Special Enrollment Period and Relaxed Eligibility Requirements

16.° de abril de 2020

We previously communicated about options that may be available to groups to help group members who may need coverage support due to COVID-19. We want to remind you about the relaxed eligibility requirements and optional special enrollment period.

Requisitos de elegibilidad
Tenemos requisitos de elegibilidad más flexibles para los asegurados de grupos actualmente inscritos/con cobertura.

• From now through April 30, employers can maintain employees who were enrolled on their plans as of March 20, regardless of the eligibility definition stated in their plan or the BPA. 
• Esto incluye las horas de trabajo reducidas, los permisos de ausencia, licencias y suspensiones. 
• Los grupos no necesitan hacer nada. No se necesita completar papeles ni enviar un correo electrónico, ya que aceptaremos los archivos de elegibilidad actuales y precisos.
• This flexibility does NOT apply to those who are newly electing coverage via the special enrollment period (see below).

Período especial de inscripción
We are also offering groups (ASO and fully insured) an optional special enrollment period from March 30 through April 30. This would apply to eligible employees and their dependents who previously declined coverage and now want to enroll, or currently enrolled employees who wish to add an eligible spouse or dependent on their existing coverage.

• Los cambios pertinentes a la solicitud de cobertura se deben recibir antes del viernes 1 de mayo.
• Effective date of coverage will be the group’s standard coverage effective date/billing date (in April) – for most groups this will be April 1.
• Este motivo de elegibilidad será únicamente para las coberturas médica/de farmacia y dental.

Los empleadores no necesitan notificar a su representante de cuentas si desean utilizar esta opción de período especial de inscripción. Los empleadores pueden seguir usando el proceso de elegibilidad estándar de su segmento del mercado para agregar empleados.