It’s easy. Your client can apply either online or by mail.
Your clients can apply using your own personal enrollment link. Applying online allows you to track your clients current status of their application.
If you do not have a personal enrollment link please call Producer Support at 877-205-9725, Option 1.
Starting January 1, 2014, applicants will only need to complete the application to apply for coverage as required by the Affordable Care Act (ACA)
If your clients qualify for premium credit assistance, cost share reduction plans or American Indian/Alaska Native plans, they will want to enroll in a plan through Washington Healthplanfinder.
Individuals eligible to apply for a Premera plan must be:
Eligible dependents that can enroll on a plan include:
The open enrollment period this year is October 1, 2013 – March 31, 2014. Your client can select a new plan during this period. If they do not enroll during this period, they’ll have to wait until November 15, 2014, to change their plan or purchase coverage for January 1, 2015.
Your Sales Executive and Producer Support are available to help answer any questions you might have about these plans.
Your clients can retain their grandfathered plans (established prior to March 23, 2010) or select a new plan. If a grandfathered client wants to select a new plan, they'll have until March 31, 2014. After that, they will need to wait until November 15, 2014, to change plans for a January 1, 2015, effective date.
Individuals are eligible to apply for coverage outside of the annual open enrollment period only when they have a qualifying event.
Application and supporting documentation must be received within 60 days of the qualifying event.
For birth of child to policyholder or enrolled spouse, submit:
For placement for adoption or adoption of the applicant for whom coverage is sought, submit:
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:
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:
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 submitted within 60 days of the qualifying event:
If COBRA coverage has been exhausted due to failure of the employer to remit premium, submit:
Application and supporting documentation must be submitted within 60 days of event:
For loss of coverage as a dependent on a group plan due to age, submit
For individuals who lost coverage in a qualified health plan by the health benefit exchange pursuant to 45 C.F.R. 155.430 and the three-month grace period for continuation of coverage has expired, submit:
For loss of coverage due to divorce, dissolution of marriage, or termination of domestic partnership submit
For loss of employer-sponsored coverage, submit:
If you have recently married or entered domestic partnership, submit one of the following, with both names clearly listed:
For a loss in Medicaid or other public program providing health benefits, submit:
For loss of minimum essential coverage including loss of employer-sponsored insurance coverage (except for voluntary termination, misrepresentation, or fraud) submit:
If there is a situation in which a plan no longer offers benefits to the class of similarly situated individuals that includes the applicant, submit:
If a Qualified Health Plan substantially violated a material provision of its policy, submit:
For loss in coverage due to permanent change in residence, work, or living situation where your prior health plan does not provide coverage in your new service area, submit: