Qualifying Life Event (QLE)

What is a Qualifying Life Event (QLE)?

A qualifying life event (QLE) is a significant change in an employee’s life circumstances that allows them to enroll in health insurance outside the regular open enrolment period. QLE is a change in events or circumstances in one’s life, like getting married, having a baby, or losing health insurance coverage.

The QLE coverages include:

• Health coverage: Losing existing health coverage, including job-based, individual, and student plans, or losing eligibility for Medicare, Medicaid, or CHIP.
• Household: Events like getting married or divorced, having a baby or adopting a child, or a death in the family.
• Residence: Moving to a different ZIP code or county, students moving to or from the place they attend school, seasonal workers moving to or from the place they live and work or 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, or leaving incarceration.

Note: Special enrolment periods in the individual market last for 60 days after the QLE. However, if the QLE is due to a loss of coverage, the special enrolment period runs for 60 days before the actual loss of coverage.