Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 21, 2017

Program Area: Enrollment and Eligibility (ENR)

Question: During Open Enrollment (OE) 2018, a current Marketplace enrollee makes an active selection to a new Qualified Health Plan (QHP) effective January 1, 2018. The issuer cancels the 2018 passive enrollment. The issuer then positively identifies this member as having Medicare. Therefore, following state law (as it was determined to be a plan change) and the anti-duplication regulation, the issuer cancels the 2018 coverage and sends a termination notice (cancellation) to the member. If the referenced member returns to the Marketplace (provided OE has not closed for 2018) and actively selects the same plan in which they were enrolled for the 2017 Plan Year (PY) (2017 or 2018 crosswalk), is the issuer expected to accept this enrollment?

Answer: Please reference the 2018 Enrollment Bulletin found at: https://www.regtap.info/reg_librarye.php?i=2356

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