Special Enrollment Periods

The 2015 Annual Open Enrollment period has come to a close. Individuals are now limited on when and how often they are able to purchase an individual policy until the next Annual Open Enrollment period begins. Annual Open Enrollment for 2016 is currently scheduled for Nov. 1, 2015 through Jan. 31, 2016.

Individuals may be eligible for a special enrollment period if they experience a qualifying life event. Applicants may apply for coverage either On- or Off- Exchange.

OFF-Exchange Special Enrollment Periods:

To apply for coverage outside of Annual Open Enrollment, individuals must experience a qualifying life event listed below. Unless specifically stated otherwise, a qualified individual or enrollee has 60 days from the date of the triggering event to select a Health Plan.

COMMON QUALIFYING LIFE EVENTS INCLUDE:

  • Marriage
  • Birth or Adoption
  • Divorce
  • Relocating
  • Losing minimum essential health coverage
  • Loss of employer-sponsored health coverage
  • Loss of coverage for a dependent
  • Death of the policy holder
  • Cobra expiration
  • Medicaid or CHIP Expiration
  • Health plan decertified
  • No longer incarcerated
  • Gaining status as a citizen, national or lawfully
  • Change in income that results in an individual determined newly eligible or newly ineligible for tax credits
  • Change in eligibility for cost-sharing reductions
  • Return from active military service

A Special Enrollment Period Authorization Form MUST ACCOMPANY THE INDIVIDUAL APPLICATION for consideration of an off-Exchange special enrollment period. The individual will receive a first-of-the-month affective date following the processing of the application.

ON-Exchange Special Enrollment Periods:

According to Healthcare.gov, individuals may buy a private health plan through the Marketplace outside Annual Open Enrollment only if they qualify for a special enrollment period due to a qualifying life event such as marriage, birth, or adoption of a child, or loss of other health coverage.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s