Professional Insurance Programs

Special Enrollment Period Examples of Qualifying Events

Do You Qualify for Special Enrollment Period?

If you have experienced any of these events recently, you may qualify! Call us today to confirm your Health Insurance!

Definition:

Loss of coverage due to termination of employment, reduction in hours worked or employer is no longer offering coverage.

 Supporting Documentation:

  • Termination letter from employer
  • Pay stubs indicating hours worked
  • Letter from employer confirming loss of coverage

Application Submition:

Within 60 days of coverage loss

Effective Date:

1st day of month following application receipt

Definition:

COBRA coverage ends

 Supporting Documentation:

  • Documentation showing the date COBRA coverage ends and all individuals covered

Application Submition:

Within 60 days of the event

Effective Date:

1st day of month following application receipt

Definition:

Loss of coverage because individual is no longer eligible as a dependent. Examples: dependent age maximum, death of policyholder

 Supporting Documentation:

  • Letter from carrier document loss of coverage due to dependent status

Application Submition:

Within 60 days of the event

Effective Date:

1st day of month following application receipt

Definition:

Addition of dependent due to dependent status

 Supporting Documentation:

  • Marriage license
  • Domestic partner certificate

Application Submition:

Within 60 days of the event

Effective Date:

1st day of month following application receipt

Definition:

Loss of coverage due to a separation or divorce

 Supporting Documentation:

  • Copy of divorce decree or custody agreement
  • Termination letter from insurance carrier

Application Submition:

Within 60 days of the event

Effective Date:

1st day of month following application receipt

Definition:

Addition of new dependent as a result of birth, adoption or placement for adoption

 Supporting Documentation:

  • Birth certificate
  • Adoption  papers

Application Submition:

Within 60 days of the event

Effective Date:

1st day of month following application receipt

Definition:

A qualified individual or enrollee gains access to new Qualifed Health Plans as a result of a permanent move to another state

 Supporting Documentation:

  • Previous/Current address utility bills
  • Previous/Current signed Lease
  • Previous/Current property Dead

Application Submition:

Within 60 days of the event

Effective Date:

1st day of month following application receipt

Definition:

Loss of Medicaid or CHIP (Children’s Health Insurance Plan) coverage

 Supporting Documentation:

Termination letter from insurance carrier including the date of loss of coverage

Application Submition:

Within 60 days of coverage loss of Medicaid or CHIP coverage

Effective Date:

1st day of month following application receipt

Definition:

An individual, not previously a US citizen, nationally or lawfully present gains such status

 Supporting Documentation:

  • Valid US passport or passport card

Application Submition:

Within 60 days of the event

Effective Date:

1st day of month following application receipt