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Individual U65: Grandfathered/grandmothered (GF/GM) special enrollment events and process

  • Health Insurance

To follow-up to a Special Enrollment event changes article that was published in the Nov. 22 BBO, an updated special enrollments chart has been published on Producer Connection.

Important changes to guidelines include:

  • Loss of coverage has been changed to only allow previously enrolled dependents back onto the policy.
    • Any dependent over the age of 26 must be a full-time student and unmarried.
  • Birth of a child is only a special enrollment event for the baby being added to the policy.
  • Marriage is only a special enrollment event for the new spouse and new dependents of the spouse.
  • Removing dependents 19–25 is not considered a special enrollment event in which they can move onto their own GF/GM plan.
    • Dependents aging off or dependents who are 26 and older, but no longer a fulltime student, will continue to have SEP rights to move to a like GF/GM policy.
  • Effective date rules will return to the first of the month following the special enrollment event unless the special enrollment period is one that honors the date of the event (i.e. birth).

Please call me with you questions and concerns, I will be happy to assist you.

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Debbie SearsJanuary 15, 2018

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