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'll be asked to provide proof that you're a Washington state resident. Your completed application and supporting documentation must be received within 60 days of the life event. In addition to the requirements listed, you may be asked to provide additional documentation of your life event.
The birth, placement for adoption, or adoption of the applicant for whom coverage is sought. For Qualified Health Plans (QHPs), this also applies to children placed in foster care, legal wards, guardianship, or medical support orders.
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.
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.
Loss of COBRA coverage due to failure of the employer to remit a health plan bill.
Letter from employer or COBRA administrator indicating loss of COBRA coverage was due to the failure of the employer to remit a health plan bill.
Loss of coverage as a dependent on a group plan due to age.
A Letter from employer or insurance health plan indicating that the loss of coverage is due to age.
If coverage is discontinued in a qualified health plan by the health benefit exchange, and the three-month grace period for continuation of coverage has expired.
A Letter from the Exchange or health plan indicating that coverage was discontinued by the Exchange, and that the 3-month grace period for continuation of coverage has expired.
If the person discontinues coverage under the Washington State Health Insurance Pool (WSHIP).
A Letter from WSHIP indicating coverage has been discontinued.
The loss of coverage as the result of dissolution of marriage or termination of a domestic partnership.
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.
Loss of minimum essential benefits, including loss of employer sponsored insurance coverage; except for voluntary termination of health coverage, misrepresentation, or fraud.
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.
Loss of coverage purchased on the Exchange, due to an error by the Exchange, the health plan, or Health and Human Services (HHS).
A Letter from the Exchange, health plan, or HHS indicating that coverage was lost due to an error.
Marriage or entering into a domestic partnership, including eligibility as a dependent.
Copy of marriage certificate, state registration, utility bill, a declaration of domestic partnership, lease, or car title with both names clearly listed.
The loss of eligibility for Medicaid or a public program providing health benefits.
A Letter from Medicaid or other program indicating loss of eligibility.
Loss of minimum essential benefits, including the loss of employer-sponsored insurance coverage; except for voluntary termination of health coverage, misrepresentation, or fraud.
Your COBRA offer letter or a letter from your employer listing each applicant that experienced a loss of coverage AND reason for termination of health coverage.
A situation in which a plan no longer offers benefits to the class of similarly situated individuals that includes the applicant.
A Letter from the prior health plan indicating that the loss of coverage is due to not being in a class of similarly situated individuals.
A permanent change in residence, work, or living situation, where the prior health plan does not provide coverage in that person's new service area.
Documentation such as a utility bill, rental, or lease agreement showing the prior address and new address within the last 90 days and documentation from the prior health plan indicating a loss of coverage.