As of June 19, 2017, to qualify for an SEP due to a marriage, at least one spouse must have:
- Had qualifying coverage OR
- Lived in a foreign country or in a U.S. territory for one or more days during the 60 days preceding the date of the marriage.
This prior coverage requirement does not apply to members of a federally recognized tribe or shareholders of Alaska Native Corporations (sometimes referred to as “AI/AN”).
Example: Bob and Britney got married on May 5th.
Since Britney was already enrolled in a Marketplace plan:
- Bob can join her plan
- Bob can enroll in a different plan
- Britney can enroll in a different plan with Bob
They can report their marriage and pick a Marketplace plan up to 60 days after May 5th. Their coverage will start based on accelerated prospective coverage effective dates – the first of the month after they choose a plan, regardless of when during the month they select their plan. For example, if they pick a plan on May 18, their coverage will start on June 1.