Special Enrollment

Special Enrollment

Open Enrollment has ended. You can still enroll for coverage if you have a qualifying life event that gives you a Special Enrollment Period. You will be required to provide proper documentation before your coverage becomes effective. Learn about qualifying events to see if you qualify.

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Qualifying Life Events

Types of Qualifying Life Events (QLEs)

If you’ve had a QLE and submitted your application, please submit your supporting documentation so we can validate your eligibility for an SEP. You can:

Email items to: BCHPIND@BlueChoiceSC.com or

Mail items to: BlueChoice HealthPlan Attn.: MEMBERSHIP (AX-425) P.O. BOX 6170 Columbia, SC 29260-9915

 

Enrollment Period - Within 60 days after marriage

Effective Date - First of month following receipt of enrollment

Document Required - 

  • Marriage certificate
  • Marriage license

Enrollment Period - Within 60 days of birth

Effective Date - Date of birth

Document Required - 

  • Birth certificate
  • Hospital discharge papers

Enrollment Period - Within 60 days after legal adoption or placement in home

Effective Date - Date of adoption or placement in home

Document Required - 

  • Adoption papers

Enrollment Period - Within 60 days after court approval of legal guardianship/custody

Effective Date - 

  • Date of placement for adoption or placement in foster care
  • Date of legal guardianship or legal custody

Document Required - 

  • Birth certificate

LOC due to: 

  • Job loss
  • Divorce
  • Loss of eligibility for Medicaid/Children's Health Insurance Program (CHIP)
  • Expiration of COBRA or decertification of a health plan
  • Loss of eligible dependent status

Voluntary cancellation of coverage or loss of coverage due to non-payment of premium are not qualifying events

 

Enrollment Period - Within 60 days before or after termination of other coverage

Effective Date - First of following month following selection of a new plan or the loss of coverage, whichever comes first

Document Required - 

  • Certificate of creditable coverage
  • Written notification from employer, insurer, Medicaid or the Children's Health Insurance Program that coverage is terminated or terminating
  • Divorce or separation decree

Enrollment Period - Within 60 days after court's order to provide coverage

Effective Date - 

  • First following month if enrollment is received on the 1st-15th of the month
  • First or second following month if enrollment is received on the 16th-31st of the month

Document Required - 

  • Court papers

Permanent residency in South Carolina is also required

 

Enrollment Period - 

  • Within 60 days after naturalization
  • Within 60 days after gaining legal residency/national status

Effective Date - 

  • First following month if enrollment is received on the 1st-15th of the month
  • First or second following month if enrollment is received on the 16th-31st of the month

Document Required - 

  • Certificate of naturalization
  • Federal government-issued proof of legal residency and one of these:
    • Utility bill in member's name
    • South Carolina driver's license
    • South Carolina state-issued ID
    • Voter's registration

Effective 7/11/2016, all qualified individuals/enrollees/dependents must have had qualifying coverage for one or more days in the 60 days prior to the move AND must be moving to a new county or ZIP that offers different health plan options.

 

Enrollment Period - Within 60 days before or after move

Effective Date - 

  • First following month if enrollment is received on the 1st-15th of the month
  • First or second following month if enrollment is received on the 16th-31st of the month

Document Required - 

  • Proof of prior coverage and
  • Proof of prior and new residence with any combination of these:
    • Utility bill in member's name
    • South Carolina driver's license
    • South Carolina state-issued ID
    • Voter's registration

Enrollment Period - Within 60 days before or after move

Effective Date - 

  • First following month if enrollment is received on the 1st-15th of the month
  • First or second following month if enrollment is received on the 16th-31st of the month

Document Required - 

  • Proof of prior coverage and
  • Proof of prior and new residence with any combination of these:
    • Utility bill in member's name
    • South Carolina driver's license
    • South Carolina state-issued ID
    • Voter's registration

You gain access to an individual coverage health reimbursement account (ICHRA) or are newly eligible for a qualified small employer health reimbursement arrangement (QSEHRA)

 

Enrollment Period - Within 60 days of becoming eligible for QSEHRA or ICHRA

Effective Date - First of the month following eligibility date of QSEHRA or ICHRA, or first of the month following enrollment, whicever comes first

Document Required - 

  • Written notice of QSEHRA or ICHRA eligibility from employer including eligibility date

The information above depicts certain QLEs and their corresponding effective dates, assuming the individual selects a plan and makes timely premium payment. Special Enrollment Period (SEP) coverage effective dates depend on the type of event, the date of request for the SEP and the date of plan selection. BlueChoice HealthPlan will require supporting documentation to validate enrollee eligibility for SEPs. BlueChoice HealthPlan is an independent licensee of the Blue Cross Blue Shield Association.