What Are Qualifying Events for Insurance Changes?

Health insurance plans typically do not allow policyholders to make changes to their plan before an open enrollment period. Qualifying events are a different matter and represent life changes, which allow the insured to make changes to their policy. Health Insurance companies may require that policyholders make these changes within a certain period. They may also require documentation to prove the qualifying event.

Marital Status

• Changes to marital status are a qualifying event, which allow the policyholder to make changes to his policy. This can include adding a new spouse or removing a spouse. This gives newly married couples an opportunity to select the best health insurance policy that meets both of their needs. It is also necessary after a divorce to make changes to insurance policies to comply with a divorce order.

Employment

• An employment status change in a policyholder's dependent or spouse allows changes to health insurance coverage. For example, if a spouse changes from a full-time employee to a part-time employee, he may require coverage under his spouse's policy. Dependent children who begin working in a job that offers health insurance coverage may no longer require the coverage provided by their parent. This can allow the policyholder to change insurance plans from a family plan to a couple's only or an individual plan.

Childbirth

• The birth of a child is a life event that insurance companies recognize as a time when changes will need to be made to health insurance coverage. The qualifying event allows the new parent to add the baby to her policy.

Death

• The death of a spouse or dependent is an event that qualifies for changes to a health insurance policy. Removing a deceased dependent or spouse from a policy may allow the insured to qualify for a lower-cost plan.

Change in Eligibility

• Dependents may become ineligible for health insurance coverage after completing school or getting married. This qualifies as a reason to make changes to the insurance policy.