Virginia Notice of Special Enrollment Rules

State:
Multi-State
Control #:
US-359EM
Format:
Word; 
Rich Text
Instant download

Description

This notice informs an individual of his or her rights for special enrollment involving health insurance coverage.

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FAQ

2022 HIPAA allows eligible individuals to enroll in health plan coverage outside of the regular enrollment periods. 2022 These special enrollment rights apply to employees and their dependents, depending on the circumstance.

What is the contract called that is issued to an employer for a Group Medical Insurance plan? (An employer would be a possible applicant and contract policyholder of a single master contract or master policy for group health benefits.)

In general, employers must allow all employees who had at least 1,000 hours of service in the preceding plan year to participate in a simple cafeteria plan. However, employers may exclude from the plan employees who meet one of the following criteria: Are under age 21 before the close of a plan year.

You qualify for a Special Enrollment Period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs).

The HIPAA certificate of creditable coverage is no longer a required notice. The certificate was eliminated at the end of 2014 because its primary function was to address pre-existing condition exclusions (PCEs). The ACA has since prohibited all PCEs, which is why the certificate is no longer required.

If there is a court order that states the parents share joint custody without designating that one parent is responsible for medical expenses, the parent whose birthday falls earliest in the plan year will be primary.

If you get married, you're eligible to get coverage effective the first of the following month, regardless of how late in the month you enroll. If you have a baby, adopt a child, or receive a court order for medical child support, the coverage can be backdated to the date of the birth, adoption, or court order.

A change in your situation like getting married, having a baby, or losing health coverage that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period.

You qualify for a Special Enrollment Period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

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Virginia Notice of Special Enrollment Rules