Insurance Now
Insurance Now
Specializing in Affordable Health Insurance Plans in Georgia In Atlanta Call 770-396-9517 or Toll Free 1-877-711-8376
Specializing in Affordable Health Insurance Plans in GeorgiaIn Atlanta Call 770-396-9517 or Toll Free 1-877-711-8376

What is a Qualifying Life Event?

A Qualifying life event is any situation that has caused you to loose your insurance involunatarily.  Below is a list and the time frame you have to obtain insurance with the qualifying life event.

 

Qualifying 

Event

Definition

Supporting

Documents

Time Frame Eff. Date

 

Loss of

Employer

Coverage

 

 

 

 

 

 

 

 

 

Termination of employment, reduction in hours, no longer offered health coverage.

 

 

 

 

 

 

-Term letter

-pay stub of  both current and previous hours 

-letter from employer stating no longer offering to pay for or offer insurance

 

-60 Days of Event

 

 

 

 

 

 

 

 

 

1st day of month following app submission date

 

 

 

 

 

 

 

 

No longer a

Dependent

 

 

 

 

 

 

 

 

Loss of coverage due to no longer eligible as a dependent on employer or individual either because of age, death of policy holder, etc.

carrier letter stating coverage loss due to dependent status

 

 

 

 

-60 Days of Event

 

 

 

 

 

 

1st day of month following app submission date

 

 

 

 

Divorce

 

 

 

Loss of coverage due to Divorce

 

 

Divorce decree or custody agreement

 

-60 Days of Event

 

 

 

1st day of month following app submission date

 

 

Loss of Govt. Sponsored

plan, Medicaid

or CHIP

 

 

 

 

 

 

 

 

Loss of Medicad, CHIP, Medicare, TRICARE, Verterans program, Peace Corps Program, Non-appropriated Fund Health Benefits Program Dept. of Defense 

 

Term letter of loss of Govt. sponsored plan coverage from the Admin. including the date coverage ends

 

 

 

 

 

 

-60 Days of Event

 

 

 

 

 

 

 

 

 

 

 

1st day of month following app submission date

 

 

 

 

 

 

 

 

 

Birth, 

Adoption,

Foster Care, 

Legal Guardian

Change

 

All Listed Triggers an Event for Enrollment, Plan Change, or Dependent Addon 

-Birth Cert.

-Adoption Papers or Foster Care Papers

-Legal Guardianship

Papers

-60 Days of Event

 

 

 

 

Date of Birth, Adoption, placement for Adoption, Foster care, or Legal Guardianship

 

Marriage

 

 

 

 

 

Triggers event for Enrollment, Plan Change, Dependent Addon for either spouse

Marriage license or domestic partner certificate

 

-60 Days of Event

 

 

 

1st day of month following app submission date

 

Termination

of a pre-ACA

plan during

2014

 

 

 

 

pre-ACA plan terminated by carrier in 2014. Also applies where carrier offers renewal which member declines.

Carrier letter stating when current pre-ACA plan will end

 

 

 

-30 Days prior to loss of coverage OR 60 days After

 

1st day of month following app submission date

 

 

 

 

Loss of

Minimum

Essential

Coverage

 

 

 

 

 

 

 

 

 

 

 

loss of employer contributions, student health policy, Refugee Medical Assistance supported by Admin. for Children and Families. Medicare Advantage Plans, State high risk pool Coverage

Letter Documenting Loss of Minimum Essential coverage

 

 

 

 

 

 

 

 

 

-60 Days of Event

 

 

 

 

 

 

 

 

 

 

 

 

 

1st day of month following app submission date

 

 

 

 

 

 

 

 

 

 

 

Move to a

new area

 

 

 

 

 

Permanent move to a new area that offers different plan options

 

 

proof of prior  AND new residence location (utility bill/rental bill/lease agreement)

-60 Days of Event

 

 

 

 

1st day of month following app submission date

 

 

 

COBRA

Expiration

 

 

 

 

 

COBRA is exhausted at end of COBRA period

 

 

 

Document Showing COBRA is ending for the people covered by COBRA

 

-60 Days of Event

 

 

 

 

1st day of month following app submission date

 

 

 

Return from

Active Military

Duty

 

 

Return from Active Military Service

 

 

 

Supporting Documents confirming departure date from active Military Service

-60 Days of Event

 

 

 

1st-15th of Mo.: 1st day of month following app submission date

16th-last day of Mo.: 1st day of 2nd month following app submission date

 

Release from Incarceration

 

 

 

 

Newly eligible due to Release from Incarceration

 

 

Copy of Certified letter Documenting release date from incarceration

-60 Days of Event

 

 

 

 

Employer

Bankruptcy

Results in Loss

of Coverage

for Retirees

Retiree coverage is terminated due to Employer Bankruptcy, i.e. Chapter 11 Filing

Copy of legal supporting documentaion requiring health coverage

 

-60 Days of Event

 

 

 

 

Unintentional

Error

 

 

 

 

error in Enrollment/

Disenrollment in HIX plan is unintentional or erroneous

Documentation confirming the unintentional error

 

 

-60 Days of Event

 

 

 

1st-15th of Mo.: 1st day of month following app submission date

16th-last day of Mo.: 1st day of 2nd month following app submission date

 

Material

Violation

by Health Plan

 

 

 

 

Material violation by a Health Plan or HIX Plan violated a material provision of its contract

Document confirming violation

 

 

 

 

 

-60 Days of Event

 

 

 

 

 

 

Newly Eligible/

Ineligible for Exchange

Subsidies or Premium

Tax Credits

or Cost-Sharing Reductions

Newly Eligible/

Ineligible for Exchange 

Subsidies or Premium 

Tax Credits 

or Cost-Sharing Reductions

 

 

Document confirming the change in eligibility for subsidy, premium tax credit, or cost-sharing reductions.

 

-60 Days of Event

 

 

 

 

 

 

 

Phone:

770-396-9517

Fax:

770-396-4318

Email:

holly@insurance-now.com

shelly@insurance-now.com

2472 Jett Ferry Rd #400-350 

Atlanta, Ga 30338
Ask for Holly or Shelly

Click here for our Privacy Policy

Proud Members of :

Print Print | Sitemap
© Insurance Now