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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)

Open Enrollment

Each year, Open Enrollment for health insurance benefits generally runs from November 1st to December 15th.

Outside of Open Enrollment, you’ll need a Qualifying Life Event (QLE) to trigger a Special Enrollment Period before you can purchase a plan.

What Is a Qualifying Life Event?

A Qualifying Life Event is a change in your life that affects your health insurance options or requirements.

If you experience a life event mid-year and need to change your health plan, you can now start a change request on your own in your benefitbay profile. Review this article for step-by-step instructions.

⚠️ Act quickly! Start a change request in benefitbay as soon as you’re aware of a life event. Waiting may cause you to miss your opportunity to change your enrollment.

Examples of Qualifying Life Events

Category Examples
Loss of health coverage
  • Losing health insurance for any reason except not paying premiums
  • Losing eligibility for Medicaid, Medicare, or CHIP
  • Turning 26 and losing coverage through a parent’s plan
  • Losing job-based coverage (quit or fired)
Changes in household
  • Marriage, divorce, or legal separation
  • Pregnancy, adoption, or adding any dependent
  • Losing coverage due to a death in the family
Changes in residence
  • Moving to a different coverage area (state, county, or ZIP code)
  • Students moving to or from school
  • Seasonal workers moving to or from where they live and work
Other qualifying events
  • Becoming a U.S. citizen
  • Being released from incarceration
  • Your spouse retires, causing you to lose coverage
  • Your spouse changes jobs, causing you to lose coverage

For a full list of Qualifying Life Events, visit Healthcare.gov.

Documentation

After applying for a plan during a Special Enrollment Period, you may need to provide documentation of your QLE so the insurance carrier can confirm you meet the requirements. You can upload these documents directly in your change request inside benefitbay.

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

🔑 Key Takeaway: If you don’t qualify for a Special Enrollment Period, you’ll need to wait until the next Open Enrollment to get health insurance or change your current plan.