ACA
Resource Center

Qualifying Life Events (QLE)

If you miss the Open Enrollment Period, you’ll need to have a “qualifying life event” in order to enroll in a new major medical health plan or change your existing health insurance coverage. Below are some examples of Qualified Life Events.

Qualifying Life Events

Qualifying Life Events

Changes in family:

  • Marriage or divorce
  • Birth or adoption of a child
  • Death of a family member

Loss of existing health coverage because of a:

  • Job change or
  • Job loss

Permanently moving to a new location, that has a different:

  • Coverage area

Loss of eligibility for:

  • Medicaid
  • CHIP (Child Health Insurance Plan)

Students / Dependents losing coverage due to:

  • Graduating college or
  • losing coverage from your parent’s health plan (turning age 26)

Other

  • Gaining or losing a dependent
  • Expiration of your COBRA benefits
  • Change in disability status
  • Certain changes to your income
  • Changes to the size of your household

A Note About Special Enrollment Periods:

  • If you have a qualifying event that triggers a special enrollment period, we recommend having documentation stating the reason and date of your loss of coverage (your qualifying event). The insurance carrier will request it when you apply for new coverage.
  • In addition, if you voluntarily cancel your existing coverage or lose it because you didn’t pay your premiums or other bills, you will not likely qualify for a Special Enrollment Period.

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