Qualifying Life Events

Now that Open Enrollment has ended, you must have a “Qualifying Event” to make any changes or enroll in a new plan outside of Open Enrollment.  As of today’s regulations (always subject to change), the next Open Enrollment period will begin on Nov. 15th, 2014.

Examples of Qualifying Life Events:

In all state-based, federal and partnership exchanges, individuals may also enroll outside of the open enrollment window if they have a qualifying life event. The consumer and the agent should contact each specific exchange directly for their qualifying life event procedures. For your reference, qualifying life events include:

  • Marriage
  • Having a baby
  • Adopting a child or placing a child for adoption or foster care
  • Moving outside your insurer’s coverage area
  • Losing other health coverage—due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP and similar circumstances. Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.
  • Gaining citizenship
  • Leaving incarceration
  • Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.
  • For people already enrolled in marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions

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