What is a QLE?

A qualifying life event is a big, life-changing situation – sometimes planned, sometimes unexpected – that can impact you and your health insurance. Experiencing a significant life change can make you eligible for a Special Enrollment Period, which will allow you to change your health plan outside of the annual Open Enrollment Period.

A Special Enrollment Period (SEP), under the Affordable Care Act (ACA), is a set period in which you would be allowed to enroll in or change your health insurance coverage. If you are approved for an SEP, your policy will begin when you have picked a plan, but you will not be able to use the insurance until your eligibility has been confirmed and the initial premium has been paid. If you are not approved for an SEP, then the policy will be canceled, or you will need to provide additional documents supporting the qualifying event.

Qualifying life events include, but are not necessarily limited to:

  1. Initial opportunity to enroll. Your initial Opportunity to Enroll qualifies when you have met the new hire waiting period of your employer.
  2. Part Time to Full Time. When you move from Part Time to Full Time you are now eligible for benefits after you have met the waiting period set by your employer.
  3. After your child is born you have 30 days from the DATE of BIRTH to notify Resourcing Edge with your enrollment complete. The coverage would be retroactive to date of birth, premium would apply as well.
  4. Legal Adoption. After the date of the adoption, you will have 30 days to notify Resourcing Edge with your enrollment complete.
  5. Marriage. You will have 30 days from the date of Marriage to notify Resourcing Edge with your enrollment complete.
  6. Divorce. You will have 30 days from the date of the final Divorce Decree to notify Resourcing Edge with your enrollment complete.
  7. Geographical employment changes. You will have 30 days from the date of the event to notify Resourcing Edge with your enrollment complete.
  8. Loss or Gain of other coverage. You will have 30 days from the date of Loss or Gain of other coverage to notify Resourcing Edge with your enrollment complete.
  9. Restoration to civilian position after serving in uniformed services. You have 30 days from the return to your Civilian Position to notify Resourcing Edge with your enrollment complete.
  10. Death. You have 30 days from the date of death to notify Resourcing Edge with the passing of your family member.

*Other QLEs include Turning 26, Turning 65, and/or Earning U.S. Citizenship.

Our Advice

If you experience a qualifying life event, sign up right away. You will most often have 30 days from the date of the event to notify Resourcing Edge with your enrollment complete. Missing this deadline could mean having to wait until the next open enrollment, which could be as long as a year.

Resourcing Edge exists to assist. Please contact your REI Client Account Manager if you have recently experienced a qualifying life event and need support, or if you have any additional questions or would like additional information.

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