Open enrollment periods are special times of the year when you can change or adjust your health insurance policy. And the enrollment deadlines vary based on the type of health insurance being purchased — like employer-sponsored plans, individual health plans, and Medicare. But what happens with a missed enrollment deadline? Let’s find out.
Missing an Open Enrollment Period
An open enrollment period is the only time of the year you can update or change your health insurance policy. They typically last for about two months, and it’s crucial to understand when your open enrollment period is because it can vary depending on whether you have employer-sponsored insurance, individual insurance, or Medicare.
If time gets away from you and you end up with a missed enrollment deadline, it can cause some issues. In most cases, enrollment may not be available again until the next open enrollment period. Basically, you’re stuck with the plan you have.
However, there are special instances when you can switch insurance plans between open enrollments, even with a missed enrollment deadline. They’re called Qualifying Life Events (QLEs) and Special Enrollment Periods (SEPs).
Examples of Qualifying Life Events
A qualifying life event (QLE) is a special circumstance that allows you to change your insurance coverage between open enrollment periods. Here are some of the most common QLEs:
- Loss of health coverage
- Birth of a child
- Marriage or divorce
- Change in residence
Each qualifying life event has its own deadline to apply for new coverage. For example, a loss of employer-sponsored health insurance allows enrollment before the end of the month to secure coverage effective the first day of the following month. Childbirth rules are often different, requiring action within a specific timeframe while providing coverage retroactive to the child’s birth date.
Each life event has unique rules, timelines, and documentation requirements, which is why it’s important to do your research and work with a knowledgeable, local broker.
Special Enrollment Periods and Common Deadlines
Following a qualifying life event, you enter into a special enrollment period. Many SEPs last up to 60 days, though timelines can vary depending on the life event and the carrier. Typically, applications are due by the last day of the month before the desired effective date. For example, if your qualifying life event happens on June 5th, you must apply for new coverage before June 30th to ensure coverage on the July 1st.
Missed enrollment deadlines don’t necessarily mean a denial of coverage and instead may result in coverage being delayed until the following month. Check with your carrier for full details.
What to Do with a Missed Enrollment Deadline
A missed enrollment deadline doesn’t always mean your coverage options are exhausted until next year. Employer-sponsored plans may occasionally allow late enrollment exceptions based on the employer, broker, and insurance carrier discretion. Exceptions are usually less common in the individual market; however, it’s not entirely unheard of.
If you do miss an enrollment deadline, the first thing you should do is contact your insurance company, broker, or plan administrator to determine whether any exceptions or alternative enrollment opportunities exist. Acting quickly after discovering a missed enrollment deadline can improve your chances of finding a solution.
If you have any questions about enrollment deadlines or alternate insurance options, contact us at Health Benefits Associates. Our team of local agents will walk you through the options to find a plan that works best for your unique needs. Schedule an appointment by calling 775-828-1216 today.
