Data about 2015 Special Enrollment Period Report Snapshot – February 23 – June 30, 2015

The next open enrollment period for Marketplace coverage begins on November 1, 2015 for coverage starting on January 1, 2016. Some people can sign up for health coverage outside of open enrollment, before November 1, because they qualify for a special enrollment period (SEP). A consumer can qualify for a SEP for such circumstances as loss of health coverage, losing Medicaid eligibility, changes in family status (for example, marriage or birth of a child), or other exceptional circumstances.

This snapshot provides information about consumers who selected a plan between February 23 and June 30, 2015 through the HealthCare.gov platform, which includes 37 states with Federally Facilitated Marketplaces, State Partnership Marketplaces, and supported State-Based Marketplaces.

Nearly 950,000 new consumers selected a plan through the HealthCare.gov platform using a SEP between February 23 and June 30, 2015.

“Life changes are often impossible to predict, but access to affordable and quality health care coverage should never be. So far this year, nearly 950,000 people have gained the peace of mind that comes with access to coverage by taking advantage of a special enrollment period, providing us with further evidence that the Health Insurance Marketplace is working for America’s families,” said Kevin Counihan, CEO of the Health Insurance Marketplace. “We want people to know that if they lose a job, get married, have a baby, or experience other life changes, we’re here to help them find coverage they can afford.”

Today’s Special Enrollment Period Snapshot only reflects plan selection activity and, as such, does not capture whether consumers effectuated their enrollment and continued paying for health insurance coverage following the plan selection.

Overall SEP Activity

Between February 23 and June 30, 2015, about 944,000 new consumers made plan selections through HealthCare.gov using a SEP. Eighty-four percent of plan selections occurred via three types of SEPs: 50 percent of plan selections occurred via SEPs for the loss of health coverage or “minimum essential coverage”, 19 percent occurred via SEPs for being determined ineligible for Medicaid, and 15 percent were as a result of tax season SEP (Table 1). The remaining 16 percent of plan selections were attributable to other types of SEPs (see glossary).

States info, graphic, and snapshot can be found at: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-08-13.html