Health

You are able to switch a covered family member during the annual Open Season and outside of Open Season upon experiencing a change in family status, a change in coverage, or a change in eligibility, as long as switching the family member is consistent with the QLE experienced. For example, if an enrollee has a spouse and a child, but only covers their spouse with a Self Plus One enrollment, in the event that the enrollee and spouse are divorced, the enrollee may choose to stay in Self Plus One and switch their covered family member to terminate their spouse’s coverage and add their eligible child to the enrollment. However, if an enrollee covers a spouse under a Self Plus One enrollment and then has a child, the enrollee would be allowed to increase to Self and Family to cover all of their eligible family members, but not to switch from covering their spouse to covering their new child under a Self Plus One enrollment. A full list of QLE codes and their definitions will be outlined in the updated SF2809, which will be available soon.