What to Know About Special Enrollment

  • Individual Market News
    Published March 9, 2021

    To help people who don’t have health coverage during the pandemic in accordance with President Biden’s executive order, the federal marketplace has opened a special sign-up period through May 15, 2021. This is different than the special enrollment period that opens when people experience a qualifying life event.

    Here’s what you need to know to about both options to help your clients:

    Special enrollment ending May 15

    Customers who are currently uninsured and have not experienced a qualifying event can sign up for an individual health plan on HealthCare.gov.

    Qualifying event coverage

    If your client has experienced a qualifying life event, they’re also able to apply for coverage during a special enrollment period by completing an application with supporting documentation within 60 days of the life event. These qualifying life events include:

    • Birth, adoption, foster care, or guardianship
    • COBRA benefits have been lost
    • Marriage or domestic partnership, including eligibility as a dependent
    • Divorce, annulment, or termination of domestic partnership
    • Employer-sponsored coverage is lost
    • Loss of coverage due to death
    • Termination of employer contributions
    • Termination of employment or reduction in hours
    • Loss of health benefits from Medicaid or a public program
    • A change in residence
    • Plan discontinues coverage to individual as a part of larger group or class
    • Dependent losing employer-sponsored coverage due to age
    • Loss of minimum essential coverage
    • Expiration of a non-calendar year policy
    • Became legally present in the United States

    Required documentation for qualifying life event varies. If your client has experienced any of the above qualifying life events, see our list of required documentation needed to begin the application process.

  •    Email this article