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However, once a person's initial six-month enrollment period has expired, Medigap insurers in nearly every state are permitted to employ medical underwriting to assess an applicant's eligibility for coverage.

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Some benefits are paid in full by the company, while others are paid in part by the employee through salary deferral or a section cafeteria plan. People can enrol in a health-care plan or make adjustments to their current coverage during open enrollment. Open enrollment, which occurs once a year in the fall, may also apply to other forms aca changes benefits, such as dental and life insurance.

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