How To Transition From OEP To Outside OEP With Success

The last day of Open Enrollment was January 31, 2016, so now is the time to shift toward assisting clients enroll in a Qualified Health Plan on/off exchange.

What does this period mean for agents? For agents, this means you have the opportunity to fill your client’s coverage gap with a short-term medical plan, aimed at severely reducing the risk of catastrophic financial loss in the event of hospitalization, critical illness diagnosis or medical accident.

3 steps to successfully transition from the Open Enrollment Period (OEP) to outside the OEP:

  1. Understand the value of short-term medical coverage and be prepared to present options in order to fill the gap in coverage your client may have if they are currently without a Qualified Health Plan, and lack a Qualifying Life Event/Special Enrollment Period in order to enroll in a QHP.
  2. Follow a systematic process of helping your client understand they must have a QLE to enroll in a Major Medical plan, perform a QLE/SEP screening, and pivot to short-term medical options in cases where the client lacks a QLE/SEP.
  3. Always be prepared to offer additional coverage to supplement high-deductible Major Medical and Short-Term Medical plans (i.e. Critical Illness, Accident Medical Expense, and SecureAssist).

If consumers have a QLE, you simply need to follow the application process and make sure to select/designate the appropriate QLE so that the submitted plan will be accepted by the carrier.

What should Agents do differently during outside of OEP than within OEP?

  • Perform a QLE/SEP screening (ask your consumer if they have experienced any of the following within the last 60 days and list the various QLEs). Based on their answer, either offer a QHP or pivot to short-term medical, with a focus on the value of short-term medical coverage to someone without any coverage whatsoever.

For more information on Qualifying Life Events (QLE) and Special Enrollment Periods (SEP), be sure to check out this quick, one-page report which defines QLE and SEP and lists what’s included in both.

To solidify your success, make sure you have the right technology and enrollment solution in place. We recommend the GoHealth Marketplace for a user-friendly shopping and enrollment experience. See for yourself — request a free demo today!

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