Yes, there is a HIPAA special enrollment period (SEP) when enrolling with HMAA after a loss of coverage or acquiring a new dependent due to birth, marriage, adoption, or placement of adoption. The standard SEP of 30 days (or 60 days in the case of special enrollment rights under the Children’s Health Insurance Program Reauthorization Act of 2009) may be extended in certain circumstances as described in the following examples:

  • Example 1: On April 27, 2020, Jane adopted a child. When can she enroll the child in her HMAA plan, and when will the child be covered? Because the adoption of Jane’s child triggered a SEP (adoption as a qualifying event), the Outbreak Period is disregarded. Jane has 30 days from the end of the one-year extension date that the timeline would have started (April 27, 2021), in this case until the deadline (May 27, 2021), to enroll the child with HMAA, provided she pays the premium for all periods of coverage. If the child is a newborn, coverage is effective on the date of birth; otherwise, coverage is effective on the date of adoption.
  • Example 2: On February 10, 2020, Michelle gave birth. When can she enroll the child in her HMAA plan, and when will the child be covered? Because the birth of Michelle’s child triggered a SEP (birth as a qualifying event), the Outbreak Period is disregarded. Michelle has 11 days* from the end of the Outbreak Period (February 28, 2021), in this case until the deadline (March 11, 2021), to enroll the child with HMAA, provided she pays the premium for all periods of coverage. Coverage is effective on the child’s date of birth. *Timeframe calculation: 30 days (SEP) – 19 days (utilized prior to Outbreak Period) = 11 days (SEP remaining).
  • Example 3: On May 20, 2020, Jon married. When can he enroll his spouse/partner in his HMAA plan, and when will his spouse/partner be covered? Because the marriage triggered a SEP (marriage as a qualifying event), the Outbreak Period is disregarded. Jon has 30 days from the end of the one-year extension date that the timeline would have started (May 20, 2021), in this case until the deadline (June 19, 2021), to enroll his spouse/partner with HMAA, provided he pays the premium for all periods of coverage.
  • Example 4: On February 25, 2020, Mike’s spouse lost her job and her employer-sponsored health coverage which also covered their two children. When can Mike enroll his spouse and children in his HMAA plan, and when will they be covered? Because the loss of coverage of Mike’s spouse triggered a SEP (loss of coverage as qualifying event), the Outbreak Period is disregarded. Mike has 26 days* from the end of the Outbreak Period (February 28, 2021), in this case until the deadline (March 26, 2021), to enroll his spouse and children with HMAA, provided he pays the premium for all periods of coverage. The earliest coverage effective date is the first day of the month following loss of coverage. *Timeframe calculation: 30 days (SEP) – 4 days (utilized prior to outbreak period) = 26 days (SEP remaining).