The Centers for Medicare & Medicaid Services (CMS) provided a special enrollment period for consumers who:

  • Are not currently enrolled in 2016 coverage through the Marketplace,
  • Are not receiving APTC in 2016 because they failed to file a tax return and to reconcile their APTC for 2014, and
  • Filed their 2014 tax return and reconciled their 2014 APTC.


This SEP will only be available to customers who restored their eligibility for APTC by filing a 2014 tax return, reconciled the APTC paid in full on their behalf in 2014, and return to the Marketplace to make updates on their application.

For the 2016 coverage year, it’s required to file a tax return and reconcile previously paid APTC. Consumers who enrolled in health care coverage have been re-enrolled in 2016 coverage without APTC and income-based CSRs. As a result, consumers may choose to end their Qualified Health Plan (QHP) coverage through the Marketplace because it’s too expensive without financial support.

If you were enrolled in the Marketplace with APTC in 2014, but were not enrolled in 2015 and tried to apply for health care coverage in 2016, you will be deemed ineligible for APTC in 2016, if you failed to file a 2014 tax return.  

CMS will offer a time-limited special enrollment period—from February 1, 2016 through March 31, 2016 for consumers who were previously deemed ineligible by the Marketplace to receive APTC in 2016 due to failure to file and reconcile. In order to access this special enrollment period, you must not be enrolled in 2016 Qualified Health Plan coverage through the FFM as of the end of open enrollment.

Under the special enrollment period, the effective date of health care coverage will be the first of the month following your selection of a plan. Eligible consumers will have access to this special enrollment period through their online applications at


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