Cigna: Staying compliant when using a DST SEP

Staying compliant when using a Disaster Special Election Period

Recently, a disaster was declared in Georgia for the passing of First Lady Eleanor Rosalynn Carter (see below). As a reminder, the use of a Disaster (DST) Special Election Period (SEP) is only for the purpose of providing an SEP to impacted individuals who had a valid election during the incident and were unable to make that election due to the emergency.

When using a DST SEP, the agent must confirm the customer:

• Resides, or resided at the start of the SEP eligibility period in an area declared a disaster or other emergency or they do not reside in an affected area but rely on help making health care decisions from one or more individuals who reside in an affected area; and
• Was eligible for another election period at the time of the SEP eligibility period; and
• Did not make an election during that other valid election period due to the disaster or other emergency.

42 CFR 422.62(b)(18) SEP for Government Entity-Declared Disaster or Other Emergency

Agents found out of compliance with the regulation will be issued corrective action, which could include termination.

Please reach out to our Cigna Agent Resource Line if you have any questions