Qualifying Event

What Does Qualifying Event Mean?

A qualifying event refers to a life change that impacts a person’s insurance coverage eligibility. Proof of this change allows the individual to enroll in insurance coverage that aligns with their new circumstances through government-sponsored insurance programs in the United States.

Insuranceopedia Explains Qualifying Event

Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), insurance coverage can be extended in certain situations, such as job termination, the birth of a child, marriage, or divorce. These events may otherwise render existing coverage inadequate or discontinued. For employees who lose their job, COBRA insurance lets them stay on their former employer’s group plan temporarily, though premiums are usually much higher since the employer no longer pays a share. However, reforms to social insurance under the Obama administration have changed these scenarios. Now, if a U.S. citizen experiences a qualifying event, they may apply for Special Enrollment to maintain continuous coverage. The Special Enrollment window typically lasts 60 days, so anyone going through a qualifying event should compare their health insurance options soon after the change happens.