New SEPS In California, Florida, and Oregon
This is an important announcement for agents with customers in California, Florida, and Oregon and for those with business in those states. The counties below are under a state-designated SEP due to an emergency.
CALIFORNIA
FEMA declaration: Severe Winter Storms, Flooding, and Mudslides
SEP incident dates: 01/08/2023 – Ongoing
This SEP declaration is effective: 01/08/2023 – Ongoing
Impacted counties for SEP purposes: El Dorado, Los Angeles, Mariposa, Mendocino, Merced, Monterey, Napa, Placer, Riverside, Sacramento, San Bernardino, San Mateo, Santa Clara, Santa Cruz, Sonoma, Stanislaus and Ventura counties.
FLORIDA
State declaration: Illegal Migration
SEP incident dates: 01/06/2023 – 04/04/2023
This SEP declaration is effective: 01/06/2023 – 05/31/2023
Impacted counties for SEP purposes: All counties
OREGON
State declaration: Severe Winter Storms
SEP incident dates: 12/22/2022 – 02/04/2023
This SEP declaration is effective: 12/22/2022 – 03/31/2023
Impacted counties for SEP purposes: Clackamas, Coos, Curry, Douglas, Hood River, Jackson, Josephine, Lane, Lincoln, Multnomah, Washington, and Umatilla counties.
IMPORTANT: Please be aware
- This does not mean that active marketing can occur.
- The SEP is only for the purpose of providing a SEP to impacted individuals who had a valid election during the incident and were unable to make that election due to the emergency.
- This does not mean we initiate waiving of authorization or referral requirements.
- This does not extend waiving of prior authorizations, referrals etc.
SEP for Government Entity-Declared Disaster or Other Emergency
42 CFR 422.62(b)(18)
(Rev. 2, Issued: August 12, 2020; Effective/Implementation: 01-01-2021)
An SEP exists for individuals affected by a disaster or other emergency declared by a Federal, state or local government entity who were unable to, and did not make an election during another valid election period. This includes both enrollment and disenrollment elections.
Individuals are eligible for this SEP if they:
- Reside, or resided at the start of the SEP eligibility period described in this guidance, in an area for which a federal, state or local government entity has declared a disaster or other emergency or they do not reside in an affected area but rely on help making healthcare decisions from one or more individuals who reside in an affected area; and
- Were eligible for another election period at the time of the SEP eligibility period; and
- Did not make an election during that other valid election period due to the disaster or other emergency.
The SEP starts as of the date the declaration is made, the incident start date or, if different, the start date identified in the declaration, whichever is earlier. The SEP ends two full calendar months following the end date identified in the declaration or, if different, the date the end of the incident is announced, whichever is later.
If you have any questions, call us today at 866-568-9649!