Special Election Period Declared: COVID -19

Please be advised FEMA has declared the Novel Coronavirus Disease (COVID-19) Outbreak as national emergency and major disaster. This declaration allows for a one-time Special Enrollment Period (SEP) for those affected by COVID-19, who were unable to and did not make an election during another qualifying election period as a result of the emergency and major disaster. Please reference the following guidelines for the incident period. This SEP applies to all 50 states and all counties. The timeline of this SEP is March 1, 2020 and runs for 4 months from the start date— and will end June 30th, 2020.

Eligibility:

This SEP opportunity is available to beneficiaries who:

  • Reside, or resided at the start of the incident period, in an area for which FEMA has declared an emergency or a major disaster and has designated affected counties as being eligible to apply for individual or public level assistance.
  • Had another valid election period at the time of the incident period, and,
  • Did not make an election during their other valid election period.
  • In addition, the SEP is available to those individuals who don’t live in the affected areas but rely on help making healthcare decisions from friends or family members who live in the affected areas.

Attention Agents:

Agents should conduct the following business practice with beneficiaries that believe may qualify for this SEP:

  • Confirm and/or verbally attest that beneficiary lives/lived in an impacted area at the start of the incident period. Beneficiaries will not be expected to provide proof that they were affected by the pandemic-related emergency.
  • Confirm that they had another election period available during the time of the incident period.
  • Confirm that the beneficiary lived in a county that has been declared an emergency or major disaster and FEMA has determined is eligible for Public or Individual assistance. Once eligibility has been verified, proceed with the application.
  • On applications, use election code SEP DST.

Agents must adhere to the enrollment process for Blue Shield of California, Blue Shield of California Promise Health Plan and CMS guidelines. The Disaster SEP should not be used as a marketing tool to promote MAPD or PDP sales. Agents must not actively market the SEP. However, should be aware that it is available in case they are approached by a beneficiary who believes they have missed an election period due to the incident.