A qualifying life event is a big life-changing situation — sometimes planned, sometimes unexpected — that can impact you and your health insurance. Experiencing a significant life change may allow you to change your health plan outside of the annual enrollment period (also called open enrollment).

There are a few main types of QLEs:

  • Loss of health coverage

    • 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

  • Changes in household

    • Getting married or divorced

    • Having a baby or adopting a child

    • Death in the family

  • Changes in residence

    • Moving to a different ZIP code or county

    • A student moving to or from the place they attend school

    • A seasonal worker moving to or from the place they both live and work

    • Moving to or from a shelter or other transitional housing

  • Other qualifying events

    • Changes in your income that affect the coverage you qualify for

    • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder

    • Becoming a U.S. citizen

    • Leaving incarceration (jail or prison)

    • AmeriCorps members starting or ending their service

The situations listed above are just examples and aren’t an exhaustive list. Please feel free to check out this publication from the IRS:

Reference: IRS Qualifying Life Events

If you have any questions about this, please reach out to our Member Experience Team at support@joinforma.com or send us a live chat message through your Forma mobile app!

For questions regarding pre-tax accounts (HSA, FSA, DCFSA, etc.) you can also reach us by phone at 844-902-2902 Monday through Friday, 8 AM EST - 8 PM EST. We're here to help!

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