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Qualifiying events for Special Enrollment periods ACA

March 31, 2014 By NevadaHealth

Qualifying events for special enrollment periods or SEP

 

The Affordable Act makes it very clear that special enrollment periods, which fall outside of the annual open enrollment period, must be made available to everyone.  A special enrollment period is would be a time when a qualifying event occurs that would make you eligible to enroll in a Qualified Health Plan outside of the annual open enrollment period.

 

What’s a qualifying event?

 

A qualifying event is an event that takes place in your life that would make eligible to qualify for a special enrollment period or SEP.

 

Here are some examples of qualifying events this is not the entire list so you should contact your health insurance broker for help.

 

  • Loss of Essential Health Coverage: If you lose, or have one of your dependents lose health coverage that meets minimum government standards.
  • A Change in Family Structure: If you gain a dependent or become a dependent because of a marriage, death in the family, birth or adoption of a child or even having a new baby.
  • Change Citizenship Status: If you become a U.S. citizen, national, or gain lawful status in the U.S this would qualify you.
  • Experience Government Error:From not fault of your own,  If you lose, change or enroll in coverage because of an error committed by an officer, employee or agent of the Exchange or the Department of Health and Human Services as determined by the Exchange.
  • Change Subsidy Eligibility: If you are determined newly eligible or newly ineligible for subsidies “advance payments of the premium tax credit or cost sharing reductions”.
  • Move to a New Coverage Area: If you permanently move to a new area and gain access to new qualified health plans. Example You move from Colorado to Utah. Your new health plan will be in Utah

 

Basically A qualifying event is a change in your life that can make you eligible for a Special Enrollment Period to enroll in health coverage. Need Help Start your quote now

Filed Under: Uncategorized Tagged With: qualifying event, qualifying events, special enrollment period

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