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Proof Needed to Enroll in Health Plan Post-Deadline

WASHINGTON — People who want to buy health insurance in the federal marketplace outside the annual open enrollment period will now have to provide documents to show they are eligible, the Obama administration announced on Wednesday.

In the last two years, insurers say, many people went without coverage and then signed up under the Affordable Care Act when they became sick and needed care. Insurers say that people who sign up after the deadline tend to generate more claims and more costs, raising premiums.

In the last two years, insurers say, many people went without coverage and then signed up under the Affordable Care Act when they became sick and needed care. Insurers say that people who sign up after the deadline tend to generate more claims and more costs, raising premiums.

The National Association of Insurance Commissioners, representing state officials, complained recently that “consumers are not required to provide documentation to substantiate their eligibility for a special enrollment period.”

The new policy requires people to submit documents like a birth or marriage certificate if they want to sign up after the deadline using any of the most common special enrollment periods. These are available after a marriage or the birth or adoption of a child. They are also available when people move permanently to a new address or lose coverage provided by an employer, a government program or other source.

The administration has created more than 30 special enrollment categories and sent emails to millions of Americans last year urging them to see if they might be able to sign up after the open enrollment deadline.

It is unclear how rigorous the government will be in checking eligibility. Consumers who appear to qualify for a special enrollment period will be allowed to obtain insurance while the government tries to confirm eligibility based on the documents provided, federal officials said.

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