What is considered a “qualifying event”?

Qualifying events include, but are not limited to, the following:

• Marriage
• Birth, adoption or placement for adoption of a child
• Obtaining legal guardianship of a child
• Loss of eligibility for other health coverage for you or your dependent if:
  • The other coverage was in effect when you were first eligible to enroll for this coverage
  • The other coverage is not terminating for (such as failure to pay premiums or making a fraudulent claim)
  • Where required, you stated in writing that coverage under another group health plan or other health insurance coverage was the reason for declining enrollment in this coverage. This includes, but is not limited to, loss of coverage due to:
  • Legal separation, divorce, cessation of dependent status, death of an employee, termination of employment, or reduction in the number of hours of employment
  • In the case of HMO coverage, coverage is no longer provided because an individual no longer resides in the service area or the HMO no longer offers coverage in the HMO service area in which the individual resides
  • Another group health plan is no longer offering any benefits to the class of similarly situated individuals that includes you or your dependents
  • When Medicaid or children’s health insurance program (CHIP) coverage is terminated as a result of loss of eligibility
  • When you or your dependents become eligible for a premium assistance subsidy under Medicaid or CHIP
  • Termination of employer contributions towards your or your dependents’ other coverage
  • Exhaustion of COBRA continuation coverage or state continuation coverage

How long do I have to submit an application from the date of a qualifying event?

You have 30 days from the qualifying event date to sign and submit an application.