Special Enrollment Periods (SEP) 

These periods allow eligible employees and eligible dependents to be added to or make changes to their plan outside of Open Enrollment. 

Loss of other coverage 

Employees who did not enroll in a plan for themselves and/or their dependent(s) when initially eligible may enroll at a time other than an annual OEP if the following conditions are met:

• Employee did not initially enroll because they had other qualified health coverage and that coverage has terminated
• The loss* of health plan coverage occurred because the employee was no longer eligible (does not apply for lost coverage due to nonpayment of premiums)

 *The employee and/or dependent(s) who lost coverage must enroll in the  plan within 31 days of the date previous coverage was lost.

Proof of loss of other coverage must be submitted to Select Health before their application can be approved. This must be submitted before any benefits will be paid. 

If the special enrollment period occurs because the employee or their spouse loses coverage, they can enroll individually with all of their eligible dependents. If the special enrollment period occurs because one of their dependents reaches the limiting age specified in the group contract, then only that dependent has the special enrollment period. Coverage of any members properly enrolled under this special enrollment period will be effective on the date the other coverage was lost.

New dependent(s)

If enrolled or eligible employees gain a dependent(s) through marriage, birth, adoption, placement for adoption, or placement under legal guardianship, then the employee may enroll the dependent(s) in the plan. If needed, the employee may enroll in the plan as well. For adoption, placement for adoption, or birth, an eligible spouse may be enrolled, even if the child is not newly eligible as a dependent. 

This special enrollment period is only available if enrolling within 60 days of the marriage, birth, adoption, placement for adoption, or placement under legal guardianship.

Coverage of members enrolled during this special enrollment period is effective:

• As of the date of marriage
• As of the date of birth
• As of the date of birth for children less than 31 days old when adopted or placed for adoption
• For children more than 30 days old when adopted or placed for adoption, the date of placement, or the later of:
  • The effective date of the court-ordered guardianship or testamentary appointment; or 
  • The date the court-ordered guardianship or testamentary appointment is received by Select Health

Loss of Medicaid or CHIP coverage

Employees and/or their dependent(s) can enroll in the plan if their application is made within 60 days of the loss of coverage.

NOTE: Proof of loss of other coverage must be submitted to Select Health before an application can be approved and benefits will be paid.