Frequently asked questions

You cannot switch to an alternative outside the Open Enrollment Period unless you qualify for a Special Enrollment Period (SEP). A SEP is triggered by specific Qualifying Life Events (QLEs) such as moving to a new area, losing employer-sponsored coverage, getting married, or having a baby. Without a QLE, your ability to change to another ACA plan is limited.

HMO: Requires you to use in-network providers and choose a primary care doctor. Referrals are needed for specialists.
PPO: Offers more flexibility with in-network and out-of-network providers and doesn’t require referrals.
EPO: Covers only in-network providers (except emergencies) and doesn’t require referrals.
POS: A mix of HMO and PPO features; requires referrals but allows out-of-network coverage.

What is qualifying life event (QLE)?

What is qualifying life event (QLE)?

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What is qualifying life event (QLE)?

What is qualifying life event (QLE)?

What is qualifying life event (QLE)?