What is a special enrollment opportunity?
Special enrollment allows individuals who previously declined health coverage to enroll for coverage. Special enrollment rights arise regardless of a plan’s open enrollment period. There are two types of special enrollment – upon loss of eligibility for other coverage and upon certain life events. Under the first, employees and dependents who decline coverage due to other health coverage and then lose eligibility or lose employer contributions have special enrollment rights. For instance, an employee turns down health benefits for herself and her family because the family already has coverage through her spouse’s plan. Coverage under the spouse’s plan ceases. That employee then can request enrollment in her own company’s plan for herself and her dependents. Under the second, employees, spouses, and new dependents are permitted to special enroll because of marriage, birth, adoption, or placement for adoption. For both types, the employee must request enrollment within 30 days of the los
