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, the state exchange has opened a special sign-up period through May 15, 2021. This is different than the typical 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 WA Healthplanfinder. This includes people enrolled in short-term limited duration plans or COBRA, as well as those with non-insurance coverage through health sharing ministries.

    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 or lifetime limit has been met
    • COBRA benefits have been lost because the employer didn’t remit the health plan bill
    • Dependent losing employer-sponsored coverage due to age
    • Discontinued coverage through the Exchange and expired grace period
    • Discontinued coverage under WSHIP (Washington State Health Insurance Pool)
    • Divorce, annulment, or termination of domestic partnership
    • Employer-sponsored coverage is lost
    • Enrollment error through the Exchange, health plan, or Health and Human Services
    • Marriage or domestic partnership, including eligibility as a dependent
    • Loss of health benefits from Medicaid or a public program
    • Minimum essential coverage is lost
    • Plan discontinues coverage to individual as a part of larger group or class
    • A change in residence

    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.

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