Open Enrollment is an annual period when you can apply for health insurance. This is the one time each year that you don't need a "qualifying event" (like a marriage, move, or birth of a child) to change your health insurance plan. We always encourage people to take advantage of the Open Enrollment period by looking at all their options so you can find the plan that best meets your needs at the lowest cost.
If you apply for coverage during Open Enrollment, your new plan typically starts on January 1 of the following year.
Missing this window may result in the inability to secure health coverage for the entire plan year, making it crucial to review and make decisions during this time.
Without an active plan, you may face penalties or lose access to essential healthcare services, adding to the importance of meeting the deadlines.
During Open Enrollment, employees will receive notifications via email that include instructions and deadlines for completing their health insurance selections. Employees are encouraged to log into their enrollment platform to review options, select plans, or upload necessary documentation to complete the process.
Open Enrollment runs from November 1st through December 15th in most states. That means that between November 1 & December 15, you can apply for coverage to start January 1. If you apply for a plan after Dec 15, you'll need a qualifying life event to qualify for "Special Enrollment." For example, the Open Enrollment period for 2025 will run from November 1, 2025, through December 15, 2025.
Certain states may provide extended deadlines beyond December 15, with some allowing enrollments until January 15 for plans effective January 1. It is recommended to check state-specific guidelines for accurate deadlines.
If you are outside of Open Enrollment, only Qualifying Life Events (QLEs) allow you to make changes. Examples of these events include changes in employment such as losing health coverage or starting a new job, household changes like marriage or the birth of a child, and losing coverage from other sources. Refer to plan-specific details or consult your benefits advisor for guidance.
Qualified life events (QLEs) include significant life changes such as marriage, birth of a child, adoption, job loss, or relocation. Common categories of QLEs are:
Changes in Employment: This may include losing health coverage due to job changes, starting a new job, or transitioning into a role with new benefits. Sometimes, temporary coverage through the health marketplace might be necessary until employer benefits kick in.
Household Changes: Events such as marriage, the birth or adoption of a child, or adding a dependent allow alteration of your health coverage to meet new needs.
Loss of Coverage: This might occur due to aging out of programs like Medicaid or CHIP or the expiration of previous policy terms. After experiencing a QLE, you typically have 60 days to make changes to your health insurance plan. Proof of the QLE, such as marriage certificates, proof of loss of coverage, or birth certificates, is usually required to apply changes. During Open Enrollment, QLEs can still allow you to adjust your policy for the upcoming term or activate earlier policy coverage through the Special Enrollment process. Changes must typically be submitted through your employer’s portal, directly via the carrier, or with help from a benefits administrator.