What is a Qualifying Life Event?

A change in your situation — like getting married, having a baby, or losing health coverage — can make you eligible for a special enrollment period. A qualifying life event (QLE) allows you to enroll in health insurance benefits outside of your employer's annual open enrollment period. Typically, you have up to 30 days after the qualifying event to enroll in coverage.

4 Basic Types of QLEs

The most common examples include:

  1. Loss of 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
  2. Changes in household

    • Getting married or divorced
    • Having a baby or adopting a child
    • Death in the family
  3. Changes in residence

    • Moving to a different ZIP code or county
    • 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
    • Moving to or from a shelter or other transitional housing
  4. Other qualifying events

    • Changes in your income that affect the coverage you qualify for
    • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
    • Becoming a U.S. citizen
    • Leaving incarceration (jail or prison)
    • AmeriCorps members starting or ending their service

View the full list at HealthCare.gov.

Required Documents

When you have a qualifying life event (QLE), you will be required to provide 1) supporting documents, and 2) the date the change occurred. Below are examples of qualifying life events and supporting documents.

QLE CategoryType of ChangeSupporting Documents
Legal Marital StatusMarriageMarriage certificate

Divorce or annulmentDivorce decree/court ruling for annulment

Legal separationCourt order of legal separation

Death of spouseDeath certificate
Number of DependentsBirthBirth certificate

DeathDeath certificate

Adoption/placement for adoptionCourt order for adoption /placement for adoption
Employment Status of Employee or SpouseLoss of employmentTermination documents or unemployment application

Start of employmentEmployer documentation with employment start date

Change in worksiteEmployer documentation showing change and impact on eligibility

Leave of absenceEmployer documentation stating employee has started or returned from leave
Gain/Lose Eligibility for Other Group Coverage (HIPAA special enrollment)Group health planDocumentation from plan or issuer regarding change in eligibility with effective date
Employment status of Employee or SpouseLoss of employmentTermination documents or unemployment application

Start of employmentEmployer documentation of start date

Change in worksiteEmployer documentation showing change and impact on eligibility

Leave of absenceEmployer documentation stating employee has begun or returned from leave
Place of ResidenceChange in place of residence of employee, spouse, or dependent that affects eligibilityDocumentation on how residence change affects employee
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