Washington Open Enrollment Notice for Non-Grandfathered Individual Medical Plans

On June 10, 2015 Assurant Health’s parent company, Assurant, Inc. announced its exit from the health insurance marketplace. Assurant Health
will not participate in or offer products during the next open enrollment period. Please consult your agent for assistance with plan selection for
coverage in 2016.

 

Special Enrollment

A special enrollment period of 60 days is available to any individual that experiences a qualifying event. Beginning on the date of the qualifying event, the individual will have 60 days to apply for new coverage.

A "qualifying event" means the occurrence of one of the following:
  • The loss of minimum essential coverage, including employer sponsored insurance coverage of a person (for any reason) or the loss of the individual or group coverage of the person under whose policy a person was enrolled, unless the loss of coverage is based on the individual's misrepresentation of a material fact affecting coverage or a result of fraud related to the coverage.
  • The loss of eligibility for Medicaid, or a public program providing health benefits.
  • The loss of coverage as the result of dissolution of marriage or termination of a domestic partnership.
  • A permanent change in residence, work, or living situation (whether or not within the choice of the individual) where the health plan does not provide coverage in that person's new Service Area.
  • The birth, placement for adoption, or adoption of the person for whom coverage is sought.
  • A situation in which a plan no longer offers any benefits to the class of similarly situated individuals that includes the individual.
  • The coverage is discontinued in a qualified health plan (QHP) by the Washington Health Benefit Exchange (HBE), and the 3 month grace period for continuation of coverage has expired.
  • The exhaustion of COBRA coverage due to failure of the employer to remit premium.
  • The loss of COBRA coverage when the individual has exceeded the lifetime limit in the plan, and no other COBRA coverage is available.
  • The person's discontinuance of coverage under a health plan offered pursuant to the Washington State Health Insurance Coverage Access Act.
  • The loss of coverage as a dependent on a group plan due to age.
  • Marriage or entering into a domestic partnership, including eligibility as a dependent of an individual marrying or entering into a domestic partnership.
  • An otherwise eligible individual was unable to gain, or maintain coverage, in a QHP or a qualified dental plan (QDP) offered through the HBE due to an error, misrepresentation, or inaction of the HBE or of the Department of Health and Human Services (HHS).