Health Insurance Solutions

What is a Qualifying Life Event (QLE)
that would make you eligible for a Special Enrollment Period (SEP)?


Under the Affordable Care Act, individual health insurance can normally be purchased or modified once a year, during the Annual Enrollment Period. However, there are certain circumstances (called Qualifying Life Events) that make an individual or family eligible to change or purchase an insurance policy. Among the most common QLEs are:
  • Getting married
  • Having a baby
  • Adopting a child or placing a child for adoption or foster care
  • Losing other health coverage (through death, divorce, a move or job loss – non-payment of premiums does not count)
  • Permanently moving outside your plan’s coverage area
  • Gaining citizenship or lawful presence in the U.S.
  • Gaining or continuing status as a member of an Indian tribe or an Alaska Native shareholder.
  • Leaving incarceration
  • For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions

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