Covered California Special Enrollment Instructions for 2016

Covered California has released instructions for navigating the Special Enrollment Periods consumers are eligible for when they have a qualifying event. It’s important that the online application be filled out a certain way for different qualifying events.

Consumers who experience a Qualifying Life Event can enroll in a Covered California health insurance plan up to 60 days from the date of the event. This is called a Special Enrollment.

http://www.coveredca.com/individuals-and-families/getting-covered/special-enrollment/

Certified Enrollers (Agents and Counselors) may assist all consumers eligible for a Special Enrollment. During this period, Certified Enrollers processing applications on behalf of a consumer will no longer have the ability to complete new or in progress applications without a Qualifying Life Event. New fields are displayed on the Application Signature Page that will require entry of a consumer’s Qualifying Life Event.

If applicable, consumers may choose from the following Qualifying Life Events. Eligibility and coverage start dates are determined by the type and date of the Qualifying Life Event.

http://www.coveredca.com/individuals-and-families/getting-covered/special-enrollment/qualifying-life-events/

Consumers may also select “Other Qualifying Life Event”

• This selection should be used if the consumer’s life event is not listed, uncertain, or an exceptional circumstance and may require Covered California review of the application to approve the Special Enrollment. Consumers may also select “None of The Above (continue to review my application for Medi-Cal)”
• Special Enrollment does not apply to Medi-Cal applicants. These consumers can apply for coverage anytime during the year and do not need a Qualifying Life Event to gain coverage. The consumer’s Qualifying Life Event date must be within 60 days to qualify for Special Enrollment. If the life event date is more than 60 days in the past, the consumer will not qualify for Special Enrollment.

2016 Special Enrollment Period Job Aid

This document goes over step-by-step how to fill in the fields to validate a qualifying event for a Special Enrollment Period approval. Even if the application is perfectly filled out, after submission the Covered California enrollment portal may still not allow the consumer to select a health plan. Covered California must be called, have the qualifying event explained to them, and then they will flip the switch for a health plan selection.