Source: https://www.law.cornell.edu/cfr/text/42/406.24
Timestamp: 2019-05-26 03:12:25
Document Index: 764748091

Matched Legal Cases: ['§ 406', '§ 406', '§ 406', '§ 411', '§ 411', '§ 411', '§ 406']

42 CFR § 406.24 - Special enrollment period related to coverage under group health plans. | CFR | US Law | LII / Legal Information Institute
Section 406.24. Special enrollment period related to coverage under group health plans.
42 CFR § 406.24 - Special enrollment period related to coverage under group health plans.
§ 406.24 Special enrollment period related to coverage under group health plans.
(a)Terminology. As used in this subpart, the following terms have the indicated meanings.
(1)Current employment status has the meaning given this term in § 411.104 of this chapter.
(2)Family member has the meaning given this term in § 411.201 of this chapter.
(3)Group health plan (GHP) and large group health plan (LGHP) have the meanings given those terms in § 411.101 of this chapter, except that the “former employee” language of those definitions does not apply with respect to SEPs because -
(4)Special enrollment period (SEP) is a period provided by statute to enable certain individuals to enroll in Medicare without having to wait for the general enrollment period.
(b)Duration of SEP.2 (1) The SEP includes any month during any part of which -
2 Before March 1995, SEPs began on the first day of the first month the individual was no longer covered under a GHP or LGHP by reason of current employment status.
(ii) An individual under age 65 and disabled -
(c)Conditions for use of a SEP.3 In order to use a SEP, the individual must meet the following conditions:
3 Before August 10, 1993, an individual under age 65 could qualify for a SEP only if he or she had LGHP coverage as an “active individual”, which the statute defined 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”.
(1) When first eligible to enroll for premium hospital insurance under § 406.20(b) or (c), the individual was -
(d)Special rule: Additional SEPs.
(1) Generally, if an individual fails to enroll during any available SEP, he or she is not entitled to any additional SEPs.
(e)Effective date of coverage.
(1) If the individual enrolls in a month during any part of which he or she is covered under a GHP or LGHP on the basis of current employment status, or in the first full month when no longer so covered, coverage begins on the first day of the month of enrollment or, at the individual's option, on the first day of any of the three following months.