Quantifying The Qualifying Life Events

Quantifying The Qualifying Life Events

Qualifying Life Events/Group Insurance

The Three Scenarios That Will Enable Coverage Through A Group Plan

The world of health care continues to change in the United States. With the last open enrollment period ending a little over a month ago (on February 15th), many Americans are unfortunately left without marketplace coverage. Other than securing short-term coverage and facing penalty fees, they may feel there is nothing they can do. Fortunately, there are a handful of scenarios—called qualifying live events—that will allow your employee to opt into your group plan, even when it is not an open enrollment period. They are:

  • Becoming Eligible In The Group: Whether you offer health insurance coverage from day one or require a waiting period before offering this benefit, the day your employee becomes eligible for coverage under your group plan a period begins during which he or she can apply for coverage.
  • Involuntary Loss Of Coverage: Excluding cases of failure to pay one’s premium, misrepresentation, and fraud, if an individual involuntarily loses coverage he or she is able to apply for coverage under your group plan for a period of time. This also applies if the individual lost Medicaid or CHP+.
  • Gaining A Dependent: The major life change that happens during the birth of adoption of a child, getting married or entering into a civil union, and entering into a designated beneficiary agreement carries over to health care as well. Any of these life events qualify an individual for a special enrollment period during which he or she can apply to the group plan.

Do you have an insurance expert keeping you up to date on all of the changes in the American health care industry and keeping you informed? To work with a dedicated team who will help you stay ahead of the changing tides, contact Employee Benefit Plans Inc. in Greenwood Village, CO. Our team is here to help you serve your team.