It refers to the life-changing event in the employee’s life circumstances that forces them to enrol in health insurance outside the open general enrollment period. Events like getting married, having a baby, or losing coverage of health insurance are some of the general circumstances that fall under such a category. Here is a list of factors that QLE coverage includes:
Health coverage: loss of health coverage, including individual and student plans and job-based plans, or loss of eligibility for Medicare or CHIP.
Residence: Relocating across ZIP code or county lines, students transitioning between their home and school locations, seasonal workers migrating for temporary employment opportunities, or individuals moving into or out of shelters and other temporary or transitional housing arrangements.
Household: practices like getting married, divorced, having a baby or adopting a child come under such circumstances.
Other qualifying events: changes in the income that are affecting the coverage or gaining membership in a federally recognised tribe.
