Special Enrollment Period
CHANGE IN HOUSEHOLD SIZE
You may qualify for a special enrollment period if you have had a change in your household size due to a marital status change, dependent status change or death of family member. You have 60 days from the date of your qualifying life event to enroll in coverage.
MARITAL STATUS CHANGE
– Legal separation
• Marriage certificate showing the date of the marriage
• Marriage license showing the date of the marriage
• An official public record of the marriage, including a foreign record of marriage
• Affidavit or statement signed by the person who officiated the marriage
• Affidavit or statement signed by a person who was an official witness to the marriage
• A religious document that recognizes the marriage
• Divorce/separation court documents
• Proof of current of coverage may also be required
DEPENDENT STATUS CHANGE
– Birth of a child
– Aged out of dependent status
If you had a child:
• Medical record from a clinic, hospital, physician, midwife, institution, or other medical provider showing the date of birth
• Letter from hospital, clinic, physician, or other medical provider attesting the date of birth
• Letter or other document from the health insurance company, like an Explanation of Benefits, showing that services related to birth or post-birth care were provided to either the child or the mother, including the dates of service
• Birth certificate or application for a birth certificate for the child
• Application for a Social Security Number (SSN) for the child
• A foreign birth record showing the child’s date and place of birth
• Military record showing the child’s date and place of birth
• Religious record showing the child’s date and place of birth
• Social Security card for the child
If you adopted a child:
• Adoption letter or record showing date of adoption dated and signed by a court official
• Government-issued or legal document showing the date that the child was placed in the home
• Government-issued or legal document showing the date legal guardianship was established
• Court order showing the effective date of the order
• U.S. Department of Homeland Security immigration document for foreign adoptions
• Medical support order
• Foster care papers dated and signed by a court official
Losing a dependent or no longer being considered a dependent because enrollee or enrollee’s dependent passes away.
• Death Certificate
• Copy of termination letter from prior insurance company
Anytime that you enroll in a plan you will be asked to provide the following information:
1. What was your qualifying event?
2. What was the date of this event?
3. You’ll be asked to submit supporting documents.