Special Enrollment Events

Your situation: You added a dependent to your household. Qualifying events include birth, adoption, placement for adoption, placement in foster care or through a child support order or court order.

Apply no later than: 60 days since the dependent was added to your family.

Coverage starts: The day of the event or the first day of the month following the event. *
Note: (With regard to a child support order or other court order). The Marketplace allows a Qualified Individual/Enrollee to elect a coverage effective date pursuant to the 15th of the month rules.

Your situation: You added a dependent, such as your spouse, or became a dependent on someone else's plan.

Apply no later than: 30 days since the marriage.

Coverage starts: 1st day of the following month.

Your situation: Your income level is at or below 150% of the Federal Poverty Level and you qualify for an Advanced Premium Tax Credit (APTC) through the Health Insurance Marketplace.

Application Dates: From March 18, 2023, through December 31, 2023, you may sign up for new coverage that you already purchased on the Marketplace once a month, however you may be subject to certain plan category limitations.

Coverage starts: The coverage effective date will be determined by Health Insurance Marketplace, but will generally be effective on the first day of the month following plan selection.

Notes: A current member who is adding a dependent through this SEP may add the new dependent to their current plan or change to a silver plan. Existing enrollees may not use the monthly SEP to select a different plan of a metal level other than silver.

The Exchange will verify applicants projected annual household income.

Your situation: Your change in income, household or other status affects your eligibility for cost savings. This includes Advanced Premium Tax Credits (APTCs) and Cost-Sharing Reductions (CSRs). Changes in APTC amount do not apply. Must currently be enrolled in a qualified health plan.

Apply no later than: 60 days since your income changed.

Coverage starts: If the plan selection is between the 1st and the 15th of the month, your coveragewill start as soon as the 1st day of the following month. If the plan selection is between the 16th and the end of the month, your coverage will start the 1st day of the second month.*

This may qualify as an SEP through the Marketplace.

Your situation: Your former employer provided you with coverage. You no longer work at the company that provided your plan. Or, your company's plan covered you, but you had your hours reduced. As a result, you are no longer eligible for coverage.

Apply no later than: 30 days before or after you lose coverage.

Coverage starts: First day of the following month.*

Your situation: Your spouse's former employer provided you with coverage, but he or she no longer works at the company or had their hours reduced. As a result, you are no longer eligible for coverage.

Apply no later than: 30 days before or after you lose coverage.

Coverage starts: First day of the following month.*

Your situation: Your spouse's employer provided you with coverage. He or she has switched to a Medicare plan.

Apply no later than: 60 days before or after you lose coverage.

Coverage starts: First day of the following month.*

Your situation: You recently moved to Wyoming and lost the coverage previously available to you.

Apply no later than: 30 days before or after you lose coverage.

Coverage starts: If applying on the Marketplace and your application is received….(use language below). If applying directly with BCBSWY, coverage starts first day of the following month.*

Your situation: Loss of coverage can happen for a number of reasons. You may lose job-based health coverage, either your own or as a result of a death or divorce. You may age out of a parent's plan at age 26. Or you could become ineligible for Medicaid or CHIP. These reasons and others like it could qualify you for a special enrollment period.

Apply no later than: 30 days before or after you lose coverage.

Note: When you lose Medicaid or CHIP coverage you have 60 days to apply.

Coverage starts: First of the month following receipt of the application.

Note: You are not eligible for an SEP if you voluntarily drop a job-based plan without leaving your job, an individual insurance plan, unexpired COBRA coverage, or any plan that dosn't qualify as minimum essential coverage. Additionally, you are not eligible if you lose coverage for nonpayment of premiums.

Your situation: Your health insurance policy that covered minimum essential health benefits expired outside of the standard January - December calendar year.

Apply no later than: 60 days before or after you lose coverage.

Coverage starts: First day of the following month if you apply for a product through Highmark.*

Your situation: Your spouse provided you with coverage. You legally separated or divorced, or your spouse died. As a result, you are no longer eligible for coverage. This may also pertain to you if you are no longer eligible to be on your parent's plan.

Apply no later than: 30 days before or after you lose coverage.

Coverage starts: First of the month following receipt of the application.*

Note: This is an extremely rare situation. Immediately contact your health insurance provider or the Health Insurance Marketplace.

Your situation: You did not register during open enrollment due to a factor outside of your control. This is called an "Exceptional Circumstance." One potential example of an "Exceptional Circumstance" is that you were in the hospital long-term during the open enrollment period. Another example would be if your region was a state-or federally-declared disaster region. These are two of many example situations.

Whether you can reapply (or apply) is determined by the Health Insurance Marketplace. Also, this only pertains to plans purchased through the Health Insurance Marketplace.

Coverage starts: Coverage effective date will be determined by the Health Insurance Marketplace.

Note: This is an extremely rare situation. If you think there was a problem with your enrollment, immediately contact your health insurance provider or the Health Insurance Marketplace.

Your situation: There was a problem when you signed up for-or tried to sign up for-a plan.

Whether you can reapply (or apply) is determined by the Health Insurance Marketplace.

Coverage starts: Coverage effective date will be determined by the Health Insurance Marketplace.

Note: This is an extremely rare situation. If you think there is an error in your coverage, immediately contact your health insurance provider or the Health Insurance Marketplace.

Your situation: You think there is an inconsistency between the coverage you purchased and the way that your insurance plan is administered.

Whether you can reapply is determined by the Health Insurance Marketplace.

Coverage starts: Coverage effective date will be determined by the Health Insurance Marketplace.

Your situation: You are an American Indian or Alaska Native. You are part of a federally-recognized tribe. You may sign up for new coverage on the Health Insurance Marketplace at any time.

You can also change the coverage that you already purchased on the Marketplace. You can do this once a month.

Please note: all other Special Enrollment Period situations apply to American Indians and Alaska Natives.

Coverage starts: Based on applicable laws defined by the Health Insurance Marketplace.

Your situation: You became a U.S. citizen, national or lawfully present. This change allows you to sign up for new coverage on the Health Insurance Marketplace.

Apply no later than: 60 days since your immigration status changed.

Coverage starts: Based on applicable laws defined by the Health Insurance Marketplace.