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What events qualify?

When life changes, your health plan may need to as well. Maybe you got married and need to add your spouse to your plan, or you left a full-time job and need new coverage. Good news: You can update your plan without waiting for open enrollment, during a special enrollment period.

Make changes to your coverage

It's easy to update your coverage, whether you have an individual and family plan, or health coverage through your employer. Review the types of qualifying life events to see the details and recommended next steps.

 

Qualifying life events

Involuntary loss of coverage

Sometimes things happen unexpectedly and you need to change your coverage.

Happy birthday! If you are about to or just turned 26, have been on your parent's health plan and are no longer a full-time student, you will need your own coverage. 

Your special enrollment period is 60 days before and after you turn 26.

  • You may have the option of enrolling in your employer-based insurance. Contact your company's HR benefits manager to learn your coverage options.
  • Or, you may choose an individual health plan from Wellmark on the Health Insurance Marketplace® (HealthCare.gov External Site). Contact your authorized Wellmark agent to enroll or shop individual plans online to get started.
  • If your parent’s plan was a grandfathered or grandmothered plan, you may have the opportunity to enroll in one of those health plans. An authorized Wellmark agent will be able to help you find what’s best for you.
Enrollment and effective dates vary by event, and you may be asked to provide proof of the qualifying event.

When you experience a major shift in your family life, your coverage may need to change.

Your special enrollment period is 60 days before and after the event.

  • If you have employer-based coverage, contact your company's HR benefits manager to update your coverage.
  • If you have an individual health plan from Wellmark through the Marketplace, you can update your coverage through the Marketplace External Site.
  • If your individual health plan is not through the Marketplace, contact Wellmark Customer Service at the number on the back of your ID card to update your policy.
  • If you need to shop for a new individual health plan, contact your authorized Wellmark agent to enroll or shop individual plans online.
Enrollment and effective dates vary by event, and you may be asked to provide proof of the qualifying event.

We are so sorry for your loss.

With the loss of your plans policyholder, you will need to adjust your health plan.

Your special enrollment period is within 60 days of the passing.

  • If you have employer-based coverage, contact your company's HR benefits manager to update your coverage.
  • If you have an individual health plan from Wellmark through the Marketplace, you can update your coverage through the Marketplace External Site.
  • If your individual health plan is not through the Marketplace, contact Wellmark Customer Service at the number on the back of your ID card to update your policy.
Enrollment and effective dates vary by event, and you may be asked to provide proof of the qualifying event.

A change in employment status is a qualifying life event, whether you changed employers or you lost coverage due to a layoff, dismissal, resignation or retirement.

Your special enrollment period is within 60 days of the employment status change.

  • Contact your company's HR benefits manager to discuss your options, including election of COBRA (The Consolidated Omnibus Budget Reconciliation Act) coverage.
  • If you are not enrolling in COBRA or other employer-based coverage, you can enroll in an individual health plan from Wellmark. Contact your authorized Wellmark agent to enroll or shop individual plans online.
Enrollment and effective dates vary by event, and you may be asked to provide proof of the qualifying event.

If your plan’s policyholder enrolled in other coverage, such as Medicare, Medicaid, Medicare supplement, Medicare Advantage, Veteran Affairs (VA) coverage, TRICARE or group coverage, you will need your own coverage. You may have the option of enrolling in employer-based insurance. Or, you may choose a Wellmark health plan on the Health Insurance Marketplace (HealthCare.gov External Site).

Your special enrollment period is 60 days before or after the policyholder's coverage ends.

Contact your authorized Wellmark agent to enroll or shop individual plans online.

Enrollment and effective dates vary by event, and you may be asked to provide proof of the qualifying event.

Adding a dependent

Some life events may call for you to add someone to your plan. These are the qualifying events.

Congratulations! Welcoming a new baby is an exciting time, but it can also be exhausting. Don't forget to change your coverage during the special enrollment period to ensure your new bundle of joy is covered.

Your special enrollment period is within 60 days of the birth of your baby.

  • If you have employer-based coverage, contact your company's HR benefits manager to update your coverage.
  • If you have an individual health plan from Wellmark through the Marketplace, you can update your coverage through the Marketplace External Site.
  • If your individual health plan is not through the Marketplace, contact Wellmark Customer Service at the number on the back of your ID card to add your newborn to your policy.
Enrollment and effective dates vary by event, and you may be asked to provide proof of the qualifying event.

What an exciting time, congratulations! With the newest addition to your family, you will need to change your coverage.

Your special enrollment period is 60 days before or after the adoption date.

  • If you have employer-based coverage, contact your company's HR benefits manager to update your coverage.
  • If you have an individual health plan from Wellmark through the Marketplace, you can update your coverage through the Marketplace External Site.
  • If your individual health plan is not through the Marketplace, contact Wellmark Customer Service at the number on the back of your ID card to update your policy.

Enrollment and effective dates vary by event, and you may be asked to provide proof of the qualifying event.

Congrats to the couple! Along with making sure you are covered, you will want to ensure your new spouse is covered, too.

Your special enrollment period is 60 days before or after your marriage.

  • If you have employer-based coverage, contact your company's HR benefits manager to update your coverage.
  • If you have an individual health plan from Wellmark through the Marketplace, you can update your coverage through the Marketplace External Site.
  • If your individual health plan is not through the Marketplace, contact Wellmark Customer Service at the number on the back of your ID card to add your new spouse.

Enrollment and effective dates vary by event, and you may be asked to provide proof of the qualifying event.

If you've received a court order to add a dependent, you may be looking for health coverage options. We can help.

Your special enrollment period is 60 days before or after the order.

  • If you have employer-based coverage, contact your company's HR benefits manager to update your coverage.
  • If you have an individual health plan from Wellmark through the Marketplace, you can update your coverage through the Marketplace External Site.
  • If your individual health plan is not through the Marketplace, contact Wellmark Customer Service at the number on the back of your ID card to update your policy.
Enrollment and effective dates vary by event, and you may be asked to provide proof of the qualifying event.
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