Health First Individual Special Enrollment Periods
Individual Plans (2014)

Special Enrollment Periods (SEPs)

Open Enrollment for 2014 coverage ended on March 31. After Open Enrollment, you can enroll in Individual coverage only if you have a qualifying life event or a complex situation related to applying for insurance during Open Enrollment.

SEP Event When can I enroll? When does my coverage begin?

Loss of coverage (Some examples include losing job-based coverage, divorce, receiving a renewal for a non-ACA compliant plan, COBRA expiration, aging off a parent’s plan, or losing eligibility for Medicaid or CHIP.)

Up to 60 days before and up to 60 days after the event

If you’ve already lost coverage, your new plan will begin on the first day of the month after you enroll. If you will be losing coverage, your new plan begins on the first day of the month after your old plan ends.

Marriage

Denial of Medicaid or CHIP

Up to 60 days after the event

Your new plan will begin on the first day of the month after you enroll.

Birth, adoption, foster care

Up to 60 days after the event

Coverage begins on the child’s date of birth, adoption, placement for adoption, or placement in foster care.

Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions (for people already enrolled in Marketplace coverage)

Up to 60 days after the event

If you enroll within first 15 days of the month, your coverage begins on the first day of the month after you enroll.
—or
If you enroll on or after the 16th day of the month, your coverage begins on the first day of the next month after you enroll.

Moving outside of your insurer’s coverage area

Gaining citizenship or lawfully present status

Gaining status as a member of a federally recognized Indian tribe

Up to 60 days after the event

If you enroll within first 15 days of the month, your coverage begins on the first day of the month after you enroll.
—or
If you enroll on or after the 16th day of the month, your coverage begins on the first day of the next month after you enroll.

Errors related to the Exchange/ Marketplace, incorrect or incomplete information provided by an enrollment assister (Navigator, broker or sales agent, insurance company, etc.), or other problems related to your enrollment process

Exceptional circumstances (for example if you faced a serious medical condition, natural disaster, or other crisis that kept you from enrolling)

Determined by the US Department of Health & Human Services (HHS)

Depending on your situation, coverage may begin on the date of the triggering event.
—or
If you enroll within first 15 days of the month, your coverage begins on the first day of the month after you enroll.
—or
If you enroll on or after the 16th day of the month, your coverage begins on the first day of the next month after you enroll.

Incarceration release

Up to 60 days after the event

If you enroll within first 15 days of the month, your coverage begins on the first day of the month after you enroll.
—or
If you enroll on or after the 16th day of the month, your coverage begins on the first day of the next month after you enroll.

 

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Health First Individual health insurance policies are underwritten by Health First Insurance, Inc. Applications are subject to eligibility requirements. Exclusions and limitations may apply. Health First Insurance has entered into an agreement with CMS to provide health insurance coverage through Qualified Health Plans on the Federally Facilitated Marketplace. For more information, contact your agent or your local Health First Insurance office. Health First Insurance does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.