Reporting Life Change Events (LCE). Objectives. This Presentation will Provide an overview of the types of changes that can be reported and when Provide an overview of the LCE reporting process Familiarize you with the Report Life Change Events (LCEs) Form
This Presentation will
Coverage Effective Date Rules follow the 1-15th of the month; 16th-end of the month logic.
Qualified Life Change Event is a change that allows new and current customers to enroll in or update health care coverage outside of an open enrollment period.
Cancellations may be made if the consumer has not yet paid to effectuate enrollment. During the open enrollment window, selection of a new plan is permissible after a cancellation.
Terminations occur after the consumer has made a payment to the issuer to effectuate coverage.
*In order for the effective date to remain and go into effect, the payment for the Individual must have been successfully processed.
*In order for the effective date to remain and go into effect for the group, the employer must pay in full by the 15th of the month before coverage.
Effective date is always the first of the following month
Small Business Marketplace:
Effective date is always the first of the following month for current employees
Allows current enrollees to Shop for a new plan:
No new plan OR Shopping for a New Plan
**Generally, customers will need to report changes through PEAK if the change affects household composition, income, immigration/lawful presence status. Job aid forthcoming.
The Report Life Change Events Form is a paper application designed to capture two types of Information:
Those who are not yet Customers
Someone Working on Customer’s Behalf:
Gain other MEC
Loss of MEC
Change in Residence/Mailing Address
General Account / Application Changes / Corrections
New Marital Status