Health insurers and health insurance agents may have a few stories to tell about health insurance special enrollment period fraud, but not all that many they want to share with the government.
The Centers for Medicare & Medicaid Services recently included tougher SEP verification rules in a new package of draft regulations. CMS officials say they hope the regulations will help stabilize the individual major medical market, and persuade insurers to stay in the market for the rest of this year and all of 2018.
CMS added the SEP rules in response to complaints from insurance company executives and others that some consumers are gaming the system, by using loopholes in the SEP rules and the SEP verification process to wait until they get sick to pay for coverage.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
