Can I Buy a Health Insurance Policy After the Annual Election Period?

As you know, open enrollment ended on March 31, 2014. However, individuals may still be able to apply for coverage before the next annual open enrollment if they, or someone in their family, has a qualifying life event.

Qualifying life events, which create a special enrollment period (SEP), are defined in federal law. Certain events may require certification from the Federally Facilitated Marketplace (the Exchange).

The following are some examples of common qualifying life events. This is not a complete list. There may be other events that apply.  Federal law determines whether an event is a “qualifying” event.

• The individual, or someone in their family, has:
  • Married someone
  • Had a baby
  • Adopted a child, or had a child placed for adoption
• Individual, or someone in their family, has lost minimum essential health insurance through job loss, divorce, expiration of COBRA coverage, or other, similar situations
• Individual, or someone in their family, has lost eligibility for Medicaid (AHCCCS) or Children’s Health Insurance Program (CHIP)
• Individual has moved to a new home in an area with different health plan options
• Individual, or someone in their family, no longer has access to health insurance that is considered “affordable” under federal law, or which provides “minimum value”
• There was an error in the enrollment process for Individual’s current plan (as defined in federal law)
• Individual’s plan or issuer has substantially violated a material provision in the current plan
• Individual, or someone in their family, has become eligible or ineligible for federal financial help to pay for health insurance or health care costs due to a change in income

Voluntarily quitting other health coverage or being terminated for not paying premiums is not considered loss of coverage.

Losing coverage that does not qualify as “minimum essential coverage” under federal law, is not considered a qualifying event.

All carriers will require proof of the qualifying event before they will issue coverage.

For more information,give us a call at (520) 721-4848.