Qualifying Life Events (QLE) for Special Enrollments

Employees can trigger Special Enrollment Periods to enroll in an ICHRA Health Care Plan by having a Qualifying Life Event (QLE)

Every year an Open Enrollment for health insurance benefits generally runs from November 1st to December 15th. Outside of Open Enrollment, employees need a Qualifying Life Event to trigger a Special Enrollment Period to purchase a plan.

Qualifying Life Events are situations that cause a change in your life that has an effect on your health insurance options or requirements. If you have a life event mid-year and you need to make changes to your health care plan, you can now initiate a change request on your own in your benefitbay profile. Review this article for instructions.

NOTE: You must take action by initiating a change request inside benefitbay as soon as you are aware of a life event. Delaying action may result in missing your opportunity for changes in enrollment elections.

Category	Examples of Qualifying Life Events
Loss of health coverage	Losing health insurance for any reason except not paying premiums Losing eligibility (Medicaid, Medicare, or a Children's Health Insurance Program) Turning 26 and losing coverage through a parent's plan Loss of job-based coverage (quit or fired)
Changes in household	Marriage, divorce, or legal separation Pregnancy, adoption of a child, or any addition of dependents Losing coverage due to a death in the family
Changes in residence	Moving to a different coverage area (state, county, or zip code) Student moving schools Workers moving to and from the place they live and work
Other qualifying events	Becoming a U.S. citizen Released from incarceration Your spouse retires, which forces you to lose coverage Your spouse changes jobs, which forces you to lose coverage

To view a full list of Qualifying Life Events visit Healthcare.gov

After applying for your health care plan during a Special Enrollment Period, you may need to provide documentation of your Qualifying Life Event so the insurance provider can confirm that you meet Special Enrollment Period requirements. You can upload these documents in the change request inside benefitbay.

If you are not approved for a Special Enrollment Period, then the request will be canceled.

Key Takeaway: If you do not qualify for a Special Enrollment Period due to not meeting the requirements of a Qualifying Life Event, you will have to wait until the next Open Enrollment Period to obtain health insurance or to change your existing health care plan.