I. Special Election Period (SEP) Elections A common SEP that many beneficiaries are given at this time of year is the SEP for plans that are not renewing with CMS or a plan that is leaving the service area. In this case, the member would qualify for an “SEP NON”. All MA and PDP plans are offered through an annual contract with CMS. If the beneficiary’s MA or PDP plan is not going to be renewed in the coming year, they will be notified in writing and given an SEP that allows them additional time to consider plan options for the next year. Please note: The dates for SEP NON have recently changed and was not included in recent AHIP trainings
• The SEP NON begins on December 8th and ends on the last day of February 2012.
• The beneficiary can make ONE (1) SEP NON code election between Dec 8th and the last day of February.
• Any enrollment completed between Oct 1st and Dec 7th should use the AEP code
• If the member has already enrolled using the AEP code prior to December 8th but they qualified for the SEP NON, another application using the SEP NON code can be submitted up until the last day of February.
• For SEP NON enrollment taken prior to January, the proposed effective date would be January 1st
• For SEP NON enrollments taken in January or February, the proposed effective date would be the first of the following month (e.g. application taken in February, proposed effective date March 1st)
• For all SEP NON enrollments, agents must verify the beneficiary’s eligibility by asking to see the letter they should have received by their plan sponsor.
• The SEP type needs to be documented on the application.
• The SEP code for non-renewal in “NON” and must be marked on the application or selected from the drop down menu for MAPA enrollments. Failure to correctly note the SEP type will cause the application to pend.