TN 19 (03-93)

A. Policy - IEP overlaps GEP

An individual's IEP may overlap a GEP in whole or in part. In such a case, the following considerations apply.

1. GEP ends with or before end of IEP

When the GEP ends with or before the end of an individual's IEP, the GEP has no effect on either the individual's enrollment or date of coverage. That is, the enrollment is based on the IEP.

2. IEP ends prior to end of GEP

If the IEP extends into, but ends prior to, the end of the GEP, the individual has the benefit of the additional time remaining in the current GEP in which to enroll, with a July 1 effective date for SMI.

REMINDER: Months that elapse between the end of the IEP and the end of the GEP may count against the individual for premium penalty purposes if the period of SMI coverage terminates and the individual subsequently re-enrolls. See HI 01001.010 for information on premium surcharges for late enrollment or re-enrollment.

B. Example

Mrs. Benton was born 11/4/22. Her IEP is 8/1/87 through 2/29/88. If she enrolls in SMI during January or February 1988, it is considered an IEP enrollment. If she enrolls during March 1988, it is a GEP enrollment and coverage begins with July 1, 1988.