What is a Qualifying Life Event (QLE)?

Bob Gearhart Jr.
Bob Gearhart Jr.
  • Updated

A Qualifying Life Event, also known as a QLE, is a change to your current life situation that affects your health insurance options or requirements. 

Qualifying Life Events typically fit into one of four categories. 

  1. Loss of health coverage - Such as losing existing health coverage, including job-based, individual, and student plans; Losing eligibility for Medicare, Medicaid, or CHIP; Turning 26 and losing coverage through a parent’s plan. 
  2. Changes in your household - Such as getting married or divorced, having a baby or adopting a child, or a death in the family. 
  3. Changes in residence - Such as a student moving to or from the place you attend school.
  4. Other qualifying events include changes in your income or job classification that can affect the coverage for which you qualify.

These life events may alter the amount of insurance needed or the number of people covered under the policy. Under the Health Insurance Portability and Accountability Act (HIPAA), employees who have experienced a qualifying life event may enter a special enrollment period. This Special Enrollment Period (SEP) allows employees to enroll in health insurance and other benefits outside of the annual Open Enrollment Period. For instance, this can be very helpful if you were recently married, as you may want to add your spouse to the health insurance policy.

The Special Enrollment Period lasts 30 days from the date of a Qualifying Life Event. During these 30 days, employees would be allowed to enroll in a new health insurance plan and make changes to or drop an existing coverage. Any changes made during this period will be effective on the qualifying event date. 

You may need to provide documentation of your Qualifying Life Event so the insurance carrier can confirm that you meet Special Enrollment Period requirements.

You can cancel your health insurance plan without a qualifying life event at any time. But it is important to remember that once you cancel your policy, you cannot enroll again until the next open enrollment period. Until such time, you will have no insurance coverage. 



Was this article helpful?

0 out of 0 found this helpful