Author Topic: What qualifies as voluntary loss of coverage for insurance purposes?  (Read 555 times)

Paul der Krake

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I'm considering going on my wife's company health plan.

The twist here is that her company uses the calendar year as their plan year, but mine does not. If I decline to enroll in my company's plan at the next enrollment, does that constitute a QLE (qualifying life event) that lets me enroll with her company's plan mid-year?

I found the following link that seems to make a distinction between voluntary and involuntary loss of coverage:
https://help.zenefits.com/Medical_Dental_Vision/Learn_About_Health_Insurance/Qualifying_Life_Events/03-Voluntary_vs_Involuntary_Loss_of_Coverage/

Has anyone done this?


ixtap

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Re: What qualifies as voluntary loss of coverage for insurance purposes?
« Reply #1 on: January 15, 2018, 05:00:09 PM »
For your wife's plan, your open enrollment does count as involuntary. It is clearly defined if you click through:

https://help.zenefits.com/Medical_Dental_Vision/Learn_About_Health_Insurance/Qualifying_Life_Events/01-Common_Qualifying_Life_Events/

Paul der Krake

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Re: What qualifies as voluntary loss of coverage for insurance purposes?
« Reply #2 on: January 15, 2018, 05:03:27 PM »
Oh, awesome! And that applies to every plan out there, not just whatever Zenefits sells, correct? I just found that link through some googling around, we have no relationship with them.

ixtap

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Re: What qualifies as voluntary loss of coverage for insurance purposes?
« Reply #3 on: January 15, 2018, 05:07:28 PM »
Oh, awesome! And that applies to every plan out there, not just whatever Zenefits sells, correct? I just found that link through some googling around, we have no relationship with them.

No, you will need to read the definition of qualifying event for the plan you want to join.

This particular case is not covered in the general healthcare.gov QLEs.