Special Enrollment Periods. Outside of the annual open enrollment period, You, Your Spouse or Child can enroll for coverage within 30 days of the date the Subscriber gains a Dependent through marriage, birth, adoption, or placement for adoption. We must receive notice and any premium payment within 30 days of one of these events. If You have a newborn or adopted newborn Child and We receive notice of such birth within 30 days thereafter, coverage for Your newborn starts at the moment of birth; otherwise coverage begins on the date on which We receive notice. Your adopted newborn Child will be covered from the moment of birth if You take physical custody of the infant as soon as the infant is released from the Hospital after birth and You file a petition pursuant to Section 115-c of the New York Domestic Relations Law within 30 days of the infant’s birth; and provided further that no notice of revocation to the adoption has been filed pursuant to Section 115-b of the New York Domestic Relations Law, and consent to the adoption has not been revoked. If You have individual or individual and Spouse coverage You must also notify Us of Your desire to switch to parent and child/children or family coverage and pay any additional Premium within 30 days of the birth or adoption in order for coverage to start at the moment of birth. Otherwise, coverage begins on the date on which We receive notice provided that You pay any additional Premium when due. In all other cases, the effective date of Your coverage will depend on when We receive Your selection. If Your selection is received between the first and fifteenth day of the month, Your coverage will begin on the first day of the following month, as long as Your applicable Premium payment is received by then. If Your selection is received between the sixteenth day and the last day of the month, Your coverage will begin on the first day of the second month, as long as Your applicable Premium payment is received by then.
Special Enrollment Periods. Outside of the annual open enrollment period, You, the Subscriber, Your Spouse, or Child, can enroll for coverage within 60 days prior to or after the occurrence of one (1) of the following events:
Special Enrollment Periods. Allows declining participants to later enroll into the plan like a new employee, if certain criteria are met such as: a) marriage or divorce; b) birth, adoption or placement for adoption of a child; c) death of a spouse or child; d) change in spouse’s employment status; e) change in employee’s employment status; f) change in a dependent’s eligibility; g) unpaid leave of absence taken by the employee or spouse; h) loss of health insurance.
Special Enrollment Periods. An Eligible Employee or Eligible Dependent will not be considered a Late Enrollee if:
Special Enrollment Periods. Consumers can qualify for a Special Enrollment Period (SEP) to enroll for health insurance coverage if they meet certain eligibility criteria. Below is a list of the categories of SEPs currently available.
Special Enrollment Periods. In general, a qualified individual has 60 days to report certain life changes, known as “qualifying events” to the plan or by using Xxxxxxxx’s Enhanced Direct Enrollment tool. Qualified Individuals may be granted a Special Enrollment Period where they may enroll in or change to a different plan during the current plan year if they have a qualifying event. Qualifying events include:
Special Enrollment Periods. A special enrollment period occurs when a person experiences a triggering event. If You experience one of the triggering events listed below, You can enroll for coverage and enroll Your eligible Dependent(s) during a Special Enrollment Period instead of waiting for the next Annual Open Enrollment Period. Triggering events for a special enrollment period are: ▪ An eligible individual, and any dependent(s), loses his or her minimum essential coverage; or ▪ An eligible individual and his or her dependent(s) lose employer-sponsored health plan coverage due to voluntary or involuntary termination of employment for reasons other than misconduct, or due to a reduction in work hours; or ▪ An eligible individual gaining or becoming a dependent through marriage, birth, adoption or placement of adoption; or ▪ An eligible dependent spouse or child loses coverage under an employer-sponsored health plan due to employee’s becoming entitled to Medicare, divorce, legal separation of the covered employee, and death of the covered employee; ▪ An eligible individual loses his or her dependent child status under a parent’s employer- sponsored health plan; or ▪ An individual who was not previously a citizen, national or lawfully present individual gains such status, is only applicable to the marketplace; or ▪ An eligible individual’s enrollment or non-enrollment in a qualified health plan is unintentional, inadvertent, or erroneous and as the result of the error, misrepresentation, or inaction of an officer, employee or agent of the state marketplace, or of the Department of Health and Human Services (HHS), or its instrumentalities as determined by the marketplace. In such cases, the marketplace may take such action as may be necessary to correct or eliminate the effects of such error, misrepresentation or action; or ▪ An eligible individual adequately demonstrates to the marketplace that the qualified health plan in which he or she is enrolled substantially violated a material provision of its contract in relation to that person; or ▪ An eligible individual is determined newly eligible or newly ineligible for advance payments of the premium tax credit or has a change in eligibility for cost-sharing reductions, regardless of whether such individual is already enrolled in a qualified health plan. The marketplace must permit individuals whose existing coverage through an eligible employer-sponsored plan will no longer be affordable or provide minimum value for his or her employer...
Special Enrollment Periods. Special enrollment is allowed for certain individuals who lose coverage. Special enrollment is also allowed with respect to certain Dependent beneficiaries. If only the Subscriber is eligible under this Evidence of Coverage and Dependents are not eligible to enroll, special enrollment period for a Spouse /Dependent child are not applicable.
Special Enrollment Periods. 1. An active employee may apply for coverage for himself/herself or for his/her dependents if one (1) of the following occurs:
Special Enrollment Periods. If you experience a life or special enrollment event as determined by the Marketplace you may be eligible to apply for coverage outside of the Annual Open Enrollment Period. A Special Enrollment Period is the period of time immediately before or after one of these life or special events, as determined by the Marketplace. The Effective Date of your new coverage will depend on what type of special event occurred. To apply for coverage, you must complete the applicable Enrollment Form and submit it to the Marketplace within the Special Enrollment Period. The Marketplace will determine whether you qualify for a Special Enrollment Period, the length of the Special Enrollment Period and your Effective Date. Special enrollment events are established by state and federal law. Below are examples of special enrollment events. This is not intended to be a complete list. For more detailed information on what qualifies for a Special Enrollment Period go to xxx.XxxxxxXxxx.xxx. • Loss of minimum essential coverage (e.g., job loss, divorce, aging off parents’ plan); or • Gaining a dependent (e.g., marriage, having a baby, Adoption or placement for Adoption or xxxxxx care). • To qualify for a marriage Special Enrollment Period, at least one spouse must: • Be enrolled in minimum essential coverage at least 1 day in the 60 days before marriage, • Have lived abroad for 1 or more days in the 60 days before marriage, or • Be an American Indian or Alaska Native (AI/AN)
