This SEP is for participants who are losing their group health coverage, whether voluntary or involuntary.
Loss of COBRA coverage also triggers this SEP.
The enrollment window begins three months prior to the date of the loss of coverage.
The effective date typically occurs on the first day of the month immediately after the group coverage ends but extends an additional two months.
Situation
The shopper is losing or leaving an employee group sponsored plan.
When to Enroll
| Expand |
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| title | Medicare Advantage/PDPs/Medigaps |
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Up to 3 months before the earliest possible effective date (the earliest possible effective date is the first of the month after group coverage ends), the month of, and up to 3 months after. If the enrollment is completed during the initial 3 months of the enrollment window, the effective date will occur on the first day of the month after group coverage ends. If the enrollment occurs anytime after the initial 3 months of the enrollment window, the effective date will occur on the first day of the month after the enrollment took place. It is best to complete the enrollment during the first 3 months to avoid a potential lapse in coverage.
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Enrollment Reasons
Plan | Code/Reason | Uses |
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MA/MAPD/PDP | LEC | May not be used again after the plan goes into effect |
Medigap | GI | May not be used again after the plan goes into effect |