Section 220-RICR-90-00-1.6 - Annual Open Enrollment and Special Enrollment PeriodsA. In General - §1311 of the ACA and its implementing regulations, 45 C.F.R. §§ 155.410 and 155.420, incorporated above at § 1.3 of this Part, and R.I. Gen. Laws § 42-157-12 establish requirements for annual open enrollment, and special enrollment periods for Qualified Health Plans.B. Annual Open Enrollment Period 1. The Exchange will establish the annual open enrollment period and shall provide a minimum of one hundred twenty (120) days advance public notice prior to its first (1st) day.2. Annual Open Enrollment Periods as established by the Exchange shall last a minimum of thirty (30) days.C. Annual Open Enrollment Period Coverage Effective Dates 1. Qualified individuals must select a QHP and the Exchange must receive the first (1st) month's premium in full by the payment deadlines established by the Exchange in order to effectuate coverage.2. The Exchange shall establish a deadline relative to the Annual Open Enrollment Period by which a qualified individual's first (1st) month's premium must be received in order to make coverage effective as of the first (1st) day of the Benefit Year.D. Special Enrollment Periods - The Exchange shall provide special enrollment periods consistent with 45 C.F.R. § 155.420, incorporated above at § 1.3 of this Part, and R.I. Gen. Laws § 42-157-12, during which qualified individuals may enroll in Qualified Health Plans and enrollees may change Qualified Health Plans. 1. Triggering Events The Exchange will allow a qualified individual or enrollee, and, when specified below, his or her dependent, to enroll in or change from one (1) QHP to another if one (1) of the triggering events defined in 45 C.F.R. § 155.420(d), incorporated above at § 1.3 of this Part, or R.I. Gen. Laws § 42-157-12 occurs. The Exchange shall also have the authority to define other triggering events not otherwise specified in 45 C.F.R. § 155.420(d), incorporated above at § 1.3 of this Part.
2. Effective Dates Except as specified in 45 C.F.R. §§ 155.420(b)(2) and (3), incorporated above at § 1.3 of this Part, the Exchange shall establish a monthly deadline by which a qualified individual enrolling during a special enrollment period must select a QHP and the Exchange must receive the first (1st) month's premium in full by the payment deadlines established by the Exchange in order to make coverage effective on the first (1st) day of the following month. The Exchange shall make coverage effective on the first (1st) day of the second (2nd) following month for a qualified individual not meeting the monthly deadline.
220 R.I. Code R. 220-RICR-90-00-1.6
Amended effective 12/22/2019
Amended effective 12/31/2020
Amended effective 4/2/2023