Glossary Term

Special Enrollment Period

A Special Enrollment Period (SEP) is an opportunity to join a health plan outside its standard open enrollment period. In most cases, a SEP is temporary and has a finite window in which to enroll (e.g. 60 days).

A SEP normally comes with restrictions on who is eligible to take advantage of the secondary enrollment window. For example, a SEP often requires a qualifying life event such as moving to a new region, marriage, birth of a child, or loss of existing health coverage. The restrictions on who qualifies for a SEP protects the health plan from individuals who would wait until sick before joining and paying premiums.

In states using the federal health insurance marketplace, Healthcare.gov, there is a year-round special enrollment period for Affordable Care Act health plans offered to people whose household earnings do not exceed 150 percent of the Federal Poverty Level.


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