Change in Household Size

21
Feb

Special Enrollment Period

CHANGE IN HOUSEHOLD SIZE

You may qualify for a special enrollment period if you have had a change in your household size due to a marital status change, dependent status change or death of family member. You have 60 days from the date of your qualifying life event to enroll in coverage.

marriage

MARITAL STATUS CHANGE

DUE TO:
– Marriage
– Divorce
– Legal separation

REQUIRED PROOF:

• Marriage certificate showing the date of the marriage
• Marriage license showing the date of the marriage
• An official public record of the marriage, including a foreign record of marriage
• Affidavit or statement signed by the person who officiated the marriage
• Affidavit or statement signed by a person who was an official witness to the marriage
• A religious document that recognizes the marriage
• Divorce/separation court documents
• Proof of current of coverage may also be required

status change

DEPENDENT STATUS CHANGE

DUE TO:
– Birth of a child
– Adoption
– Aged out of dependent status

REQUIRED PROOF:

If you had a child:
• Medical record from a clinic, hospital, physician, midwife, institution, or other medical provider showing the date of birth
• Letter from hospital, clinic, physician, or other medical provider attesting the date of birth
• Letter or other document from the health insurance company, like an Explanation of Benefits, showing that services related to birth or post-birth care were provided to either the child or the mother, including the dates of service
• Birth certificate or application for a birth certificate for the child
• Application for a Social Security Number (SSN) for the child
• A foreign birth record showing the child’s date and place of birth
• Military record showing the child’s date and place of birth
• Religious record showing the child’s date and place of birth
• Social Security card for the child

If you adopted a child:
• Adoption letter or record showing date of adoption dated and signed by a court official
• Government-issued or legal document showing the date that the child was placed in the home
• Government-issued or legal document showing the date legal guardianship was established
• Court order showing the effective date of the order
• U.S. Department of Homeland Security immigration document for foreign adoptions
• Medical support order
• Foster care papers dated and signed by a court official

death

DEATH

Losing a dependent or no longer being considered a dependent because enrollee or enrollee’s dependent passes away.

REQUIRED PROOF:

• Death Certificate
• Copy of termination letter from prior insurance company

Anytime that you enroll in a plan you will be asked to provide the following information:

1. What was your qualifying event?

2. What was the date of this event?

3. You’ll be asked to submit supporting documents.

 

 

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