Benefits Buzz COVID-19 Special Enrollment Period

Posted on January 29th, 2021

President Joseph Biden signed an executive order on Thursday which instructs the Department of Health and Human Services (HHS) to authorize a new special enrollment period in the individual health insurance market. The special enrollment period will be available because of the exceptional circumstances that have been created by the COVID-19 pandemic.

The special enrollment period only applies to individual plans that are sold on the federal Health Insurance Marketplace ( The special enrollment period will be available from February 15, 2021 until May 15, 2021.

Although it is being called a special enrollment period, it will function much like the open enrollment period that occurred between November 1, 2020 and December 15, 2020. Anyone residing in one of the 36 states that uses will be able to enroll in an individual health insurance plan (unless they already have coverage through Medicare). Similarly, residents of these states who are currently enrolled in an individual plan will have an opportunity to change their coverage to any plan that is available in their area.

The executive order does not apply to states that operate their own Health Insurance Marketplace; however, states could elect to provide a similar special enrollment period to their residents.

Special enrollment periods for exceptional circumstances are also not required to be made available for individual plans that are sold outside of (i.e., off-Exchange plans). It would be up to each insurance carrier who sells off-Exchange plans to determine if they will accept enrollments for this type of special enrollment period. 

It is important to point out that effective dates for enrollments under this special enrollment period will be prospective. Effective dates will be the first of the month following the individual plan selection. Retroactive effective dates will not be permitted.

The Centers for Medicare & Medicaid Services (CMS), a division of HHS, put out a summary of what to expect in the coming weeks and months. CMS will be conducting outreach activities to encourage those who are eligible to enroll in an individual plan. CMS has indicated the functionality to accept enrollments under this special enrollment period will be available directly at the website, through the Health Insurance Marketplace call center, and through other direct channels that accept enrollments on behalf of such as private exchanges.  


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