Individual Insurance

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Need Health Insurance? Qualifying Events can Help!

April and May are beautiful months for new life, butterflies, trees and flowers. However, it is not the ideal season for enrolling in health insurance. This year, November 1st is the beginning of “Open Enrollment”, a timeframe for individuals to freely shop and select a health insurance plan. Spanning over a three-month period, Open Enrollment comes along once every year with no exceptions. However, what if you’re in need of insurance now? You may be in luck as there are special circumstances, known as “qualifying life events,” that may allow you to sign up for coverage outside of Open Enrollment. Be sure to mark your calendar this year as Open Enrollment will last from November 1st to December 15th.

Whether you’ve had a career change, become a parent or relocated to a new state/country, one or more of the various qualifying circumstances may apply to you. Life happens and considers these qualifying life events for gaining health coverage:

 

 

Qualifying Event Definition Suggested Documentation
Loss of Employer Loss of employment, due to termination,
reduction in hour or coverage no longer offered
– Termination letter from employer
– Current and previous pay stubs supporting reduced hours
– Letter from employer stating no longer paying for insurance
– COCC (Certificate of Creditable Coverage)
– Renewal Letter
No Longer a dependent Loss of employer or individual coverage
because no longer eligible for coverage
Carrier letter that documents loss of coverage, i.e.
– dependent age maximum reached
Change in Family Status Loss of coverage due to divorce, death, etc. Copy of divorce decree, death
certificate, etc.
Marriage   Addition of new dependent as a result of  marriage Marriage License or Domestic
Partner certificate
Birth, Adoption or
Placement of Adoption
Addition of new dependent as a result of birth,
adoption or placement of adoption
Birth certificate adoption/placement
papers
Loss of Medicaid or CHIP Loss of Medicaid or CHIP Termination letter of loss of coverage
from the insurance carrier which includes the date of loss of coverage
Move Permanent move to a new area that has
different plan options
Proof of move such as utility bill
or rental lease
Return from Active Military Service Newly eligible due to return from active
military
Paperwork confirming departure date
from active military service
Minimum Essential Coverage Existing coverage no longer provides essential
minimum coverage
Letter documenting loss of
Minimum Essential Coverage