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Health Insurance Exchange Special Enrollment Periods


Published: March 4, 2015



DATE: March 4, 2015


RE: Health Insurance Exchange Special Enrollment Periods

Dear Colleague:

We are pleased to announce that on February 27, 2015, the Centers for Medicare and Medicaid Services published a Final Rule, which, among other things, establishes provisions for special enrollment periods for medical coverage that must be obtained under court orders, including child support orders. A new or modified medical support order is a qualifying event for parents who will need to enroll their child(ren) in health care coverage outside of the open enrollment period. This provision will become effective on April 28, 2015.

The Final Rule adds paragraph 45 CFR 155.420(d)(2)(i), which states: “The qualified individual gains a dependent or becomes a dependent through marriage, birth, adoption, placement for adoption, placement in foster care, or through a child support or other court order.”

Additionally, 45 CFR 155.420 (b)(2)(v) states: “In the case of a court order as described in paragraph (d)(2)(i) of this section, the Exchange must ensure that coverage is effective for a qualified individual or enrollee on the date the court order is effective…” This requirement is intended to minimize any gap in coverage the individual may experience and allow Exchanges to provide consumers with a choice for regular effective dates.


Vicki Turetsky
Office of Child Support Enforcement

cc: ACF/OCSE Regional Program Managers

Last Reviewed: June 13, 2019

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