Special Enrollment Periods
Qualifying Events
Renewal or cancellation of a pre-ACA plan during 2014
Carrier letter communicating that current pre-ACA coverage will end on a certain date req’d, with coverage starting the following month
Loss of Minimum Essential Coverage
Letter documenting Loss of Minimum Essential Coverage req’d within 60 days of event, with coverage starting the following month
Loss of eligibility for health insurance exchange subsidies
Documentation showing no longer eligible for health exchange subsidies, within 60 days of event, with cov. starting the following month
Loss of employer coverage
Termination letter req’d from employer if terminated, pay stubs showing reduction in hours, or letter from employer stating no longer paying for insurance. Application must be submitted within 60 days of coverage loss, coverage starts 1st day of following month.
COBRA Expiration
Documentation showing the date that COBRA coverage ends and the people covered by the COBRA coverage req’d within 60 days of event, with coverage starting the following month
No longer a dependent
Carrier letter req’d documenting loss of coverage due to loss of dependent status, (i.e. dep age maximum reached) within 60 days of loss of dependent eligibility event. App must be submitted within 60 days of coverage loss, coverage starts 1st day of following month.
Permanent move to a new area that offers different plan options (Even within a state)
Proof of move such as utility bill or rental/lease agreement req’d within 60 days of event with coverage starting the following month
Divorce
Copy of the divorce decree or custody agreement and app req’d within 60 days of divorce, coverage starts 1st day of following month.
Loss of Medicaid or CHIP (to add Dependents)
Termination letter including the date of the loss of coverage from the Insurance carrier within 60 days of loss of Medicaid or CHIP coverage. Application must be submitted within 60 days of coverage loss, and coverage starts 1st day of mo. following receipt.
Birth or adoption
Birth certificate, adoption papers, or foster care papers req’d within 60 days of event. Coverage effective immediately.
Marriage
Marriage license or domestic partner certificate req’d within 60 days of event, with coverage starting following month.
Return from active military service
Paperwork confirming departure date from active military service req’d within 60 days of event, coverage starts the following month
Release from Incarceration
Copy of certified letter documenting release date from incarceration req’d within 60 days of event, coverage starts the following month
Court Order or Chapter 11 filing
Copy of legal supporting documentation requiring health coverage req’d within 60 days of event , coverage starts the following month