Enrollment Periods & Qualifying Events

Learn about special enrollment periods, qualifying events,
and how GoHealth Marketplace can help you sell year-round

The Affordable Care Act does allow agents to sell major medical policies all year, but only under certain conditions. Here you can learn more about the designated enrollment period and the rules that affect agents selling policies though GoHealth Marketplace.

 

Enrollment Periods and Qualifying Events

Why can't I sell major medical year round?

You can sell major medical policies year round, but only under special circumstances. Under the rules of President Obama's Affordable Care Act, individuals can only purchase subsidy-eligible health insurance policies during the Major Medical Open Enrollment period.

Exceptions:

  • Qualifying Life Event
  • Medicaid
  • Children's Health Insurance Program (CHIP)

For 2014 policies, the Open Enrollment period ends on March 31, 2014. For 2015 policies, the Open Enrollment period begins on November 15, 2014 and ends on February 15, 2015.

What is the Special Enrollment Period and who can purchase plans during this time?

The Special Enrollment Period is the time outside of Open Enrollment that allows individuals and families facing special circumstances (Qualifying Life Events) to enroll in a Qualified Health Plan. Most eligible individuals have 60 days to enroll after their triggering event. If they do not enroll during that 60 day window, they must wait until the next Open Enrollment to purchase a policy.

What are considered Qualifying Life Events?

  • Marriage
  • Birth, adoption, or placement of a child in your household
  • Permanent relocation to an area offering different plan options
  • Loss of other health coverage (examples include: job loss, divorce, loss of Medicaid or CHIP eligibility, expiration of COBRA coverage, a health plan becomes decertified). Note: The following are not considered loss of coverage: voluntarily cancellation, termination of a health plan as a result of missing premium payments, or losing coverage that is not minimum essential coverage.
  • Change in income or household status that affects tax subsidy eligibility or cost-sharing reductions of a current Marketplace plan

Can I sell any other plans outside of Open Enrollment?

Yes, agents can still sell short-term medical, fixed indemnity/limited benefit, Medicare Advantage (only during the Annual Enrollment Period: October 15th - December 7th), and Medicare Supplement.

Learn more

To learn more about the new GoHealth Marketplace, access a free demo, or to request a quote please fill out the form below and a member of our Sales & Support Team will contact you with more information.

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