Special Enrollment Qualifying Events

  • The regular open enrollment period for 2015 health coverage ended February 15. But if you or your family has experienced one of the life events listed below, you may be able to apply for coverage now, as a special enrollment.

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

    Your completed application and supporting documentation must be received within 60 days of the life event. Review the specific documentation requirements for the event that applies to you:

  • Application and supporting documentation must be received within 60 days of the qualifying event.

    For birth of child to policyholder or enrolled spouse, submit:

    • Copy of the birth certificate or temporary certificate from the hospital

    For placement for adoption or adoption of the applicant for whom coverage is sought, submit:

    • Copy of the adoption papers

    For a child placed in foster care, as a legal ward, or for medical support orders (for Qualified Health Plans), submit one of the following:

    • Copy of the foster care papers,
    • Copy of the medical support order, or
    • Copy of the court order appointing a guardian

    Application and supporting documentation must be submitted within 60 days of the qualifying event:

    For loss of COBRA benefits because the COBRA coverage period has ended (usually after 18 months) or the individual has exceeded the lifetime limit in the plan, and no other COBRA coverage is available, submit:

    • Letter from employer or COBRA administrator indicating loss of COBRA coverage due to the individual exhausting the COBRA period, and that no other COBRA coverage is available, or
    • Letter from employer or COBRA administrator indicating the individual has exceeded the lifetime limit in the plan, and that 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.

    Application and supporting documentation must be received within 60 days of the qualifying event.

    If you have recently married or entered domestic partnership, submit one of the following with both names clearly listed:

    • Copy of the marriage certificate
    • Copy of state registration
    • Copy of the utility bill
    • Copy of the declaration of domestic partnership, or
    • Copy of the lease or car title

    Application and supporting documentation must be submitted within 60 days of the qualifying event.

    For loss of coverage due to divorce, dissolution of marriage, or termination of domestic partnership, submit:

    • A copy of your divorce decree, or
    • A copy of your annulment paperwork, or
    • A statement (including the date) noting when the Domestic Partnership ended or a letter from the prior health plan AND 
    • A letter from the prior health plan

    Application and supporting documentation must be submitted within 60 days of the qualifying event.

    For loss of employer-sponsored coverage, submit:

    • A copy of your COBRA letter, or
    • A letter from your employer listing each applicant who experienced a loss of coverage, AND reason for termination of health coverage

    Application and supporting documentation must be submitted within 60 days of the qualifying event.

    For a loss in Medicaid or other public program providing health benefits, submit:

    • Copy of your Medicaid letter indicating ineligibility or loss of coverage, or 
    • Copy from the public program indicating ineligibility or loss of coverage

    Application and supporting documentation must be submitted within 60 days of the qualifying event.

    For loss in coverage due to permanent change in residence, work, or living situation, where your prior plan does not provide coverage in your new service area, submit:

    • Documentation such as a utility bill or rental or lease agreement showing prior address and new address, and 
    • Documentation from your prior health plan indicating a loss of coverage

    Application and supporting documentation must be submitted within 60 days of the qualifying event.

    • Letter from the insurance health plan or school indicating a loss of coverage

    Application and supporting documentation must be submitted within 60 days of the qualifying event.

    • Letter from employer or insurance health plan indicating loss of coverage due to age