Special Election Period (SEP) in effect for New York

Special Enrollment Period: New York Emergency Declaration - Suffolk County Wildfire – EO #48

This is an important announcement for agents with customers in New York and for those with business in this state. The counties below are under a federal or state designated SEP due to an emergency.

Please be advised that this is a Special Election Period that the state has deemed. When processing an enrollment, DO NOT choose “Other”. You will choose the option listed in the image below through Think Agent. If this option is not reflected in your upline’s enrollment platform, please speak with your upline directly for guidance. Use SEPs responsibly and feel free to contact me with any questions.

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Think Agent Election Period Selection

"I was affected by an emergency or major disaster (as declared by the Federal Emergency Management Agency, or by Federal, my state, or my local government). One of the other statements applied to me, but I was unable to make my request because of the distaster.

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More about SEPs:

The length of a Special Enrollment Period (SEP) and the effective date of new coverage vary depending on the circumstances that trigger the SEP.

The plan and, in some cases, the Centers for Medicare & Medicaid Services (CMS), determine whether an applicant qualifies for an SEP based on Medicare Guidelines.

The rules for changing Medicare drug plans are the same whether you are in a stand-alone drug plan that only covers drugs or a Medicare Advantage Plan that covers both health care and drugs.

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New York – Suffolk County Wildfire – EO #48

Incident Announcement Date: 3/8/2025

Incident Period: 3/8/2025 – 4/7/2025

SEP Start Date: 3/8/2025

SEP End Date: 06/30/2025

Related Link: https://www.governor.ny.gov/executive-order/no-48-declaring-disaster-county-suffolk

Counties effected: Suffolk only

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Review requirements for the disaster/emergency Special Enrollment Period (SEP)

Overview of the SEP for Government Entity-Declared Disaster or Other Emergency A special enrollment period (SEP) exists for individuals affected by a disaster or other emergency declared by a federal, state or local government entity who were unable to, and did not make an election during another valid election period. This SEP allows for enrollment and disenrollment elections. For more information, go to CY 2024 MA Enrollment and Disenrollment Guidance [42 CFR 422.62(b)(18)].

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When can this SEP be used?

A disaster/emergency SEP is only applicable to those beneficiaries who were prevented from submitting an enrollment or disenrollment request during a given election period due to a declared disaster or emergency. CMS strictly limits when the disaster/emergency SEP may be used.

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Individuals are eligible for this SEP if they:

• Reside, or resided at the start of the SEP eligibility period, in an area for which a federal, state or local government entity has 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
• Were 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.

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Enrollment instructions IMPORTANT:

Remember, you cannot use this SEP opportunity to proactively market to beneficiaries. However, you can assist any clients who contact you about this SEP.

• If an individual wants to enroll and believes they may qualify for this SEP, you need to ask the beneficiary if they can show proof that they lived/live in an impacted area at the start of the incident period. If they do not have proof, ask them to verbally attest.
• When helping eligible clients enroll, please select the weather-related or major disaster option in the Reasons for Special Enrollment Period Eligibility section of the application.

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