Loss of Coverage

Special Enrollment Period


– Termination of group coverage
– Reduction of hours to part time status
– Loss of employer contribution
– Cobra ending

You may qualify for a special enrollment period if you or anyone in your household lost qualified health coverage. You have 60 days from the date of your qualifying life event to enroll in coverage.


You may qualify for a Special Enrollment Period if you lose health coverage through your employer or the employer of a family member, including if:

  • Your employer stops offering coverage.
  • You leave a job where you had health coverage (even if you left your job by choice or were fired).
  • You have a reduction in work hours that causes you to lose your job-based plan.
  • Your job-based health plan is ending for the year and you choose not to renew it.
  • Your former employer stops contributing to your retirement coverage, requiring you to pay full cost.

Note: You DON’T qualify for a Special Enrollment Period if: 

  • You voluntarily drop your job-based coverage during your coverage year while still working for your employer. 
  • You lose your job-based coverage because you didn’t pay your premium. 


Some special rules apply if you’re losing COBRA continuation coverage. 

You DO qualify for a Special Enrollment Period if: 

  • Your COBRA coverage runs out.

Note: You DON’T qualify for a Special Enrollment Period if:

  • You cancel your COBRA before the term expires.
  • You lose your COBRA coverage because you didn’t pay your premiums.


You may qualify for a Special Enrollment Period if you lose qualifying health coverage you had through a parent, spouse, or other family member.

This might happen if:

  • You turn 26 (or the maximum dependent age allowed in your state) and can no longer be on a parent’s health plan.
  • You lose job-based health coverage through a family member’s employer because that family member loses health coverage or coverage for dependents.
  • You lose health coverage through a spouse due to a divorce or legal separation.
  • You lose health coverage due to the death of a family member.

Health Insurance Terms

Understanding Health Insurance Terms


Coinsurance is your share of the costs of a covered health care service calculated as a percent (for example, 20 percent) of the allowed amount for the service. You pay coinsurance plus any deductibles you still owe for a covered health service.


A premium is the amount of money charged by an insurance company for coverage. The cost of premiums may be determined by several factors, including age, geographic area, tobacco use and number of dependents.

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