What should an agent do if their client receives a SEP verification issue?


Editorial team Published on

An agent should help their client gather and upload the required proof of their qualifying life event to HealthCare.gov or their state marketplace within the strict deadline (typically 30 days).

Steps to Resolve a Special Enrollment Period Verification Issue (SVI)

  • Review the notice: Check the Marketplace notice with your client to identify the specific qualifying life event and the exact documents needed.
  • Gather documentation: Help the client collect approved proof, such as marriage certificates, birth certificates, or proof of prior coverage loss.
  • Submit promptly: Instruct the client to upload the documents directly through their HealthCare.gov account or an enhanced direct enrollment pathway as the fastest method. Note that agents and brokers are prohibited from logging into or creating a Marketplace account on behalf of a consumer.
  • Meet deadlines: Ensure the documentation is submitted within the required timeframe (usually 30 days from the notice) to avoid losing the Special Enrollment Period.
  • Track status: Monitor the verification status and maintain regular communication with the client until the issue is cleared.