Photograph by Kelly on Pexels.
SEP in Multiple States
Special Election Periods are active in multiple states due to emergencies. If you have customers in Arkansas, California, Illinois, New Mexico, Ohio, Oklahoma, Oregon, and Tennessee, they may be eligible for the Special Election Period.
ARKANSAS
State declaration: Weather Related Damage and Heavy Equipment
SEP incident dates: 03/31/2023 – Ongoing
This SEP declaration is effective: 03/31/2023 – Ongoing
Impacted counties for SEP purposes: All counties
ARKANSAS
FEMA declaration: Severe Winter Storms
SEP incident dates: 01/30/2023 – 03/30/2023
This SEP declaration is effective: 01/30/2023 – 04/30/2023
Impacted counties for SEP purposes: Bradley, Calhoun, Cleveland, Dallas, Desha, Drew, Grant, Jefferson, Lincoln, Nevada, Ouachita, Searcy and Stone counties.
CALIFORNIA
FEMA declaration: Severe Winter Storms, Straight-line Winds, Flooding, Landslides, and Mudslides
SEP incident date: 02/21/2023 – Ongoing
This SEP declaration is effective: 02/21/2023 – Ongoing
Impacted counties for SEP purposes: Calaveras, Kern, Los Angeles, Mariposa, Monterey, San Benito, Santa Cruz, Tulare, Tuolumne counties
ILLINOIS
State declaration: Severe Weather and Tornados
SEP incident dates: 03/31/2023 – Ongoing
This SEP declaration is effective: 03/31/2023 – Ongoing
Impacted counties for SEP purposes: Boone, Crawford, DuPage, Marion, and Sangamon counties
NEW MEXICO
FEMA/FMAG declaration: Echo Ridge Fire
SEP incident date: 04/02/2023 – 05/01/2023
This SEP declaration is effective: 04/02/2023 – 06/30/2023
Impacted counties for SEP purposes: Torrance county
OHIO
State declaration: Emergency Adoption of Rule 4729:9-1-03_Xylazine & Opioids
SEP incident date: 03/28/2023 – 10/22/2023
This SEP declaration is effective: 03/28/2023 – 11/30/2023
Impacted counties for SEP purposes: All counties
OKLAHOMA
FEMA/FMAG declaration: Simpson Fire
SEP incident date: 03/31/2023 – 04/29/2023
This SEP declaration is effective: 03/31/2023 – 05/31/2023
Impacted counties for SEP purposes: Logan county
OKLAHOMA
FEMA/FMAG declaration: Hefner Fire
SEP incident date: 03/31/2023 – 04/29/2023
This SEP declaration is effective: 03/31/2023 – 05/31/2023
Impacted counties for SEP purposes: Oklahoma county
OKLAHOMA
FEMA/FMAG declaration: Gap Road Fire
SEP incident date: 03/31/2023 – 04/29/2023
This SEP declaration is effective: 03/31/2023 – 05/31/2023
Impacted counties for SEP purposes: Washington county
OREGON
State declaration: Homelessness
SEP incident date: 01/10/2023 – 02/28/2024
This SEP declaration is effective: 01/10/2023 – 03/31/2024
Impacted counties for SEP purposes: Clackamas, Clatsop, Crook, Deschutes, Jackson, Jefferson, Klamath, Lake, Lane, Linn, Malheur, Marion, Multnomah, Polk, and Washington counties
TENNESSEE
FEMA declaration: Severe Storms
SEP incident date: 03/31/2023 – 04/30/2023
This SEP declaration is effective: 03/31/2023 – 06/30/2023
Impacted counties for SEP purposes: Cannon, Hardeman, Hardin, Haywood, Lewis, Macon, McNairy, Rutherford, Tipton and Wayne counties
Please be aware.
- This does not mean that active marketing can occur.
- The SEP is only for the purpose of providing a SEP to impacted individuals who had a valid election during the incident and were unable to make that election due to the emergency.
- This does not mean we initiate waiving of authorization or referral requirements.
- This does not extend waiving of prior authorizations, referrals etc.
SEP for Government Entity-Declared Disaster or Other Emergency
42 CFR 422.62(b)(18)
(Rev. 2, Issued: August 12, 2020; Effective/Implementation: 01-01-2021)
A Special Enrollment Period exists for individuals affected by a disaster or other emergency declared by a Federal, state or local government entity who were unable to, and did not make an election during another valid election period. This includes both enrollment and disenrollment elections.
Individuals are eligible for this SEP if they:
- Reside, or resided at the start of the SEP eligibility period described in this guidance, in an area for which a federal, state or local government entity has declared a disaster or other emergency or they do not reside in an affected area but rely on help making healthcare decisions from one or more individuals who reside in an affected area; and
- Were eligible for another election period at the time of the SEP eligibility period; and
- Did not make an election during that other valid election period due to the disaster or other emergency.
The SEP starts as of the date the declaration is made, the incident start date or, if different, the start date identified in the declaration, whichever is earlier. The SEP ends two full calendar months following the end date identified in the declaration or, if different, the date the end of the incident is announced, whichever is later.
Tips for completing applications
For paper applications, ensure that the following fields in the “Agent Only Use” section are completed:
- Select “SEP” in the “Select Enrollment Period” field
- Enter code “DST” in the “SEP Code” field
- Enter the date the customer was affected by the disaster in the “SEP Date field”
- In the “Special Enrollment Period” section: Make sure you select the special enrollment period that applies to the customer in addition to selecting the “DST” box that states “I was affected by a weather-related emergency or major disaster (as declared by the Federal Emergency Management Agency (FEMA)). One of the other statements here applied to me, but I was unable to make my enrollment because of the natural disaster.” Both are required to be completed.
For telephonic applications, ensure that the following fields are completed:
- In the “Special Enrollment Period section: Select the actual enrollment period the customer qualified for that was missed, and
- Select the check box next to the statement that reads “I was affected by a weather-related emergency or major disaster (as declared by the Federal Emergency Management Agency, or by federal, my state or my local government).One of the other statements on this page applied to me, but I was unable to make my request because of the disaster.” This creates the DST and the second code Enrollment requires to process the application.
Agents
We hope that this information on the 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.
Quick links:
