Question: In final disclosure when purchasing plan, it states that I can’t change plans unless a life triggering event occurs. Does this mean I am wedded to this plan forever or just for the year. Also, what constitutes a “life triggering event”?
Answer: I believe you are referring to a “qualifying event”. Conception would be a “life triggering” event. Just kidding. There are certain qualifying events that must be met in order to be eligible for special enrollment (outside open enrollment) in Covered California. The length of the special enrollment window is 60 days after the qualifying event. If you do not meet one of these qualifying events, you must wait until the next open enrollment period. Here is a list of qualifying events that will trigger (there’s that word) a special enrollment.
- Lose Minimum Essential Coverage;
- Gain a dependent or become a dependent;
- Become a U.S. citizen, U.S. national or lawfully present
- Cancellation or lapse of coverage in a Covered California is unintentional, inadvertent, or erroneous as a result of an error, misrepresentation, or inaction of Covered California or Health and Human Services.
- Covered California substantially violated a material provision of its contract in relation to the enrollee.
- Become newly eligible or newly ineligible for advanced premium tax credit (subsidy) or has a change in eligibility
- Employer-sponsored plan will no longer be affordable or provide minimum value.
- A permanent move
- Recently released from incarceration.