As life changes, we sometimes change our minds about important decisions. What once didn’t seem important might suddenly become crucial. Or, as we experience life changes, we need to alter our paths to adjust to new situations.
This is certainly true regarding your enrollment in group benefits such as health insurance. If you decline to enroll in your employer’s plan, or need to change your plan at some point, you might wonder whether you can take this action outside of the Open Enrollment period.
The answer is yes, provided you experience one of these qualifying events:
- You move to a new geographic area
- You lose your existing health insurance coverage for any reason
- You become newly eligible or ineligible for tax credits or cost-sharing reductions
- You add a new child to the family through birth, adoption, or foster care
- You get married or enter into a domestic partnership
- You experience a divorce or spousal separation
- You experience domestic abuse or spousal abandonment
- You turn 26 years old and must exit your parents’ health insurance plan
- You are affected by wildfires
- You experience a change in household size
- You experience job loss or income changes due to Covid-19
- You are released from jail or prison
One common scenario is that a worker declines group health insurance coverage because they are already covered under a spouse’s plan. In the event that the covered spouse loses their plan for any reason, the whole family can enroll in the other spouse’s group plan outside of the usual enrollment period.
If you have questions about your specific group plan, contact your employer’s human resource department. If you are an employer with questions about your plan or if you wish to investigate options for a new program, contact our office for personal assistance.