man diagnosed with long term disability contemplating future

Special Enrollment Period

LOSS OF COVERAGE

DUE TO:
– Termination of group coverage
– Reduction of hours to part-time status
– Loss of employer contribution
– COBRA ending

You may qualify for a special enrollment period if you, or anyone in your household, recently lost qualified health coverage. You have 60 days from the date of your Qualifying Life Event (QLE) to enroll in coverage.

 

You may qualify for a Special Enrollment Period if you lose health coverage through your employer or the employer of a family member, if:

  • Your employer stops offering coverage.
  • You leave a job where you had health coverage (even if you left your job by choice or were fired).
  • You have a reduction in work hours that causes you to lose your job-based plan.
  • Your job-based health plan is ending for the year and you choose not to renew it.
  • Your former employer stops contributing to your retirement coverage, requiring you to pay the full cost.

Note: You DO NOT qualify for a Special Enrollment Period if: 

  • You voluntarily drop your job-based coverage during your coverage year while still working for your employer. 
  • You lose your job-based coverage because you failed to pay your premium. 

 

Some special rules may apply if you’re losing COBRA continuation coverage. 

You DO qualify for a Special Enrollment Period if: 

  • Your COBRA coverage runs out.

Note: You DO NOT qualify for a Special Enrollment Period if:

  • You cancel your COBRA coverage before the term expires.
  • You lose your COBRA coverage because you failed to pay your premiums.

 

You may qualify for a Special Enrollment Period if you lose the qualifying health coverage you had through a parent, spouse, or other family member.

This might happen if:

  • You turn 26 (or the maximum dependent age allowed in your state) and can no longer be on a parent’s health plan.
  • You lose job-based health coverage through a family member’s employer because that family member loses health coverage or coverage for dependents.
  • You lose health coverage through a spouse due to a divorce or legal separation.
  • You lose health coverage due to the death of a family member.