Common use of Special Enrollment Period (SEP Clause in Contracts

Special Enrollment Period (SEP. An individual may enroll in HPN outside of the annual open enrollment period under the following circumstances; pre-enrollment verification may apply:  Loss of Minimum Essential Coverage (MEC): An applicant may enroll sixty (60) days before and after loss of MEC; the effective date of coverage will be the first (1st) day the month following loss of MEC. HPN is allowed to reject enrollment if loss of MEC is due to non-payment of premium.  Eligible immigration status: A newly eligible applicant may enroll sixty (60) days after gaining eligible immigration status. Applications received during the month eligible status is obtained will have an effective date of the first (1st) day of following month, if the Subscriber submits the application by the fifteenth (15th) of the month that immigration status changed.  Gaining or becoming a Dependent: A new Dependent may be added to the Subscriber’s plan as follows:  Newborns: Sixty (60) days after birth with date of birth as the effective date;  Other Dependents Through Marriage: Sixty (60) days after marriage with an effective date of first of the following month. A new spouse or domestic partner of an existing Subscriber must demonstrate that, for one or more days in the sixty (60) days preceding the marriage, he/she was either enrolled in MEC or lived in a U.S. Territory or a foreign country.  Permanent move: Applicants must provide evidence that a move occurred and, that for one or more days in the 60 days preceding the move, the applicant was either enrolled in MEC or lived in a U.S. Territory or a foreign country. NOTE: Moving only for medical treatment and/or staying somewhere for vacation does not qualify as a permanent move. Verification Delays: Applicants may start their coverage no more than one (1) month later than their effective date would ordinarily have been, if the special enrollment period verification process delays their enrollment such that they would be required to pay two (2) or more months of retroactive premium to effectuate coverage or avoid cancellation.

Special Enrollment Period (SEP. An individual may enroll in HPN outside of the annual open enrollment period under the following circumstances; pre-enrollment verification may apply:  Loss of Minimum Essential Coverage (MEC): An applicant may enroll sixty (60) days before and after loss of MEC; . If enrolling before loss of MEC, the effective date of coverage will be the date of action of the loss of MEC. If enrolling after loss of MEC, the effective date will be the first (1st) day the month following loss of MEC. HPN is allowed to reject enrollment if loss of MEC is due to non-payment of premium.  Eligible immigration status: A newly eligible applicant may enroll sixty (60) days after gaining eligible immigration status. Applications received during the month eligible status is obtained will have an effective date of the first (1st) day of following month, if the Subscriber submits the application by the fifteenth (15th) of the month that immigration status changed.  Gaining or becoming a Dependent: A new Dependent may be added to the Subscriber’s plan as follows:  Newborns: Sixty (60) days after birth with date of birth as the effective date;  Other Dependents Through Marriage: Sixty (60) days after marriage with an effective date of first of the following month. A new spouse or domestic partner of an existing Subscriber must demonstrate that, for one or more days in the sixty (60) days preceding the marriage, he/she was either enrolled in MEC or lived in a U.S. Territory or a foreign country.  Permanent move: Applicants must provide evidence that a move occurred and, that for one or more days in the 60 days preceding the move, the applicant was either enrolled in MEC or lived in a U.S. Territory or a foreign country. NOTE: Moving only for medical treatment and/or staying somewhere for vacation does not qualify as a permanent move. Verification Delays: Applicants may start their coverage no more than one (1) month later than their effective date would ordinarily have been, if the special enrollment period verification process delays their enrollment such that they would be required to pay two (2) or more months of retroactive premium to effectuate coverage or avoid cancellation.

Special Enrollment Period (SEP. An individual may enroll in HPN SHL outside of the annual open enrollment period under the following circumstances; pre-enrollment verification may apply:  Loss of Minimum Essential Coverage (MEC): An applicant may enroll sixty (60) days before and after loss of MEC; . If enrolling before loss of MEC, the effective date of coverage will be the date of action of the loss of MEC. If enrolling after loss of MEC, the effective date will be the first (1st) day the month following loss of MEC. HPN SHL is allowed to reject enrollment if loss of MEC is due to non-payment of premium.  Eligible immigration status: A newly eligible applicant may enroll sixty (60) days after gaining eligible immigration status. Applications received during the month eligible status is obtained will have an effective date of the first (1st) day of following month, if the Subscriber submits the application by the fifteenth (15th) of the month that immigration status changed.  Gaining or becoming a Dependent: A new Dependent may be added to the Subscriber’s plan as follows:  Newborns: Sixty (60) days after birth with date of birth as the effective date;  Other Dependents Through Marriage: Sixty (60) days after marriage with an effective date of first of the following month. A new spouse or domestic partner of an existing Subscriber must demonstrate that, for one or more days in the sixty (60) days preceding the marriage, he/she was either enrolled in MEC or lived in a U.S. Territory or a foreign country.  Permanent move: Applicants must provide evidence that a move occurred and, that for one or more days in the 60 days preceding the move, the applicant was either enrolled in MEC or lived in a U.S. Territory or a foreign country. NOTE: Moving only for medical treatment and/or staying somewhere for vacation does not qualify as a permanent move. Verification Delays: Applicants may start their coverage no more than one (1) month later than their effective date would ordinarily have been, if the special enrollment period verification process delays their enrollment such that they would be required to pay two (2) or more months of retroactive premium to effectuate coverage or avoid cancellation.

Special Enrollment Period (SEP. An individual may enroll in HPN SHL outside of the annual open enrollment period under the following circumstances; pre-enrollment verification may apply:  Loss of Minimum Essential Coverage (MEC): An applicant may enroll sixty (60) days before and after loss of MEC; the effective date of coverage will be the first (1st) day the month following loss of MEC. HPN SHL is allowed to reject enrollment if loss of MEC is due to non-payment of premium.  Eligible immigration status: A newly eligible applicant may enroll sixty (60) days after gaining eligible immigration status. Applications received during the month eligible status is obtained will have an effective date of the first (1st) day of following month, if the Subscriber submits the application by the fifteenth (15th) of the month that immigration status changed.  Gaining or becoming a Dependent: A new Dependent may be added to the Subscriber’s plan as follows:  Newborns: Sixty (60) days after birth with date of birth as the effective date;  Other Dependents Through Marriage: Sixty (60) days after marriage with an effective date of first of the following month. A new spouse or domestic partner of an existing Subscriber must demonstrate that, for one or more days in the sixty (60) days preceding the marriage, he/she was either enrolled in MEC or lived in a U.S. Territory or a foreign country.  Permanent move: Applicants must provide evidence that a move occurred and, that for one or more days in the 60 days preceding the move, the applicant was either enrolled in MEC or lived in a U.S. Territory or a foreign country. NOTE: Moving only for medical treatment and/or staying somewhere for vacation does not qualify as a permanent move. Verification Delays: Applicants may start their coverage no more than one (1) month later than their effective date would ordinarily have been, if the special enrollment period verification process delays their enrollment such that they would be required to pay two (2) or more months of retroactive premium to effectuate coverage or avoid cancellation.

Special Enrollment Period (SEP. An individual may enroll in HPN SHL outside of the annual open enrollment period under the following circumstances; pre-enrollment verification may apply:  Loss of Minimum Essential Coverage (MEC): An applicant may enroll sixty (60) days before and after loss of MEC; the effective date of coverage will be the first (1st) day the month following loss of MEC. HPN is allowed to reject enrollment if loss of MEC is due to non-payment of premium.  Eligible immigration status: A newly eligible applicant may enroll sixty (60) days after gaining eligible immigration status. Applications received during the month eligible status is obtained will have an effective date of the first (1st) day of following month, if the Subscriber submits the application by the fifteenth (15th) of the month that immigration status changed.  Gaining or becoming a Dependent: A new Dependent may be added to the Subscriber’s plan as follows:  Newborns: Sixty (60) days after birth with date of birth as the effective date;  Other Dependents Through Marriage: Sixty (60) days after marriage with an effective date of first of the following month. A new spouse or domestic partner of an existing Subscriber must demonstrate that, for one or more days in the sixty (60) days preceding the marriage, he/she was either enrolled in MEC or lived in a U.S. Territory or a foreign country.  Permanent move: Applicants must provide evidence that a move occurred and, that for one or more days in the 60 days preceding the move, the applicant was either enrolled in MEC or lived in a U.S. Territory or a foreign country. NOTE: Moving only for medical treatment and/or staying somewhere for vacation does not qualify as a permanent move. Verification Delays: Applicants may start their coverage no more than one (1) month later than their effective date would ordinarily have been, if the special enrollment period verification process delays their enrollment such that they would be required to pay two (2) or more months of retroactive premium to effectuate coverage or avoid cancellation.