When I've explained to people that under the Affordable Care Act there will be ONE annual enrollment period for buying
or changing individual health insurance, many think that the rest of the year I'll be
sitting with my feet propped up on the desk popping bon-bons.
Uh, no. Even if I were so inclined, that's not gonna happen! I will be busy helping people get health insurance all year round because of a phenomenon known as Life Happens. And when "life happens," it often creates eligibility for what's called a Special Enrollment Period, or SEP.
The official ACA term for Life Happens is "qualifying life events."
There are all sort of reasons why people, through no fault of their own,
lose their health insurance and qualify for an SEP. (Warning: Non-payment of your health insurance premiums - for whatever reason - does NOT count!)
Here are some examples of qualifying life events that would cause an individual to be eligible for an SEP and would precipitate the need for new health insurance:
Loss of employer coverage
Loss of dependent status
Divorce from or death of policyholder
Loss of Medicaid or CHIP
Birth or adoption
Addition of new dependent as a result of marriage
Loss of eligibility for health insurance exchange subsidies
Renewal of a pre-ACA plan during 2014
Existing policy no longer provides Essential Minimum Coverage
Permanent move to a new area that offers different plan options
COBRA Expiration
Return from active military service
Release from Incarceration
Coverage directed by Court Order or resulting from Chapter 11 filing
For almost all of these life events, the insured must apply for the new
coverage within 60 days. I'm sure there will be lots of fine-tuning to
this list so it's in no way intended to be comprehensive.
But I think it does give you an idea of why I will not have a lot of "down" time even after the annual enrollment period ends!