Special Enrollment Periods: What You Need to Know
Open enrollment is over for the year. But life happens, and with it come marriages, babies, moves, and new jobs that impact the health care needs of your clients. A terrific way to help your clients navigating life changes is to remind them about special enrollment.
A special enrollment period is a time outside the open enrollment period when your clients can sign up for coverage or shop for a new plan. To qualify for special enrollment, they must’ve experienced a qualifying life event.
The following is a list of examples of qualifying life events:
- Marriage or a domestic partnership
- Birth, adoption, or placement for adoption
- Receipt of a binding court order
- Loss of a dependent or dependent status due to death, divorce, or legal separation
- Reaching age 26
- Loss of other health coverage (because of job loss, divorce, eligibility change, etc.)
- Moving to a new zip code or county
- A change in citizenship or lawful presence status
- System or human errors by the state or a federal health plan
- Late eligibility
In most cases, your clients will have 60 days from the qualifying life event date to apply for a health plan and provide the required documentation. The type of documentation they’ll need depends on the type of qualifying life event.
To see a comprehensive list of qualifying events and learn about required documentation, visit our Special Enrollment page.