There are many rules and guidelines involved in health insurance. One of these is the Open Enrollment period which is the specific period every year that you are allowed to enroll in new health insurance benefit plans or make any changes to existing health insurance plans. But what can you do if you want to make changes to your benefit plan outside the open enrollment period? Is it possible? It will depend on the reason behind it. Did a qualifying life event happen? Let’s talk about qualifying life events below.
What is a “qualifying life event”?
In the health insurance space, a qualifying life event refers to any change in an individual’s life circumstance or situation that can make them eligible to buy a health insurance plan or make changes to an existing benefit plan even if it is not during the open enrollment period. Common examples of qualifying life events are getting married, having a baby, or a death in the family.
In this case, a qualifying life event can allow the individual to make these changes in a Special Enrollment Period, named such because it falls outside the yearly designated open enrollment period. A special enrollment period provided by health insurance providers usually lasts 60 days after the occurrence of a qualifying life event during which an individual can make the necessary changes in their health insurance plans or sign up for a new plan. While this is the usual duration of a special enrollment period, it is best to contact your health insurance provider for more detailed information on the enrollment process.
What are examples of a qualifying life event?
A qualifying life event may be planned or unplanned. There are generally four types of qualifying life events:
Loss of health insurance
Changes in the household
Changes in residence
Other qualifying changes
Let’s take a look at examples under each category. Note that these are just some examples and not a complete list.
Loss of Health Insurance
Losing an existing health coverage such as a job-based, COBRA, or student plan
Losing eligibility for Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP)
Turning 26 years old and losing coverage via a parent’s plan
Losing health insurance for any other reason except not paying premiums
Changes in Household
Having a baby
Adopting a child
Receiving a foster child
Death of someone on your health insurance policy
Changes in Residence
Moving to a different county or zip code
For seasonal workers, moving to or from a work location
For students, moving to or from school
Moving in or out of a shelter or transitional housing
Moving to the United States from a U.S. territory or foreign country
Other Qualifying Changes
Changes in income that impact Medicaid coverage eligibility
Becoming a member of a federally recognized tribe
Becoming a U.S. citizen
Being released from prison
For AmeriCorps VISTA members, starting or ending their service
Aside from these qualifying life events, there can also be what is called an “exceptional circumstance” or “special circumstance” that may allow a person a special enrollment period.
Here are some examples of a special enrollment period:
If you were unable to enroll because of a natural disaster, such as an earthquake, massive flooding, or hurricane
If you were unable to enroll because of an unexpected hospitalization or temporary cognitive disability
If someone working in an official capacity to help you in enrolling made a mistake in enrollment or prevented you from enrollment
If a technical error happened when you applied or if wrong policy data was displayed
If you were determined to be ineligible for Medicaid or Children’s Health Insurance Program (CHIP) after the open enrollment period ended
Gaining a new dependent or becoming a dependent because of child support or other court order
Surviving domestic abuse or spousal abandonment and want to enroll in your own health plan that is separate from the abuser
Filing an appeal and winning an appeal after incorrect eligibility determination
Remember that a qualifying life event is a change that impacts your health insurance needs. It has to be an event that alters your health benefit plans.
Try out Workstream to hire employees for
A revolutionary hiring process for Hourly positions
A revolutionary hiring process for Hourly positions Hiring hourly staff in San Francisco can be a tough job. Workstream can help accelerate the process by letting you post on job boards like Indeed within seconds.
1-Click Job Posting
No more tedious copy and pasting. We integrate with all the top job boards. All applicants funnel into one intuitive dashboard.
Print out your unique QR code and text message number. Applicants scan/text to see all open positions and apply right away.
Automated & 2-Way SMS
Engage with applicants via text. Include links to screening questions, forms, and more. Use 2-way text to answer questions.
Connect Workstream to your calendar so applicants can schedule interviews. Streamline onboarding with background check & HR integrations.
Candidate Tracking & Scoring
View all your applicants and employees in one place. Make notes on their progress. Access their docs anytime from anywhere.
We provide templates for everything from job postings to offer letters. Send links to docs and tax forms via text message so new hires sign digital copies.
What other owners
think about hiring through Workstream
"Ease of access for our applicants. This is the biggest selling point for us."
Chick-fil-A | Lebanon
"It has cut my screening process significantly, allowing me to multi-task other duties and responsibilities instead of countless phone calls."
Air Ventures LLC
Currently hiring on Workstream for:
Barista at Barista Parlor
"User friendly, Saves a lot of time."
SevaBrands LLC dba Dunkin'
Currently hiring on Workstream for:
crew members-urgently hiring
Post a job for free!
Try Workstream for free to post a job.
Workstream is the mobile-first hiring and onboarding platform for the deskless workforce. Powered by automation and two-way texting, our platform enables businesses to source, screen and onboard hourly workers faster. More than 24,000 businesses trust Workstream to hire - and save up to 70% of time on hiring.