A qualifying life event (QLE) is a significant change in your living situation that can make you eligible for a Special Enrollment Period. This allows you to enroll in health insurance outside the yearly open enrollment period.
A qualifying event is an event that allows an individual or family to enroll in health insurance outside of the company's annual renewal. See a list of accepted qualifying events below.
Change in household
Getting married or divorced
Having a baby or adopting a child
Death in the family
Loss of other health coverage
Losing existing health coverage, including job-based, individual and student plans
Losing eligibility for Medicare, Medicaid or CHIP
Turning 26 and losing coverage through a parent’s plan
Change in residence
Moving to a different county or state
A student moving to or from the place they attend school
A seasonal worker moving to or from the place they both live and work
Other qualifying events
Changes in your income that affect the coverage you qualify for (e.g. losing Medicaid eligibility)
Changes in work status from part-time to full-time
Rehired after termination or leave of absence
Note: that there may be other qualifying events not included in this list that will make the employee eligible to enroll in coverage.
When you have a qualifying life event, you can make updates to your benefits coverage by submitting proof of the QLE within 30 days of the event. Otherwise, all changes must happen during your company's open enrollment period. In most instances, we will backdate any new coverage to the first of the month. For example, if you had a baby on May 15th and wanted to add your child to your plans, their coverage under Vitable would be effective as of May 1st.
If you're getting married or entering a domestic partnership, your new coverage will start on the 1st of the following month. For example, if you made it official on May 15th and wanted to add your partner to your plans, their coverage would be effective as of June 1st.
Remember, any QLE has to be processed within 30 days of occurring! You are not able to make any changes to an elected insurance plan after the effective date of the
plan or outside of your QLE open enrollment window.
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