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the paper enrollment form as incomplete. The documentation of this contact will complete the enrollment request (assuming all other required elements are complete).

When an enrollment request mechanism other than paper is used, the individual or their authorized representative must complete the enrollment mechanism process, including the attestation of authorized representative status as described above. A pen-and-ink signature is not required. For a telephone request, the signature element is satisfied with a verbal attestation of intent to enroll; for an electronic request, it is satisfied with an electronic signature or a clear and distinct step that requires the applicant to activate an “Enroll Now,” or “I Agree,” type of button or tool. Electronic signatures have the same legal effect and validity as pen-and-ink signatures. A plan utilizing electronic signatures in electronic enrollment must, at a minimum, comply with the HIPAA privacy and security policies. For more information on the requirements for legally binding electronic signatures, see the Electronic Signatures in Global and National Commerce Act, 15 U.S.C. § 7001, and “Use of Electronic Signatures in Federal Organization Transactions” published by the Federal Chief Information Officers (CIO) Council.

For auto- and facilitated enrollment as described in § 40.1.8, a signature is not required.

• Other Signatures and Enrollee Assistance – If the plan representative helps the individual fill out the enrollment form, then the plan representative must clearly indicate their name on the enrollment form. However, the plan representative does not have to include their name on the form when: • They prefill the individual’s name, mailing address, phone number, or other demographic information, when the individual has requested that an enrollment form be mailed to them, • They fill in the “office use only” block, and/or • They correct information on the enrollment form after verifying information (see “verification and correction of information” below).

Individuals (for example, State Health Insurance Assistance Program counselors, agents, and brokers) must indicate if they helped the applicant fill out the form and disclose their relationship to the applicant. Agents and brokers will also be expected to provide their assigned National Producer Number (NPN) if they assisted the applicant with completing the enrollment form.

• Old Enrollment Requests – If the plan receives an enrollment request that was executed more than 30 calendar days prior to the plan’s receipt of the request, the plan is encouraged to contact the individual to reaffirm intent to enroll prior to processing the enrollment and to advise the beneficiary of the upcoming effective date.

• Determining Application Date – The plan must date all enrollment requests as soon as they are initially received. Except for enrollment requests submitted via the CMS Online Enrollment Center, requests made by the group enrollment mechanism, and auto- or facilitated enrollments, the date the enrollment request is initially received is equivalent to the “application date.”