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Special enrollment period

Learn about special enrollment periods and how to qualify for one

What, exactly, is a special enrollment period, or SEP?

Generally, you can only enroll in a health plan during open enrollment. After the Open Enrollment Period, you're locked in to your health plan unless you've had a major life change or "qualifying life event" (like the birth of a child, marriage or losing your health coverage). Your life change or qualifying event allows you to enroll in a new health plan during what's called a special enrollment period, or SEP. If you qualify for an SEP, you're allowed to change your health plan or apply for a new one outside of open enrollment. You'll need to submit proof of the qualifying life event within 60 days of the date it happened.

  • What counts as a qualifying life event?
    Qualifying life event
    		 Proof required
    Marriage  A marriage certificate and proof of prior coverage within the last 60 days for at least one spouse
    Birth of a child
    		 The child's birth certificate or hospital documentation

    Adoption or placement for adoption of a child

    		 Adoption certificate or placement papers
    Divorce, legal separation or death
    		  Divorce Decree, legal separation papers or death certificate
    Noncalendar year policy renewal
    		 Copy of the renewal letter
    Permanently moving to a new area that offers now qualified health plan options
    		 Proof of prior coverage within the last 60 days, prior address and new or current address
    Job loss
    		 Proof of loss of coverage
    Loss of group health coverage
    		 Proof of loss of coverage
    Divorce Divorce decree and proof of loss of coverage
    Death Death certificate and proof of loss of coverage
    Aging off parent's health plan
    		  Proof of loss of coverage
    Losing eligibility for Medicaid or Children's Health Insurance Program (CHIP)
    		 Letter from Medicaid or CHIP
    COBRA coverage ending
    		 Proof of loss of coverage
    Other (considered on a case-by-case basis)
    		 Give full details and date of event when applying (additional proof may be needed)
  • I qualify for special enrollment. How do I enroll?

    Enroll by phone

    Give our knowledgeable, certified representatives a call at (855) 948-4427. They can guide you through the process and answer any questions you may have.

    Enroll by mail

    Print one of the following applications, and send a signed copy to the address on the form with any supporting documentation.

2018 applications

HMO Application (PDF)

PPO Application (PDF)

Need more information before you enroll? Download these helpful guides to individual and family plans and dental coverage.

Prospective New Member Brochure (PDF)

Delta Dental Brochure (PDF)

Vision Brochure (PDF)

 

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