If the individual did not enroll in the initial enrollment period (IEP), the individual
must be covered under a group health plan (GHP) based on own or a spouse’s current
employment status in the first month of eligibility for SMI and for all months thereafter.
If the individual was covered under a large group health plan (LGHP), the coverage
must be based on own, or a family member’s current employment status.
The first month of eligibility for SMI is the fourth month of the IEP, as explained
in HI 00805.015.