Source: https://www.law.cornell.edu/cfr/text/42/407.20
Timestamp: 2019-04-26 05:56:11+00:00

Document:
Section 407.20. Special enrollment period related to coverage under group health plans.
42 CFR § 407.20 - Special enrollment period related to coverage under group health plans.
§ 407.20 Special enrollment period related to coverage under group health plans.
(1)Group health plan (GHP) and large group health plan (LGHP). These terms have the meanings given them in § 411.101 of this chapter except that the “former employee” language of those definitions does not apply with respect to SEPs for the reasons specified in § 406.24(a)(3) of this chapter.
(2)Special enrollment period (SEP). This term has the meaning set forth in § 406.24(a)(4) of this chapter. In order to use a SEP, an individual must meet the conditions of paragraph (b) and of paragraph (c) or (d) of this section, as appropriate.
(1) They are eligible to enroll for SMI on the basis of age or disability, but not on the basis of end-stage renal disease.
(c)Special rule: Individual age 65 or over. For an individual who is or was covered under a GHP, coverage must be by reason of the current employment status of the individual or the individual's spouse.
(d)Special rules: Disabled individual.4 Individuals entitled on the basis of disability (but not on the basis of end-stage renal disease) must meet conditions that vary depending on whether they were covered under a GHP or an LGHP.
4 Under the current statute, the SEP provision applicable to disabled individuals covered under an LGHP expires on September 1998. Unless Congress changes that date, the last SEP available under those provisions will begin with June 1998.
(1) For a disabled individual who is or was covered under a GHP, coverage must be on the basis of the current employment status of the individual or the individual's spouse.
(i) Before August 10, 1993, as an “active individual”, that is, as an employee, employer, self-employed individual (such as the employer), individual associated with the employer in a business relationship, or as a member of the family of any of those persons.
(ii) On or after August 10, 1993, by reason of current employment status of the individual or a member of the individual's family.
(e)Effective date of coverage. The rule set forth in § 406.24(d) for Medicare Part A applies equally to Medicare Part B.

References: § 407

§ 407
 § 411
 § 406
 § 406
 § 406