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Qualifying Life Event Guidelines

Qualifying Life Event

Effective Date
of Coverage

Special Enrollment
Period

Example

Birth
(Not limited to child only)

Date of birth

Up to 60 days after the event

Your child is born on May 1. You have until June 29 to apply for an effective date of May 1.

Adoption/Foster Care*
(Not limited to child only)

Date of adoption or placement

Up to 60 days after the event

Your child is placed with family on May 1. You have until June 29 to apply for an effective date of May 1.

Loss of Coverage**

  • Losing coverage through your job
  • Legally separated or divorced from your spouse
  • COBRA expiration
  • Losing eligibility for Medicaid or CHIP

If the loss of coverage is in the future: the first (1st) of the month following the loss of coverage.

If the loss of coverage is in the past: the first (1st) of the month following the date the application was submitted.

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

You will be losing health care coverage through your job on May 1 (future date). You may apply for coverage anytime between March 3 and June 29.

  • If you apply between March 3 and April 30, your coverage will be effective on May 1.
  • If you apply between May 1 and May 31, your coverage will be effective on June 1.
  • If you apply between June 1 and June 29, your coverage will be effective on July 1.

Moved into the Insurer’s
Coverage Area

If within the first 15 days of the month: the first (1st) of the following month after the application has been submitted.

On or after the 16th of the month: the first (1st) of the second month following the submission of the application.

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

You are moving into the Independence Blue Cross coverage area effective May 1. You may apply for coverage anytime between April 2 and June 29.

  • If you apply between April 2 and April 15, your coverage will be effective on May 1.
  • If you apply between April 16 and May 15, your coverage will be effective on June 1.
  • If you apply between May 16 and June 15, your coverage will be effective on July 1.
  • If you apply between June 16 and June 29, your coverage will be effective August 1.

Marriage

If within the first 15 days of the month: the first (1st) of the following month after the application has been submitted.

On or after the 16th of the month: the first (1st) of the second month following the submission of the application.

Up to 60 days after the event

You are getting married on May 1. You may apply for coverage anytime between May 1 and June 29.

  • If you apply between May 1 and May 15, your coverage will be effective June 1.
  • If you apply between May 16 and June 15, your coverage will be effective July 1.
  • If you apply between June 16 and June 29, your coverage will be effective August 1.

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* This is the date the adopting parents receive the adoptee, regardless of whether papers were filed.

** If the loss of coverage is due to a Qualified Health Plan decertification, the life event is the official notice of decertification. In all other cases, it is the date the individual loses eligibility for Affordable Care Act compliant plan.