4 Major Qualifying Life Events That Allow Individuals to Enroll Outside of Open Enrollment

Over half of all enrollments occur outside of open enrollment, and the deadline for open enrollment is quickly approaching. The open enrollment deadline for plans effective in 2014 is March 31, 2014, but for individuals that want an effective date of April 1, 2014, the deadline is March 15, 2014.

However, consumers should be aware of major qualifying life events that allow for a “special enrollment period” to be able to purchase health plans on federal and state exchanges. The special enrollment period is from April 1, 2014 to November 14, 2014. Subsequently, open enrollment begins November 15, 2014 for plans effective 2015, and has been extended to February 15, 2015.

The four major qualifying life events for special enrollment are:

Moving to a new area. In order for this to be a qualifying event, a change of residency must incur a change in available health plan options. While most of the time, this requires someone to move states, in some cases this may happen with in-state moves. The new community based rating is relative to zip code, so you may want to look into this if you are moving.

Changes in your income. This applies to those who are already enrolled on a federal or state exchange, whereas the change in income must affect the eligibility to receive tax-credits or lower the ability to share costs.

Changes in your family size (e.g. if you marry, divorce, or have a baby). When the qualifying event that changes the number of dependents occurs, often the amount of coverage an individual seeks changes, as well.

Dropped coverage from existing health plan (e.g. coverage dropped because of job termination, marital separation, eligibility changes for Medicaid or CHIP, COBRA coverage expiring, or a health plan being decertified). However, voluntarily dropping your health plan or termination due to non-payment of premiums does not qualify individuals for special enrollment. Also, if you lose coverage from a health plan that does not offer the “minimum essential coverage” under the Affordable Care Act’s guidelines, you will not qualify for special enrollment.

REMEMBER: consumers should be aware of major qualifying life events that allow for a “special enrollment period” to be able to purchase health plans on federal and state exchanges. The special enrollment period is from April 1, 2014 to November 14, 2014. Subsequently, open enrollment begins November 15, 2014 for plans effective 2015, and has been extended to February 15, 2015.