Announcing a new process for individual off-exchange special enrollment plans (SEP). Anthem special enrollment plan submission change is effective immediately. Anthem will now require paper applications for individual off-exchange SEP enrollments.
- Anthem will accept only paper applications for special enrollment in Individual plans sold off the exchange. Online applications for plans sold off the exchange during a Special Enrollment Period (SEP) are no longer accepted.
- Anthem will require proof of the qualifying event (QE) with the paper application.
- This change does not impact enrollment in plans sold on the exchange.
Quote online, submit on paper
You’ll still be able to generate an off-exchange proposal online. But you’ll no longer be able to complete an online application for off-exchange special enrollment. When you send your clients a quote, they will still be able to navigate to the beginning of the online application. From there, they’ll get instructions on how to access a PDF of their application, pre-filled with your agent details. They can print and complete this application by hand, then mail it in. Or if you’re completing the application with your client, you can print the application and submit it via eSubmit. Remember to write your client’s name on the top of each page of supporting documentation.
Paper applications that do not have any missing information will appear in the Producer Toolbox under Incoming Business about five days after we get the completed application.
Why this change?
This change in process will help Anthem better comply with the requirement to show documented proof of a QE included with the application. As you know, SEP is that time when your clients need to have a life-changing, qualifying event — such as marriage, divorce, a new baby, or loss of other coverage — to be eligible to enroll in a health care plan outside the federal Open Enrollment period.
- As noted above, documentation of the qualifying event must be submitted with the paper application.
- Applicants cannot submit their application or proof of their qualifying event online.
- You’ll find more details about qualifying events for SEP by state on Transformation Central:
- Under Individual Enrollment Support, click on Find Answers
- Scroll down the page to Qualifying Events
- Click on Info By State
- Step 1: select Individual
- Step 2: select Qualifying Events
- Step 3: select the state from the map or the list on the right, and then click Submit
- Step 4: click on the PDF file name displayed to open
Where can you find 2015 paper applications?
- On Merrill Connect (access in Producer Toolbox > Sales & Training > External Links > 2015 Materials.
- On your Agent Connect page, pre-populated with your agent data
Online application is for Open Enrollment only
Starting November 1, you’ll be able to use the online application for 2016 Open Enrollment. But regardless of when a qualifying event happens, SEP applications will be accepted only on paper for Individual plans sold off the exchange.
Online applications started before September 25
- Consumers can get to their In Progress applications from their dashboards
- Producers can access their clients In Progress applications from the In Progress Applications tab; the Edit and Transfer buttons will take the producer to the Application Overview page
- Neither consumers nor producers can re-enter the online application screens. This means they won’t be able to continue or submit.
- Consumers and producers have the option to print the PDF application and complete it by hand. This will contain any information already completed (including producer data). It also gives instructions to mail the application with documented proof of the qualifying event.
If you have any questions, please contact Myra Gifford at Myra@agent-link.net or 1-800-960-1371 x1213