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Small Business Employee Benefits and HR Blog

ACA Special Enrollment Periods [Chart]

The following ACA special enrollment periods chart outlines how long the enrollment period is after different qualifying events.special_enrollment_periods_chart

As of 2014, consumers can only enroll in guaranteed-issue individual health insurance during specific open enrollment periods and special enrollment periods. This includes qualified health plans (QHPs) bought through the health insurance marketplaces ("On-Exchange") and outside the marketplace ("Off-Exchange").

A qualifying event makes you eligible for a special enrollment period. If you have a qualifying event you can enroll in individual health insurance outside of the annual open enrollment period for a period of time as listed below.

Chart of ACA Special Enrollment Periods

Qualifying Event
Enrollment Period
Applicable to both Marketplace and Non-Marketplace (On and Off-Exchange) Policies
Gaining/losing a dependent through birth/adoption/foster care/placement for adoption
60 days after the event
Gaining a dependent through marriage
60 days after the event
Loss of eligible coverage from legal seperation/divorce, cessation of dependent status (aging out), death, or termination or reduction of working hours with employer
60 days after the event
Loss of coverage through an HMO due to relocation to a new service area.
60 days after the event
Incurs claim that meets or exceeds lifetime limits on all benefits
60 days after the event
COBRA coverage ends
60 days after the event
Employer ceases contributions either to subscriber or dependents
60 days after the event
Permanent move (to a region where new plans are available)
60 days after the event
Newly eligible/ineligible for advanced payments of tax credits or change in eligibility from cost-sharing reductions
60 days after the event
Qualified Health Plan (QHP) substantially violates a material provision of its contract
60 days after the event
Enrollment in QHP is made in error
60 days after the event
Loss of Minimum Essential Health Coverage (Not including loss of coverage because of failure to make premium payment)
60 days before and after the event
Applicable to Non-Marketplace (Off-Exchange) Policies Only
Enrollment in non-calendar year policy ends
30 days prior to the end of the policy
Applicable to Marketplace (On-Exchange) Policies Only
Native American status
60 days after the event
Attaining citizenship
60 days after the event
Demonstration of exceptional circumstances, as determined by the Exchange
60 days after the event

Read more about the ACA special enrollment periods and qualifing life events:

 

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