Cleveland Clinic + Oscar SEP Guidance


Cleveland Clinic + Oscar will be accepting SEPs from MMO POS clients whose plans are being discontinued and provided a bit of guidance on how these should be submitted.

Clients qualify to enroll during Special Enrollment Period since they will experience a loss in coverage due to their existing individual plan is being discontinued (i.e. will no longer exist).

Oscar will require 2 pieces of proof for this QLE:

  • A copy of the notification that the plan will be discontinued AND
  • Proof showing the member had coverage through that date (ex: a paid invoice for December or the letter from the carrier that shows their termination date).

When using this QLE on the off-exchange enrollment form, please select "Employer stopped offering health insurance" as the QLE.

Submitting QLE proof documents on behalf of clients can  be submitted to Oscar in one of two ways (within 14 days of enrollment):

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