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Oct
01
,
2024

Special Election Period (SEP) in effect for North Carolina

October 1, 2024
Cigna

Special Enrollment Period: North Carolina Emergency Declaration - Tropical Storm Helene

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

Please note: A disaster SEP application is only valid while the SEP declaration is in effect. If an end date is not listed below, please refer to the Ongoing SEP tracker in Producers’ University for the most up-to-date information. Any SEP applications submitted outside of that SEP’s declaration date will be rejected.

IMPORTANT: Please be aware

  • This does not mean that active marketing can occur.
  • The SEP is only for the purpose of providing a SEP to impacted individuals who had a valid election during the incident and were unable to make that election due to the emergency.
  • This does not mean that Cigna Healthcare initiates waiving of authorization or referral requirements.
  • This does not extend waiving of prior authorizations, referrals etc.

SEP for Government Entity-Declared Disaster or Other Emergency

42 CFR 422.62(b)(18)

(Rev. 2, Issued: August 12, 2020; Effective/Implementation: 01-01-2021)

An 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 includes both enrollment and disenrollment elections.

Individuals are eligible for this SEP if they:

  • reside or resided at the start of the SEP eligibility period where a federal, state, or local government entity declared a disaster or other emergency.
  • were eligible for another election period at the time of the Disaster Election Period (DST) eligibility period.
  • did not make an election during that other valid election period due to the disaster or other emergency.

The SEP starts on the date the declaration was made or the incident start date whichever is earlier. The SEP ends two full calendar months following the end date identified in the declaration or the date the end of the incident is announced, whichever is later.

State declaration: Tropical Storm Helene

SEP incident dates: 09/25/2024 - 11/22/2024

This SEP declaration is effective: 09/25/2024 - 12/31/2024

Impacted counties for SEP purposes: All

Updates to Cigna's DST application process

Two key updates:

  1. The date of the disaster is no longer required on any DST applications.  
  2. The missed election period is not required on most applications. See clarification below.

Keep in mind: Some missed election periods will still require you to input the missed election period AND the date of the missed election period on the application. Some examples include MOV (moving) or LEC (losing group coverage). The application will contain an "open" date field next to the SEP selections that still require a date to help you know when it is required.

For all applications, ensure that the following fields are completed:

  • Select "SEP" in the Select Enrollment Period field.
  • Enter code "DST" in the SEP Code field.
  • If applicable, enter the date that applies for the missed election period. For example, a date is needed only if the missed SEP already required a date, such as moving, losing group coverage, losing or gaining Medicaid, etc. If the missed SEP or election period does not require a date on the application, the missed election period is not required. However, adding it on the application will expedite our review process. (i.e., AEP, OEP, LIS, MDE).


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