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The Biden Department of Health and Human Services (HHS) released the second portion of the 2022
Notice for Benefits and Payment Parameters (NBPP-2022).  The NBPP is the annual “rulebook” for the implementation and operation of the ACA marketplaces and insurance policies.  There is a ton of administrative discretion embedded in the ACA on how out of pocket maximums are calculated, how risk adjustment works, when open enrollment occurs, what events qualify for a special enrollment period and dozens of other details.
The new final rule has the following to say on verifying the reason on Special Enrollment Periods (SEP):
HHS is not finalizing the provision to require all exchanges to conduct SEP verification for at least 75% of new enrollments for consumers not already enrolled in coverage through the relevant exchange.

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