Frequently Asked Questions

Looking for an Individual & Family health insurance plan but have questions about where to start? Here are some common questions asked about Individual & Family plans to help you better understand them and help begin your enrollment process.

Q: Can I enroll mid-year if I do not have a qualifying life event (QLE)?

A: No. If a new enrollee does not have a qualifying life event within the last 60 days, they are not able to enroll until the designated open enrollment period, November 1 – December 15.

Q: How do I enroll?

A: If you are working with an insurance broker, they can assist you with enrollment. If not, go to our Individual & Family page where you can get a health insurance quote, compare plans, and find more information. Either way you enroll, you will be asked to create a My Benefits account to complete the enrollment process.

Q: What is a qualifying life event (QLE) and how does that determine when I can enroll?

A: When you experience a qualifying life event, the deadline to enroll is the 15th of the month prior to the effective date OR within 60 days of the qualifying life event. Qualifying life events include:

  • Involuntary loss of health coverage (failure to pay premiums that result in a loss of coverage is not considered voluntary)
  • Birth
  • Adoption
  • Permanent legal guardianship of a child
  • Marriage
  • Move to the geographic service area

Q: When is payment due for individual & family plans?

A: Payment is due on the 1st of each month with a 30-day grace period.

Q: How do I terminate coverage?

A: Log in to your My Benefits Coverage portal and select “Terminate Coverage”. Requests need to be submitted by the 20th of the month prior to the effective date.

Q: When I am enrolled, will I be able to change plans?

A: Yes, at annual open enrollment (November 1 – December 15). Plan changes will be effective on January 1.

Q: If I want to keep my plan, can I?

A: Each year we make adjustments to your plan (premium and benefits). During the open enrollment period (November 1 – December 15) you will have the opportunity to change your plan. If you do nothing, your plan will be mapped to the closest plan for the next calendar year.

Q: Who can I call if I have questions?

A: If you work with an insurance broker, we recommend contacting them OR you can contact our Engagement Center at 775-982-3232.

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