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Special Enrollment Period for Victims of Domestic Abuse or Spousal Abandonment

Information for Health Insurers

All insurers and health maintenance organizations (HMOs) that offer comprehensive health insurance coverage in the individual market should provide a special enrollment period to victims of domestic abuse or spousal abandonment regardless of whether the coverage is offered on or off the NYSOH.   This special enrollment period is consistent with the Department of Health and Human Services (HHS), which has created a permanent special enrollment period for victims of domestic abuse or spousal abandonment under its authority to grant special enrollment periods for exceptional circumstances in 45 CFR 155.420(d)(9).  Likewise, this special enrollment period is consistent with the New York State of Health (NYSOH), which has determined that this special enrollment period is available for individual coverage on the NYSOH.  Insurance Law 4328(b)(4) requires individual coverage to have the same special enrollment periods on and off exchange.  Accordingly:

For more information on this special enrollment period and definitions of domestic abuse and spouse abandonment, see the HHS guidance available at HHS Guidance on Victims of Domestic Abuse and Spousal Abandonment (PDF).

Updated 04/07/2016

 

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