Special Enrollment Requires a Qualifying Event

Now that open enrollment is closed, the only way to get on a plan or make changes to your existing plan, is with a qualifying event.  A qualifying event can open up a Special Enrollment Period or SEP.   

Timing is critical!  You must enroll in your plan within 60 days of your qualifying event.  

So, what is a qualifying event?

Examples of Qualifying Events:

  • Permanently moves to a new area that offers different health plan options
  • Involuntarily losing other health coverage (see next section)
  • Experienced an error in enrollment
  • Becomes newly eligible or ineligible for Advance Premium Tax Credits or has a change in eligibility for Cost-Sharing reductions
  • Returns from active military duty
  • Gains immigration status or citizenship
  • Released from incarceration

Loss of Minimum Essential Coverage Due to:

  • Discontinuation of a current plan that doesn’t meet health care reform requirements
  • Legal separation
  • Divorce
  • Termination of domestic partnership or civil union
  • Change in full-time employment status
  • Involuntary loss of employer-sponsored insurance
  • Death of a parent or spouse
  • Change in dependent status as a result of turning 26

Gaining or Becoming a Dependent Due to:

  • Marriage
  • Domestic partnership
  • Birth of child/children
  • Adoption of child/children
  • Placement for adoption of child/children
  • Guardian/court-ordered dependent

Additionally, Connect for Health Colorado provides these examples of Life Change Events that can help you get new coverage. 

Events that allow CURRENT customers to shop for a New plan:

  • Change of American Indian/Alaska Native status
  • Change of residence (if moving out of a service area)
  • Gain or loss of eligibility for the tax credit or cost sharing reduction
  • Incorrect or inappropriate enrollment NOT due to a customer error
  • A customer demonstrates that their health plan has substantially violated a provision of its contract