Below are some of the fine details as to what is required if you are trying to enroll outside of Open Enrollment and trying to use LOSS OF COVERAGE to stimulate a Special Enrollment.

• Annual Renewal occurs outside of Open Enrollment; provide a copy of the renewal letter from existing/prior Insurance Company.
• Divorce or legal separation results in you losing coverage under your spouse’s health insurance; provide a copy of the certificate of creditable coverage OR a copy of the termination letter from existing/prior Insurance Company. 
• Employer reduces your hours, leaving you without coverage; provide a letter from your employer on Company letterhead and signed by an officer/owner of the Company.
• Employer sponsored and/or Group coverage terminates due to non-payment of premium; provide a copy of certificate of creditable coverage OR a copy of the termination letter from existing/prior Insurance Company.
• Exhaustion of COBRA; provide a copy of certificate of creditable coverage OR a copy of the termination letter from existing/prior Insurance Company.
• No longer meets definition of dependent due to age; provide a copy of certificate of creditable coverage OR a copy of the termination letter from existing/prior Insurance Company.
• Non-payment of premium, misrepresentation or fraud; provide a copy of reinstatement denial letter OR copy of rescission letter from existing/prior Insurance Company.
• Short Term Medical Plan is exhausted; provide a copy of termination letter from existing/prior Insurance Company.

Don’t Qualify for Special Enrollment? Buy Short Term Medical Coverage.

• Spouse’s death leaves you without coverage under his/her plan; provide a copy of certificate of creditable coverage OR a copy of the termination letter from existing/prior Insurance Company.
• Spouse’s employment ends as well as coverage under his/her employer’s plan for you and/or your dependents’; provide a copy of certificate of creditable coverage OR a copy of the termination letter from existing/prior Insurance Company.
• Termination of employer contributions; provide a letter from your employer on Company letterhead and signed by an officer/owner of the Company.
• You and/or your dependents’ have a health claim that would meet or exceed the plan’s lifetime limit on all benefits; provide a copy of Explanation of Benefits from existing/prior Insurance Company indicating that all lifetime limit on all benefits have been met or exceeded.
• You and/or your dependents permanently move to another state and/or no longer live or work in the existing/prior plan’s service area.  Please provide the following:  1-Your prior residential address; 2–Proof of your current residential address by providing ONE of the following:  Mortgage Bill / Renter’s Agreement with new residential address, Driver’s License with new residential address OR Utility Bill with new residential address 3– AND A copy of certificate of creditable coverage OR termination letter from existing/prior Insurance Company to validate the loss of coverage due to the Relocation.
• You and/or your dependents are no longer eligible for eligible for CHIP (Children’s Health Insurance Program), Medicaid, PCIP (Federal Pre-Existing Condition Insurance Plan) or State High Risk Pool; provide a copy of certificate of creditable coverage OR a copy of the termination letter from existing/prior Insurance Company and/or federal or state agency.
• Your employer decides it will no longer offer coverage to a certain group of individuals (for example, those who work part time); provide a letter from your employer on Company letterhead and signed by an officer/owner of the Company.
• Your employment ends as well as coverage under your employer’s plan for you and/or your dependents’; provide a copy of certificate of creditable coverage OR a copy of the termination letter from existing/prior Insurance Company