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Qualifying Life Events For Employer-Sponsored Health Insurance

If you miss the open enrollment period for your employer-sponsored health insurance, the only other time that you can enroll is if you experience a qualifying life event, or QLE. A QLE occurs when there is a change in your circumstances that warrants a possible need for a change in your insurance as determined by your health insurance company. Your health insurance company grants you a period of typically 60 days, a special enrollment period, that allows you to make changes to your health insurance policy. While there are quite a few different QLEs that can occur, we can break them roughly into four different categories to make them a little easier to understand.

Change in Address

When you change your address, it can trigger other changes as well. Situations, where you have a new address, could be anything from a move to a new zip code to a student going away to school. Different geographical areas present different insurance plan options, and therefore, many changes of address are considered a QLE. If you suddenly are not eligible for coverage due to your location, it makes sense that you would need to change your policy.

Change in Family

The ups and downs of life bring about changes to our household situations from births and marriages to deaths and divorces; these are the types of changes that prompt a need for changes to your insurance policy. It stands to reason then that these changes and other changes to your household are QLE that provide you with a special enrollment period.

Change in Health Insurance

Twenty-six is a great age to turn, except for the fact that your parents can no longer list you under their health insurance policy. The chances that your birthday lines up with your employer’s open enrollment period are slim, but what are you supposed to do when you find yourself without medical coverage? Thankfully, this situation and others where you find yourself having lost health insurance coverage (except cancellations for nonpayment) are considered QLEs.

All Others

Other miscellaneous circumstances that might be considered QLEs are: being released from prison, becoming a U.S. citizen, as well as countless others. After all, life is unpredictable, and no two people are the same. The diversity in life paths is what QLEs are designed to reflect. If you have gone through an experience that you believe may be a QLE and requires a change to your employer- sponsored health insurance, contact your employer for a complete list of QLEs.

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