Special Enrollment Period | Documents You Need To Submit

Perhaps you already know that you can still enroll for a health plan even outside the annual Open Enrollment Period.

People with Qualifying Life Events (QLE) can take advantage of the Special Enrollment Period. If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan. Moreover, in all cases, you may need to submit certain documents to verify your eligibility.

Qualifying Life Events for Special Enrollment Period

• Loss of health insurance coverage
• Change in primary residence
• Change in household size

• Enrollment or plan error
• Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP)
• Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
• Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
• Leaving incarceration
• AmeriCorps VISTA members starting or ending their service

Documents for Loss of Health Insurance Coverage

These documents must show that you either lost health insurance coverage in the past 60 days or will be losing that coverage in the next 60 days. These should have your name and the date of coverage lost.

• A letter from your insurance company showing the termination of your health insurance coverage.
• A loss of health insurance coverage letter from an employer.
• A notification of being denied for Medicaid or CHIP. Moreover, a letter stating that your Medicaid or CHIP coverage ended or will end is also acceptable.

Documents for Change in Primary Residence

If you qualify for SEP because of moving to a different state, then you need to send documents that confirm both of these:

• You moved in the last 60 days.
– government correspondence, bills or financial statement, mortgage or rental documents, homeowner’s insurance, letter from an insurance company
• You had health coverage at least one day during the 60 days before your move.
– correspondence from your insurance company, employer, or health coverage provider

Documents for Change in Household Size

Since this QLE involves either marriage, adoption, birth, divorce or death; legal or government-issued documents tied to these events are typically requested.

Get free assistance.

If you have any questions about your health plan or want to know if you still qualify to enroll after Open Enrollment, give us a call at 503-998-6169 – Health Plans In Oregon. We’re local, independent and licensed agent in who has been helping Oregonians at no cost since 2006.

Also see:

Cost Sharing Reductions Made Simple
Moving To A Different State | Special Enrollment

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