Special Enrollment Period. An eligible individual and eligible dependents may be enrolled during special enrollment periods. A special enrollment period may apply when an eligible individual or eligible dependent loses other health coverage or when an eligible individual acquires a new eligible dependent through marriage, birth, adoption or placement for adoption.
Special Enrollment Period. A period of time that is no less than 30 days or 60 days, as applicable, following the date of a Triggering Event during which:
Special Enrollment Period. If you enroll during a special enrollment period, your coverage is effective:
Special Enrollment Period. A period of time that is no less than 60 days following the date of a triggering event during which: individuals are permitted to enroll in a standard health benefits plan or standard health benefits plan with rider; and individuals who already have coverage are allowed to replace current coverage with a different standard health benefits plans or standard health benefits plan with rider.
Special Enrollment Period. A period of time that is no less than 30 days or 60 days, as applicable, following the date of a Triggering Event during which: Late Enrollees are permitted to enroll under the Contractholder’s Policy; and Covered Employees and Dependents who already have coverage are permitted to replace current coverage with coverage under a different policy, if any, offered by the Contractholder. [SPECIALTY PHARMACETICALS. Oral or injectable drugs that have unique production, administration or distribution requirements. They require specialized patient education prior to use and ongoing patient assistance while under treatment. These Prescription Drugs [must be] [may be] dispensed through specialty pharmaceutical providers. Examples of Prescription Drugs that are considered Specialty Pharmaceuticals include some orally administered anti-cancer Prescription Drugs and those used to treat the following conditions: Crohn’s Disease; Infertility; Hemophilia; Growth Hormone Deficiency; RSV; Cystic Fibrosis; Multiple Sclerosis; Hepatitis C; Rheumatoid Arthritis; and Gaucher’s Disease. [Carrier] will provide a complete list of Specialty Phamaceuticals. The list is also available on [Carrier’s] website.]
Special Enrollment Period. The period during which a qualified individual or enrollee who experiences certain qualifying events, as defined in applicable Federal and State laws, rules and regulations, may enroll in, or change enrollment in, a QHP through the Exchange outside of the initial and annual open enrollment periods.
Special Enrollment Period a period during which an eligible individual who experiences certain qualifying events may enroll or change enrollment in the coverage provided under this Agreement when provided pursuant to enrollment through the Exchange. Special enrollment periods also apply to individuals eligible to enroll during a Limited Open Enrollment Period or who experience such other events in connection with which applicable federal laws, regulations and guidance have determined results in special enrollment rights.
Special Enrollment Period. An Eligible Person and/or Dependent may also be able to enroll during a special enrollment period, as determined by the Maryland Health Benefit Exchange. Except as otherwise specified below, an individual not currently enrolled in a Qualified Health Plan may enroll in any Qualified Health Plan. An individual currently enrolled in a Qualified Health Plan may enroll with his or her dependents in another Qualified Health Plan within the same level of coverage or one metal level higher or lower, if no such Qualified Health Plan is available. A non-covered dependent of an individual currently enrolled in a Qualified Health Plan may be added to the individual’s current Qualified Health Plan or may enroll in any separate Qualified Health Plan. If our business rules for the current Qualified Health Plan do not allow for the dependent(s) to be enrolled in the same Qualified Health Plan, we must allow the enrolled individual and the non- covered dependent(s) to enroll in a different Qualified Health Plan within the same metal level or, if no such Qualified Health Plan is available, one metal level higher or lower. An individual who is not an enrollee and has one or more dependents who are enrollees who do not also qualify for a special enrollment period may enroll in the dependent’s current Qualified Health Plan or may enroll in any separate Qualified Health Plan. If our business rules do not allow for the qualified individual to enroll in the dependent’s current Qualified Health Plan, we must allow the individual to enroll with the dependent(s) in another Qualified Health Plan within the same metal level or one metal level higher or lower if no such Qualified Health Plan is available. For the purpose of this provision, a “qualified individual” is an individual who has been determined eligible to enroll in a Qualified Health Plan through the Maryland Health Benefit Exchange. The Maryland Health Benefit Exchange will allow qualified individuals or Dependents to enroll in or change from one Qualified Health Plan to another as a result of the following triggering events: • Loss of minimum essential coverage. Loss of minimum essential coverage does not include loss due to: ▪ Failure to pay Premiums on a timely basis, including COBRA premium prior to the expiration of COBRA coverage, except for circumstances in which an employer completely ceases its contributions to COBRA continuation coverage or government subsidies of COBRA continuation coverage completely cease; ▪ Si...
Special Enrollment Period. An eligible individual and eligible dependents may be enrolled during a special enrollment period. A special enrollment period may apply when an eligible individual or eligible dependent loses other health coverage or when an eligible individual acquires a new eligible dependent through marriage, birth, adoption or placement for adoption. An eligible individual or an eligible dependent may be enrolled during a special enrollment period, if requirements a, b, c and d are met:
a. the eligible individual or the eligible dependent was covered under another group health plan or other health insurance coverage when initially eligible for coverage under HMO;
b. the eligible individual or eligible dependent previously declined coverage in writing under HMO;
c. the eligible individual or eligible dependent loses coverage under the other group health plan or other health insurance coverage for one of the following reasons:
i. the other group health coverage is COBRA continuation coverage under another plan, and the COBRA continuation coverage under that other plan has since been exhausted; or
ii. the other coverage is a group health plan or other health insurance coverage, and the other coverage has been terminated as a result of loss of eligibility for the coverage or employer contributions towards the other coverage have been terminated. • termination of HMO coverage due to Member action- movement outside of the HMO’s service area; and also the termination of health coverage including Non-HMO, due to plan termination. Loss of eligibility does not include a loss due to failure of the individual or the participant to pay Premiums on a timely basis or due to termination of coverage for cause as referenced in the Termination of Coverage section of this EOC; and
d. the eligible individual or eligible dependent enrolls within 31 days of the loss. The Effective Date of Coverage will be the first day of the first calendar month following the date the completed request for enrollment is received. The eligible individual or the eligible dependent enrolling during a special enrollment period will not be subject to late enrollment provisions, if any, described in this EOC.
Special Enrollment Period. The annual Open Enrollment period for new coverage is October 15 through January 15. These dates are subject to change pursuant to changes in the law. You may change your benefit plan, sign up for health care coverage or add eligible dependents during the Open Enrollment period. Outside of this Open Enrollment period, you can only sign up for health care, change your coverage or add eligible dependents if you have experienced a qualifying life event. You must enroll within 60 days of the qualifying event in order to be eligible for a Special Enrollment Period. If 60 days pass and you do not sign up for health coverage, you will have to wait until the next open enrollment period. WHA reserves the right to ask for verification of the qualifying event. I attest that I am or my dependents are eligible to enroll under a Special Enrollment Period due to the following qualifying event: Marriage or Divorce Birth or Adoption Death Loss of Minimum Essential Coverage Under an Employer Sponsored Plan: Termination of Employment Change in Employment Status Exhaustion of COBRA Continuation Coverage Returning from United States Active Duty or California National Guard Under Title 32 of the United States Code Dependent child’s loss of dependent status such as reaching age 26 Permanent Relocation to the WHA Service Area Provider Network Changes Court Ordered Coverage for Your Spouse or Minor Child Immigration Status Change Released From Incarceration Other Please read the following information and sign in the space(s) provided on the following page. Please read this section carefully. This section contains important information, including the reasons WHA may terminate or rescind coverage. Be sure to complete the Application/Agreement accurately. If you are unsure about the answer to any question, take the time to make sure the information is accurate before submitting your Application/Agreement. By signing this Application/Agreement, you represent that all responses are true, complete, and accurate to the best of your knowledge, and that if WHA accepts your application for coverage, the Application/Agreement, together with the Combined Evidence of Coverage and Disclosure Form (EOC/DF), will constitute the plan contract between you and WHA. If WHA accepts the Applicant or Dependent(s) for coverage, coverage will begin on the first of the month following acceptance, or the first of the following month, based on your selection under “Effective Dat...
