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Covered California Special Enrollment Team P.O. Box 13310 Sacramento, CA 95813Your destination for quality healthcare, including MediCalFIRST×NAME LAST×NAME ADDRESS×LINE1 ADDRESS×LINE2 CITY, STATE
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How to fill out special enrollment team

01
To fill out the special enrollment team, follow these steps:
02
Begin by gathering all the necessary information and documentation required for enrollment.
03
Visit the official website of the special enrollment team or contact their designated office.
04
Fill out the enrollment form carefully, providing accurate and up-to-date information.
05
Make sure to double-check all entries before submitting the form.
06
If required, attach any supporting documents or paperwork required for verification.
07
Review the completed form and ensure all information is accurate and complete.
08
Submit the form either by electronic means (if available) or by mailing it to the designated address.
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Keep a copy of the submitted form and any supporting documents for your records.
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Await confirmation or communication from the special enrollment team regarding the status of your application.
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Follow any additional instructions or requirements provided by the special enrollment team, if necessary.

Who needs special enrollment team?

01
Special enrollment team is typically needed by individuals who experience qualifying life events outside of the regular enrollment periods. These can include but are not limited to:
02
- Individuals who have recently gotten married or divorced
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- Individuals who have had a baby or adopted a child
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- Individuals who have lost their previous health coverage due to job loss or other reasons
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- Individuals who have moved to a new area outside of their current plan's coverage
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- Individuals who have aged out of their parents' health insurance
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- Individuals who have gained citizenship or immigration status
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- Individuals who have experienced other special circumstances that make them eligible for enrollment outside of the regular periods.
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It is advisable to consult the specific guidelines and criteria provided by the special enrollment team or the relevant health insurance authority to determine eligibility and requirements.
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Special enrollment team is a designated group of individuals who are responsible for assisting with enrollment in special healthcare plans outside of the regular enrollment period.
Individuals who experience qualifying life events such as marriage, birth of a child, or loss of other coverage are required to file a special enrollment team to enroll in a healthcare plan outside of the regular enrollment period.
To fill out a special enrollment team, individuals can contact their employer's HR department, insurance provider, or visit the healthcare marketplace website to submit the necessary information.
The purpose of special enrollment team is to allow individuals who experience qualifying life events to enroll in a healthcare plan outside of the regular enrollment period.
Information such as the qualifying life event, effective date of the event, and any relevant documentation must be reported on a special enrollment team.
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