Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 23, 2016

Program Area: Enrollment and Eligibility (ENR)

Question: Does a Qualifying Event, such as the birth of a child, allow an enrollment group to add additional dependents other than the newborn for a newly selected or existing Qualified Health Plan (QHP)?

Answer: Anyone who gains a dependent or becomes a dependent is eligible for a special open enrollment window, which includes both the parents and the newborn, newly adopted, or fostered child. The Federally-facilitated Marketplace (FFM) also accepts applications for the entire family (including siblings) during the special open enrollment window. Consumers living in a state that is running its own exchange should check with the state exchange to see how the state interprets regulation.

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