Special Enrollment Qualifying Events

  • Have you recently experienced a major life event?

    Have you had a baby, gotten married, or had another major life event recently?

    The regular open enrollment period to buy a 2016 individual health plan ended January 31. But, if something has changed and you or your family has experienced a qualifying life event, you may be able to apply for coverage now, in a special enrollment period.

    If you qualify for a special enrollment period, call us at 877-PREMERA (877-773-6372) for help in choosing a plan that’s right for you.

    As part of the application process, you will be asked to provide proof you’re an Alaska state resident. Your completed application and supporting documents must be received within 60 days of the life event. In addition to the requirements, you may be asked to provide additional documentation of a life event.

  • Qualifying event:

    Birth, placement for adoption, and adoption of a child. For qualified health plans (QHPs), this also applies to children placed in foster care, legal wards, guardianship, or medical support orders.

    Required documentation:

    • Copy of birth certificate
    • Copy of the adoption papers
    • Copy of foster care papers
    • Copy of medical support order
    • Copy of the court order appointing a guardian

    Qualifying event:

    The COBRA coverage period ends (usually after 18 months), or the individual has exceeded the lifetime limit in the plan, and no other COBRA coverage is available.

    Note: Voluntary termination of COBRA is not a qualifying event. If you terminate or stop paying for your COBRA, you must wait for the next open enrollment period to apply.

    Required documentation:

    A letter from your employer or COBRA administrator indicating that the loss of COBRA coverage was because you exhausted the COBRA period or exceeded the lifetime limit in the plan. The letter must also state that no other COBRA coverage is available.

    Qualifying event:

    Marriage or entering into a domestic partnership, including eligibility as a dependent.

    Required documentation:

    Copy of marriage certificate, or a Declaration of Domestic Partnership (a Declaration of Domestic Partnership form is required)

    Qualifying event:

    The loss of coverage as the result of dissolution of marriage or termination of a domestic partnership.

    Required documentation:

    A copy of divorce decree or annulment papers and a letter from the prior health plan, or a statement (including the date) the domestic partnership ended, and a letter from the prior health plan.

    Qualifying event:

    Loss of minimum essential coverage, including loss of employer-sponsored insurance coverage (except for voluntary termination of health coverage, misrepresentation, or fraud).

    Required documentation:

    Your COBRA offer letter or a letter from your employer listing each applicant who experienced a loss of coverage AND the reason for termination of health coverage

    Qualifying event:

    Loss of coverage as the result of the death of an employee.

    Required documentation:

    A COBRA offer letter or a letter from your employer indicating a loss of coverage was due to the death of an employee.

    Qualifying event:

    Termination of employer contributions for coverage other than COBRA.

    Required documentation:

    A letter from your employer indicating that the loss of coverage is due to the termination of employer contributions.

    Qualifying event:

    Loss of coverage as the result of a termination in employment or reduction in hours.

    Required documentation:

    Your COBRA offer letter or a letter from your employer that indicates the loss of coverage is due to termination in employment or a reduction in hours.

    Qualifying event:

    A loss of Medicaid or other public program providing health benefits.

    Required documentation:

    A letter from Medicaid or other program indicating ineligibility or loss of coverage.

    Qualifying event:

    A qualified individual or enrollee gains access to new Qualified Health Plans (QHPs) as a result of a permanent move.

    Required documentation:

    Utility bills from your prior address and new address from within the last 90 days.

    Qualifying event:

    A situation in which a plan no longer offers benefits to the class of similarly situated individuals that includes the applicant.

    Required documentation:

    A letter from the prior health plan indicating loss of coverage is due to not being in a class of similarly situated individuals.

    Qualifying event:

    Loss of coverage as a dependent on a group plan due to age.

    Required documentation:

    A letter from employer or insurance health plan indicating the loss of coverage is due to age.

    Qualifying event:

    Loss of minimum essential coverage, including loss of employer-sponsored insurance coverage (except for voluntary termination of health coverage, misrepresentation, or fraud).

    Required documentation:

    Your COBRA offer letter or a letter from your employer listing each applicant who experienced a loss of coverage AND reason for termination of health coverage.