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Coordinating Part D SEP:

A coordinating Part D SEP permits a prospective enrollment into a PDP.

30.6.15 – SEP for individuals disenrolling from a cost plan with optional supplemental Part D benefits 42 CFR § 423.38(c)(19)

This Part D SEP allows an individual who is enrolled in a Medicare cost plan (see § 10) and an optional supplemental Part D benefit under that contract, to elect a Part D plan upon disenrolling from the cost contract.

The SEP begins the month the individual requests disenrollment from the cost contract. The SEP ends two calendar months after the month in which the individual requested disenrollment.

30.6.16 – SEP for individuals who elect into or out of employer sponsored coverage 42 CFR §§ 422.62(b)(4) and 423.38(c)(11)

This SEP allows eligible individuals to do the following: • Enroll in an employer or union sponsored MA or Part D plan; • Disenroll from an employer sponsored MA plan or Part D plan (i.e., Employer Group Health Plan (EGHP)) and enroll in a different MA or Part D plan; • Disenroll from any employer-sponsored coverage (including Consolidated Omnibus Budget Reconciliation Act (COBRA)) to enroll in an MA or Part D plan. • Disenroll from an MA plan or Part D plan to take employer sponsored coverage of any kind.

This SEP is available to individuals who have enrolled in or are enrolling in an employer or union sponsored MA or Part D plan. The SEP ends two months after the month the employer or union coverage of any type ends or when used to disenroll from an MA or Part D plan.

This SEP typically begins when the EGHP allows the individual to make changes to their coverage, such as during the employer’s or union’s “open season.”

NOTE: An individual using this SEP may request an effective date of up to three months after the month in which the election is made; however, the effective date may not be earlier than the first day of the month following the month in which the election was made or the first day of the individual’s entitlement to Medicare Parts A and B.

30.6.17 – SEP for individuals who involuntarily lose creditable prescription drug coverage Social Security Act § 1860D-1(b)(3)(A); 42 CFR §§ 422.62(b)(19) and 423.38(c)(1)

This SEP allows individuals who experience an involuntary loss of creditable prescription drug coverage, including a reduction in the level of coverage such that it is no longer creditable