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options for enrollment

During the annual open enrollment period (starts November 1), you may change your benefit plan or sign up for health care coverage. 

Outside of this open enrollment period, you can enroll or change your coverage only if you have experienced a qualifying life event (QLE). This special enrollment period lasts 60 days after the qualifying life event occurs.

To enroll during special enrollment: Get a Quote from WHA or Shop Covered CA

 


Applicable qualifying life event:

You lose your Minimum Essential Coverage under an employer health benefit plan as a result of

  • Termination of employment

  • Change in employment status

  • Termination of the other plan’s coverage

  • The death of or divorce or legal separation from the person through whom you were covered as a dependent

  • Exhaustion of COBRA continuation coverage

  • You turn 26 years old and are no longer eligible for a parent’s plan

  • Your individual plan, Medicare, Medi-Cal, or other government-sponsored coverage ends.

  • You are a member of the United States military returning from active duty or a member of the California National Guard returning from active duty service under Title 32 of the United States Code.

A court has ordered coverage for your spouse or minor child.

  • You moved outside the service area of your existing carrier

  • You gained access to new health benefit plans as a result of a permanent move

  • You were released from incarceration

You or your eligible dependent are an Indian, as defined in Section 4(d) of the Indian Self-Determination and Education Assistance Act (Pub.L. 93-638), and have not changed health plans in the last month (Indians may change plans monthly).

You demonstrate to Covered California, with respect to health benefit plans offered through Covered California, that you or your eligible dependent did not enroll in a health benefit plan during the last available Open Enrollment Period because you were misinformed that you were covered under Minimum Essential Coverage.

You are receiving services under Continuity of Care and the provider of those services is terminated from or otherwise ceases participation in your health plan.

You gained citizenship, became a national or otherwise became lawfully present.

You are newly eligible or ineligible for Advance Payments of Premium Tax Credit under federal law, or are newly eligible or ineligible for cost sharing reduction as determined by Covered California.


Note: Allows special enrollment only to Covered California plans.

You qualify for an exceptional circumstance as established by Covered California. Your non-enrollment, or the non-enrollment of your eligible dependent is unintentional, inadvertent, or erroneous and is the result of the error, misrepresentation, or inaction of Covered California or the California Health and Human Services Agency as determined by Covered California. Note: Allows special enrollment only to Covered California plans.

A child is born, adopted or received into foster care. The entire family can use the special enrollment period to enroll in coverage.

For additional information concerning covered benefits for a dependent parent or stepparent who is eligible for or enrolled in Medicare, contact the Health Insurance Counseling and Advocacy Program (HICAP) or your agent. HICAP provides health insurance counseling for California senior citizens. Call the HICAP toll-free telephone number, 1.800.434.0222, for a referral to your local HICAP office. HICAP is a service provided free of charge by the State of California.

You and your legal spouse or adult registered domestic partner can use the special enrollment period to enroll in coverage.

 

Enroll today during this special enrollment period: Get a Quote from WHA or Shop Covered CA
 

Please note: The effective date of coverage for late enrollment under this section will be determined by in accordance with state and federal law. If any of the information presented here differs from the Evidence of Coverage/Disclosure Form (EOC/DF), the EOC/DF determines eligibility for enrollment.

Individual Advantage EOC/DF (plans purchased direct with WHA)

Covered California Individual EOC/DF (plans purchased through Covered California)

 


For additional information concerning covered benefits for a dependent parent or stepparent who is eligible for or enrolled in Medicare, contact the Health Insurance Counseling and Advocacy Program (HICAP) or your agent. HICAP provides health insurance counseling for California senior citizens. Call the HICAP toll-free telephone number, 1.800.434.0222, for a referral to your local HICAP office, or see the listing provided below. HICAP is a service provided free of charge by the State of California.

*El Dorado, Placer, Sacramento, and Yolo Counties *
Address: 505 12th Street, Sacramento, CA 95814
Telephone: 916.376.8915 (Monday – Friday: 9 a.m. – 4 p.m.)

*Marin, Napa, Solano, and Sonoma Counties *
Address: 1129 Industrial Ave, Suite 201, Petaluma, CA 94954
Telephone: 707.526.4108 (Monday – Friday: 9 a.m. – 3 p.m.)