Cigna Expiring DST SEPs and new policy

Expiring DST SEPs and new policy for open/ongoing SEPs

There are currently 64 Disaster (DST) Special Election Periods (SEPs) with open and/or ongoing declaration end dates that have not been updated by the issuing states. The SEP and Access to Care/Transition end dates for these 64 DST SEPs have been updated to June 30, 2024.

To identify these expiring SEPs, please look for 'DST Extension' in the 'Notes/Updates' section of our Ongoing SEP Tracker.

As always, please reference the Ongoing SEP Tracker found in the Resource Center of Producers' University under 'Agent Communications' for a full list of active and inactive DST SEPs. Note: Log in is required to view the file.

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New policy for open and/or ongoing DST SEPs

Cigna Healthcare is implementing a new policy for DST SEPs with open and/or ongoing declaration end dates. This policy will be applied if a declaration end date is not provided in the Emergency Order/Proclamation.

Review the policy below:

• If the Emergency Order/Proclamation does not provide an end date, and the state statute provides a duration, the state statute timeframe will be used to calculate the SEP and Access to Care/Transition end dates.
• If the Emergency Order/Proclamation does not provide an end date and no duration is provided within the state statute, the Code of Federal Regulations (CFR) 30-day timeframe will be used to calculate the SEP and Access to Care/Transition end dates.

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Please note: A disaster SEP application is only valid while the SEP declaration is in effect. If an end date is not listed below, please refer to the Ongoing SEP tracker in Producers’ University for the most up-to-date information. Any SEP applications submitted outside of that SEP’s declaration date will be rejected.

IMPORTANT: Please be aware

• This does not mean that active marketing can occur.
• The SEP is only for the purpose of providing a SEP to impacted individuals who had a valid election during the incident and were unable to make that election due to the emergency.
• This does not mean that Cigna Healthcare initiates waiving of authorization or referral requirements.
• This does not extend waiving of prior authorizations, referrals etc.

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SEP for Government Entity-Declared Disaster or Other Emergency

42 CFR 422.62(b)(18)

(Rev. 2, Issued: August 12, 2020; Effective/Implementation: 01-01-2021)

An SEP exists for individuals affected by a disaster or other emergency declared by a Federal, state, or local government entity who were unable to, and did not make an election during another valid election period. This includes both enrollment and disenrollment elections.

Individuals are eligible for this SEP if they:

• reside or resided at the start of the SEP eligibility period where a federal, state, or local government entity declared a disaster or other emergency.
• were eligible for another election period at the time of the Disaster Election Period (DST) eligibility period.
• did not make an election during that other valid election period due to the disaster or other emergency.

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The SEP starts on the date the declaration was made or the incident start date, whichever is earlier. The SEP ends two full calendar months following the end date identified in the declaration or the date the end of the incident is announced, whichever is later.

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