What are the Qualifying Life Events for Health Insurance?

Every year, people all across the United States have an opportunity to change their health insurance in an open enrollment period. When it comes to small business insurance, the options may not include as many possibilities as your employees may like. Also, if any of them have experienced a distinct change in their health or diagnosis of a specific condition, they may benefit from an earlier change in insurance coverage.


This requires what are known as qualifying life events. These situations affect insurance availability and an individual’s ability to make decisions about the health plan they use.


What Are Qualifying Life Events?


Any type of change that triggers issues with access to small business insurance coverage probably fits the definition of a qualifying life event. These can trigger a special enrollment period (SEP) so individuals and families can choose new benefit options that suit their dynamic needs.


Health Insurance Coverage Loss


If a person loses health coverage for any reason due to accessibility or eligibility, they can seek out new insurance right away. These situations include turning 26 years old and being no longer included on a parent’s coverage plan, leaving a job that provided insurance, or changing financial circumstances that removes eligibility for Medicaid or Medicare.


Moving Residences


Changing states, cities, and ZIP Codes can affect health insurance availability. Qualifying life events include a university student coming home from school, seasonal workers shifting to a new location, or any other type of voluntary move. In many cases, these types of moves also include job changes, which are one of the most common causes of switching insurance carriers or programs.


Household Changes


Small business insurances that operate family plans or package deals depend on maintaining the same household structure. If this changes through marriage, divorce, birth, adoption, or a death, health benefits may no longer exist. This is considered a qualifying life event that allows for new plan choice and enrollment outside the usual time period.


Unique Qualifying Life Events


The designation of a qualifying life event is rather flexible so people do not have to go without health insurance for long if things change considerably. Other possibilities include income changes, achieving citizenship, getting out of prison or jail, and coming back from overseas temporary work or volunteer services. 


The system’s goals are to keep as many people covered by health insurance is possible at all times. If one or more of these situations affects a person’s life, financial status, or residence, they still have the option to get coverage outside of the usual enrollment period.


While employees that work for your company may decide to make these decisions on their own, as a small business owner, you need to be aware of their needs and providing options that suit dynamic situations. Doing all the research on your own is cumbersome and time-consuming. Instead, opt for insurance consulting from experienced professionals who understand qualifying life events and the possibilities that exist to satisfy your employees’ need for proper health coverage.

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