NOTE: The example provides historical information on late enrollments prior to the changes
beginning January 1, 2023.
Irving Howard, who was born on 1950, and was eligible to enroll during the IEP ending
5/31/2015, first enrolled in 3/2017 during the extended GEP. SSA terminated Irving's
coverage for nonpayment of premiums effective 9/30/2017, and Irving reenrolled in
2/2020. Under HI 01001.010B.1. and HI 01001.010B.2.b., and had to pay a 40 percent increase in Irving's premiums.
How we determined the penalty:
The following months are counted against Irving for purposes of the premium increase:
06/2015 - 12/2015 inclusive = 7 months
1/2016 - 12/2016 inclusive = 12 months
01/2017 - 3/2017 inclusive = 3 months
10/2017 - 12/2017 inclusive = 3 months
01/2018 - 12/2019 inclusive = 24 months
01/2020 - 03/2020 inclusive = 3 months
The total number of countable months is 52, so a 40% increase would be chargeable
against Irvin Howard.