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To determine your effective date, please complete the information below.
Learn more about Special Enrollment Periods.
Existing members please note: Due to new regulations, you may not be able to switch the type of plan or Metal Level
(i.e. from Gold to Bronze) during a Special Enrollment Period (SEP).
Qualifying Event | Additional Documentation That May be Required |
---|---|
Birth or Adoption of Child | Copy of adoption papers or copy of birth certificate. |
Loss of Coverage | Copy of certificate of creditable coverage or copy of termination letter from existing / prior insurance company. |
Marriage (Includes civil union and / or domestic partner) |
Copy of signed marriage certificate, civil union certificate or domestic partner affidavit. and proof that at least one spouse had Minimum Essential Coverage for at least 1 day within 60 days prior to marriage (see loss of coverage documentation requirements) or if moving from outside the United States a Visa to prove Marriage. |
Permanent Move |
Consumer’s prior residential address and proof of current residential address by providing one of the following:
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