NEW SEPS ANNOUNCED THIS WEEK
Agents are encouraged to use caution to distinguish between the guidance in effect for each disaster. *Always verify details as events are continuously updated.
Special Enrollment Periods have been declared for the following states:
KY, NJ, CO, CA, NV, DE, MD, WA
KENTUCKY EMERGENCY DECLARATION – INCLEMENT WEATHER, FLOODING
Please be advised that a state of emergency was declared, impacting the individuals in all Kentucky counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period. This SEP applies to all the impacted counties in Kentucky.
Important Compliance Information
Who is eligible:
This SEP opportunity is ONLY available to beneficiaries who:
- 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.
Details:
Impacted Counties: All Counties
Incident Period: The incident period occurred on December 31, 2021. The declaration was announced on January 1, 2022.
Timeframe: Effective immediately, individuals meeting the requirements listed above can enroll, dis-enroll, or switch MAPD plans until March 31, 2022.
*Note: Eligible enrollments will be effective the first of the month after the application has been processed.
Reminders:
Agents can accept/submit an application by the beneficiary’s request through the following steps:
- Obtain a compliant Consent to Contact (C2C).
- Capture a compliant Scope of Appointment (SOA).
- Host a compliant 1:1 appointment.
- If the beneficiary is prepared to enroll, complete an application noting this SEP, either by selecting the “Emergency or Major Disaster” option or writing “Severe Weather” in the “Other” option. WARNING! Only select one election type.
NEW JERSEY EMERGENCY DECLARATION – INCLEMENT WEATHER
Please be advised that a state of emergency was declared, impacting individuals in certain New Jersey counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period. This SEP applies to the following counties in New Jersey.
Important Compliance Information
Who is eligible:
This SEP opportunity is ONLY available to beneficiaries who:
- 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.
Details:
Impacted Counties: Atlantic, Burlington, Cape May, Cumberland, Ocean
Incident Period: The incident period occurred on January 2, 2022. The declaration was announced on January 3, 2022.
Timeframe: Effective immediately, individuals meeting the requirements listed above can enroll, dis-enroll, or switch MAPD plans until March 31, 2022.
*Note: Eligible enrollments will be effective the first of the month after the application has been processed.
Reminders:
Agents can accept/submit an application by the beneficiary’s request through the following steps:
- Obtain a compliant Consent to Contact (C2C).
- Capture a compliant Scope of Appointment (SOA).
- Host a compliant 1:1 appointment.
- If the beneficiary is prepared to enroll, complete an application noting this SEP, either by selecting the “Emergency or Major Disaster” option or writing “Severe Weather” in the “Other” option. WARNING! Only select one election type.
COLORADO EMERGENCY DECLARATION – GRASS FIRES
Please be advised that a state of emergency was declared, impacting individuals in a certain Colorado county. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period. This SEP applies to the following county in Colorado.
Important Compliance Information
Who is eligible:
This SEP opportunity is ONLY available to beneficiaries who:
- 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.
Details:
Impacted Counties: Boulder
Incident Period: The incident period occurred on December 30, 2021. The declaration was announced on December 30, 2021.
Timeframe: Effective immediately, individuals meeting the requirements listed above can enroll, dis-enroll, or switch MAPD plans until February 28, 2022.
*Note: Eligible enrollments will be effective the first of the month after the application has been processed.
Reminders:
Agents can accept/submit an application by the beneficiary’s request through the following steps:
- Obtain a compliant Consent to Contact (C2C).
- Capture a compliant Scope of Appointment (SOA).
- Host a compliant 1:1 appointment.
- If the beneficiary is prepared to enroll, complete an application noting this SEP, either by selecting the “Emergency or Major Disaster” option or writing “Severe Weather” in the “Other” option. WARNING! Only select one election type.
CALIFORNIA EMERGENCY DECLARATION – INCLEMENT WEATHER
Please be advised that a state of emergency was declared, impacting individuals in certain California counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period. This SEP applies to the following counties in California.
Important Compliance Information
Who is eligible:
This SEP opportunity is ONLY available to beneficiaries who:
- 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.
Details:
Impacted Counties: Alameda, Amador, Calaveras, El Dorado, Humboldt, Lake, Los Angeles, Marin, Monterey, Napa, Nevada, Orange, Placer, Sacramento, San Bernardino, San Luis Obispo, San Mateo, Santa Cruz, Sierra, Yuba
Incident Period: The incident period occurred on December 10, 2021 through December 21, 2021. The declaration was announced on December 30, 2021.
Timeframe: Effective immediately, individuals meeting the requirements listed above can enroll, dis-enroll, or switch MAPD plans until February 28, 2022.
*Note: Eligible enrollments will be effective the first of the month after the application has been processed.
Reminders:
Agents can accept/submit an application by the beneficiary’s request through the following steps:
- Obtain a compliant Consent to Contact (C2C).
- Capture a compliant Scope of Appointment (SOA).
- Host a compliant 1:1 appointment.
- If the beneficiary is prepared to enroll, complete an application noting this SEP, either by selecting the “Emergency or Major Disaster” option or writing “Severe Weather” in the “Other” option. WARNING! Only select one election type.
NEVADA EMERGENCY DECLARATION – INCLEMENT WEATHER
Please be advised that a state of emergency was declared, impacting individuals in certain Nevada counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period. This SEP applies to the following counties in Nevada.
Important Compliance Information
Who is eligible:
This SEP opportunity is ONLY available to beneficiaries who:
- 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.
Details:
Impacted Counties: Douglas , Washoe, Carson City
Incident Period: The incident period occurred on December 29, 2021. The declaration was announced on December 29, 2021.
Timeframe: Effective immediately, individuals meeting the requirements listed above can enroll, dis-enroll, or switch MAPD plans until February 28, 2022.
*Note: Eligible enrollments will be effective the first of the month after the application has been processed.
Reminders:
Agents can accept/submit an application by the beneficiary’s request through the following steps:
- Obtain a compliant Consent to Contact (C2C).
- Capture a compliant Scope of Appointment (SOA).
- Host a compliant 1:1 appointment.
- If the beneficiary is prepared to enroll, complete an application noting this SEP, either by selecting the “Emergency or Major Disaster” option or writing “Severe Weather” in the “Other” option. WARNING! Only select one election type.
DELAWARE EMERGENCY DECLARATION – COVID-19 OMICRON VARIANT
Please be advised that a state of emergency was declared for the COVID-19 Omicron Variant ONLY, impacting only the individuals in all Delaware counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period. This SEP applies to all the impacted counties in Delaware.
Important Compliance Information
Who is eligible:
This SEP opportunity is ONLY available to beneficiaries who:
- 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.
Details:
Impacted Counties: All Counties
Incident Period: The incident period occurred on January 3, 2022. The declaration was announced on January 3, 2022.
Timeframe: Effective immediately, individuals meeting the requirements listed above can enroll, dis-enroll, or switch MAPD plans until March 31, 2022.
*Note: Eligible enrollments will be effective the first of the month after the application has been processed.
Reminders:
Agents can accept/submit an application by the beneficiary’s request through the following steps:
- Obtain a compliant Consent to Contact (C2C).
- Capture a compliant Scope of Appointment (SOA).
- Host a compliant 1:1 appointment.
- If the beneficiary is prepared to enroll, complete an application noting this SEP, either by selecting the “Emergency or Major Disaster” option or writing “COVID-19 Omicron Variant ONLY” in the “Other” option. WARNING! Only select one election type.
MARYLAND EMERGENCY DECLARATION – COVID-19 OMICRON VARIANT
Please be advised that a state of emergency was declared for the COVID-19 Omicron Variant ONLY, impacting only the individuals in all Maryland counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period. This SEP applies to all the impacted counties in Maryland.
Important Compliance Information
Who is eligible:
This SEP opportunity is ONLY available to beneficiaries who:
- 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.
Details:
Impacted Counties: All Counties
Incident Period: The incident period occurred on January 4, 2022. The declaration was announced on January 4, 2022.
Timeframe: Effective immediately, individuals meeting the requirements listed above can enroll, dis-enroll, or switch MAPD plans until March 31, 2022.
*Note: Eligible enrollments will be effective the first of the month after the application has been processed.
Reminders:
Agents can accept/submit an application by the beneficiary’s request through the following steps:
- Obtain a compliant Consent to Contact (C2C).
- Capture a compliant Scope of Appointment (SOA).
- Host a compliant 1:1 appointment.
- If the beneficiary is prepared to enroll, complete an application noting this SEP, either by selecting the “Emergency or Major Disaster” option or writing “COVID-19 Omicron Variant ONLY” in the “Other” option. WARNING! Only select one election type.
WASHINGTON EMERGENCY DECLARATION – INCLEMENT WEATHER
The Federal Emergency Management Agency (FEMA) have declared a weather-related emergency or major disaster in your state. Medicare beneficiaries affected may be eligible for a Special Election Period (SEP).
Name of Disaster: Washington Flooding and Mudslides (4635-DR-WA)
Type of Disaster: Flooding
State Impacted: WA
Impacted Counties from FEMA, State or Local declaration: Clallam, Lummi Indian Reservation, Nooksack Indian Reservation, Quileute Indian Reservation, Skagit, Whatcom
Incident Period: Nov 13, 2021 – Nov 15, 2021
Declaration Date: Jan 5, 2022
Who is eligible?
- Any beneficiary who resides in, or resided in (at the start of the incident), an area that Federal Emergency Management Agency (FEMA) declared an emergency or major disaster (see www.fema.gov/disasters).
- Beneficiaries who do not live in the impacted areas but receive assistance making healthcare decisions from someone who lives in one of the affected areas are also eligible; and
- The beneficiary had another valid election period at the time of the incident (Annual Enrollment Period (AEP), SEP or aged into Medicare), but did not make an election during that other valid election period due to the disaster or other emergency.
What does this mean for beneficiaries?
- Beneficiaries who were eligible for a different SEP or aged into Medicare but were unable to enroll in a plan during the allotted time period due to the disaster or other emergency have until the extended deadline to enroll.
- Enrollments received are effective the first day of the following month.
Enrollment Overview
If a consumer contacts you as a result of this SEP, you may help them enroll in one of our plans and may be eligible for a commission. You must:
- Ask the beneficiary for proof that the beneficiary resided in an affected area (e.g., driver’s license or utility bill reflecting the beneficiary’s address).
- If the beneficiary is unable to provide proof, ask the beneficiary if they attest that they lived/live in an area impacted by the FEMA declared emergency or disaster.
- Once you verify eligibility, you can proceed with the application.
- Application details:
- For paper, use the SEP election type code on the application. Write in Weather Related Emergency.
- For LEAN, please select the Declared Disaster/Emergency reason code.
WHO QUALIFIES FOR THE SEP WHEN DISASTERS OR EMERGENCIES?
Effective January 1, 2022, an SEP 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, 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 (2) 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.