Qualifying Life Events for the Special Enrollment Period

Have you ever wondered what happens to your health insurance in the case of a major life event such as marriage/divorce, childbirth, moving, turning 26, losing Medi-Cal or employer-sponsored insurance? All of these events are defined as qualifying life events which qualifies you to enroll in a health insurance plan outside of the Open Enrollment Period during the period called the Special Enrollment Period.

Normally, Californians enroll in health insurance during the Open Enrollment Period starting November 1st for changes to their plan for the following year. There is no medical underwriting during the Open Enrollment Period. However, many Californians are looking for insurance during the middle of the year during the Special Enrollment Period. The Special Enrollment Period is the period outside of the Open Enrollment Period from February 1st to October 31st, 2018. Luckily, if you have a qualifying life event, you can make a change to your health insurance with proof of your qualifying life event.

Some of the most common qualifying life events are loss of employer-sponsored coverage (resigned or lost job), loss of Medi-Cal (gained income above the Medi-Cal threshold), had a newborn child, turned 26, recently moved from a different region, got married or divorced, or major change of income (for Covered CA members).

The insurance carriers require proof of your qualifying life event with proof of residency and proof of the qualifying life event. For example, you would have to show birth records for proof of childbirth or COBRA election form for proof of loss of employer-sponsored coverage. You must enroll within 60 days of your qualifying life event to be eligible. For example, if you lost your employer’s health insurance January 31st, you must either continue with COBRA or enroll in an individual or family plan with an application submitted by March 31th.

The effective date of your new plan depends on when your application was submitted as well as your qualifying life event. For loss of Medi-Cal or employer-sponsored coverage, you have until the end of the month to apply for a plan effective the following month. For a newborn child, the effective date is the date of birth. For most other qualifying life events, you must apply by the 15th of the month to get a plan effective for the following month.

If you have any questions about your qualifying life event and the Special Enrollment Period, please do not hesitate to contact us at Solid Health Insurance Services. You can email us at info@solidhealthinsurance.com or call us at 310-909-6135 or visit our website at www.solidhealthinsurance.com.

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