coverage through Marketplace.
There are a lot of rules and tricks that apply when filling out the application for special enrollment. It needs to be done correctly, showing that you are truly eligible for coverage. It is vital to fill this out correctly, because when it comes time to do your taxes, the following year, there’s going to be some information they’re going to ask about your coverage. And if it appears that you received Marketplace coverage outside of open enrollment, or you received a subsidy when you did not qualify, you could owe a lot of money to the IRS. It is my job to try to help people avoid that. I can assist you in filling out the application form to ensure all your information is reflected correctly.
If you’re unsure if you have a special enrollment circumstance, you can always reach out to me. I’m happy to discuss this with you. You can schedule an appointment with me at any time.