Losing Your First Stop Health Coverage: What Qualifies as a Qualifying Life Event?

What is a Qualifying Life Event (QLE)?

A QLE is an event that allows you to enroll in a health insurance plan outside of the regular open enrollment period. QLEs can include things like losing your job, getting married, or having a baby.

Losing Small Group Health Coverage

Losing your First Stop Health coverage may or may not qualify as a QLE, depending on the specific details of your situation. First Stop Health is not a Qualified Health Plan (QHP), which is the type of plan that is required to provide minimum essential coverage under the Affordable Care Act (ACA).

Therefore, losing First Stop Health coverage will likely not qualify as a QLE for special enrollment in a QHP. However, there are some exceptions to this rule.

Exceptions to the QLE Rule

There are some exceptions to the rule that losing small group health coverage does not qualify as a QLE. These exceptions include:

The coverage was offered through an employer that had fewer than 50 employees.
You were employed by the same employer for at least 12 months before losing coverage.
You lost coverage due to a layoff or termination that was not for cause.

If you meet one of these exceptions, you may be able to enroll in a QHP using a special enrollment period within 60 days of losing your coverage.

What to Do if You Don’t Qualify for a QLE

If you do not qualify for a QLE, you will have to wait until the next open enrollment period to enroll in a QHP. Open enrollment for 2024 coverage begins on November 1, 2023, and ends on January 15, 2024.

Alternatives to QHPs

If you cannot afford a QHP, there are other options available to you. You may be eligible for Medicaid or CHIP, which are government programs that provide health insurance to low-income individuals and families. You may also be able to purchase a short-term health insurance plan. However, short-term plans do not offer the same level of coverage as QHPs and they may not cover pre-existing conditions.

Getting Help

If you are unsure if you qualify for a QLE or if you need help finding health insurance, you can contact a licensed health insurance agent. Agents can help you determine your eligibility for QLEs and they can help you find a plan that meets your needs and budget.

To get in touch with a licensed insurance agent locally near your area and get matched with someone who can best help you, call our national hotline today at
800-320-5948.