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CHOICE PLAN 2014 Choice Benefits Enrollment Form (1660) Participant Name (please print) Social Security # Participant Address: Street Apt. # City State Zip Code Date of Birth Sex: Male Female Marital
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How to fill out special enrollment period

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How to fill out special enrollment period:

01
Visit the official website of your state's health insurance marketplace or the federal health insurance marketplace, depending on where you reside.
02
Create an account on the marketplace website by providing your personal and contact information.
03
Determine if you qualify for a special enrollment period by experiencing a qualifying life event, such as getting married, having a baby, losing your job-based health coverage, or moving to a new state.
04
Gather the necessary documentation to verify your eligibility for the special enrollment period. This may include marriage certificates, birth certificates, proof of loss of previous coverage, or proof of address change.
05
Log into your marketplace account and select the option to start a new application or update your existing application.
06
Provide the required information accurately, including your household size, income, and any other relevant details.
07
When prompted, indicate that you are applying for the special enrollment period and provide the details of your qualifying life event.
08
Upload any supporting documents that may be requested during the application process.
09
Review your application carefully before submitting it. Make sure all information is accurate and complete.
10
Submit your application and wait for a confirmation email or letter from the marketplace. This will typically include information about the next steps to take and the deadline for submitting any additional documentation, if required.

Who needs special enrollment period:

01
Individuals who have experienced a qualifying life event, such as getting married, having a baby, losing their job-based health coverage, or moving to a new state.
02
Those who missed the annual open enrollment period and do not qualify for other exemptions that allow them to enroll in health insurance outside the regular enrollment period.
03
People who have recently immigrated to the United States and are within the first 60 days of residing in the country.
04
Individuals who were previously uninsured and have become ineligible for Medicaid or the Children's Health Insurance Program (CHIP).
05
Those who have been released from incarceration and are seeking health insurance coverage.
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Special enrollment period is a time outside of the yearly Open Enrollment Period when you can sign up for health insurance.
Individuals who experience certain life events, such as losing other health coverage, moving to a new area, or having a baby, may be required to file for special enrollment period.
To fill out special enrollment period, you need to visit the Health Insurance Marketplace website or call the Marketplace call center to start the application process.
The purpose of special enrollment period is to allow individuals to enroll in health insurance outside of the typical enrollment period due to specific qualifying life events.
When filing for special enrollment period, you must report information about the qualifying life event that makes you eligible, as well as information about the household members who need coverage.
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