Qualifying Life Events
After Open Enrollment ends, you can enroll in a private health plan through the CBC Health Insurance Marketplace for Costco Members only if you have a qualifying life event. This is a change in your life that can make you eligible for a Special Enrollment Period to enroll in health coverage. The types of life events that qualify and the documentation that is required for your enrollment are listed below.
Eligible Qualifying Life Events:
Loss of job or termination of employment
Required Documentation:Cobra Election Form
(or)
FMLA
(or)
HIPPA Certificate or Credible Coverage
Reduction in hours or change of employment
Required Documentation:Cobra Election Form
(or)
FMLA
(or)
HIPPA Certificate or Credible Coverage
(or)
Letter from employer on business letter-head confirming loss of coverage or reduction of hours
Employer stopped contributing to my coverage or my dependents
Required Documentation:Cobra Election Form
(or)
HIPPA Certificate or Credible Coverage
(or)
Letter from employer on business letter-head confirming loss of coverage or reduction of hours
Cancellation of group coverage
Required Documentation:Cobra Election
(or)
HIPAA Certificate or Credible Coverage
(or)
Letter from employer on business letter-head confirming the company group policy was canceled
Covered under deceased member
Required Documentation:Cobra Election Form
(or)
HIPPA Certificate or Credible Coverage
(or)
Death Certificate
(or)
Letter from employer on business letter-head confirming loss of coverage
(or)
Obituary (newspaper copy &/or mortuary notice)
Coverage under Medicare
Required Documentation:Copy of Medicare Card
(or)
Approval letter of entitlement from Social Security Office
Child turns age 26
Required Documentation:HIPPA Certificate or Credible Coverage
(or)
Letter from employer on business letter-head confirming loss of coverage
(or)
Copy of letter from the carrier explaining reason for dependent cancellation
Loss of coverage under Medicaid or CHIP
Required Documentation:Letter of notification of loss of coverage from the state
Returned from Active Military Service
Required Documentation:Certificate of Release of Discharge from Active Duty
Disability status changed
Required Documentation:Any relevant documentation that you have that shows when your qualifying event occurred
Immigration status changed
Required Documentation:Any relevant documentation that you have that shows when your qualifying event occurred
Marriage
Required Documentation:Marriage Certificate
Divorce
Required Documentation:Divorce Decree
Move to new coverage area
Required Documentation:Verification of recent address change
(or)
Current Utility Billing Statement confirming the California address
(or)
Lease or Renter’s agreement
(or)
Monthly mortgage statement
(or)
School Enrollment Record from the former state
Birth of a child
Required Documentation:Birth Certificate
Adoption of a child
Required Documentation:Certificate of Adoption
Registration for Domestic Partner
Required Documentation:Domestic Partner Certificate
Medical Child Support Order
Required Documentation:Letter from the court
Loss of Exchange Coverage
Required Documentation:Certificate of Coverage or evidence of other creditable coverage.
Termination of COBRA
Required Documentation:Letter from the COBRA administrator or prior insurance company verifying that you have exhausted your Federal COBRA benefits.
Some unusual circumstances may be considered. If you are unsure please contact us:
Phone: (855) 332-3821 Email: CostcoQuote@cbcins.com