Idahoans who have lost employer-sponsored health insurance as a result of termination, layoff, or furlough due to COVID-19 are eligible for a Special Enrollment Period. In partnership with the Idaho Department of Insurance and Idaho insurance providers, Your Health Idaho has relaxed the requirements for eligible Idahoans to enroll during this critical time.

Under the newly relaxed policy, a written statement explaining the loss of employer health benefits is the only documentation required to enroll. To request a Special Enrollment Period, complete the form at the bottom of this page.  

Important: Verification documents proving loss of coverage are not required to complete a Special Enrollment Period request. However, you may be asked to provide verification after enrollment to maintain insurance coverage. If requested, you will have 60 days from the date of the notice to submit documentation to Your Health Idaho. If acceptable documentation is not submitted, your enrollment could be retroactively cancelled.

Loss of Coverage

If you or someone in your household recently lost, or expects to lose, qualified health insurance coverage, you could be eligible to enroll with Your Health Idaho.

You could qualify for a Special Enrollment Period (SEP) if you experienced one of the following Qualifying Life Events (QLE) in the last 60 days:

  • Loss of employer (or spouse’s employer) coverage
  • Loss of other coverage such as Medicare, Medicaid, CHIP, Tricare, PeaceCorps or AmeriCorps coverage
  • Exhaustion of employer-sponsored COBRA or PERSI benefits
  • Discontinuation of marketplace coverage
  • Dependent turns 26 and ages out of parents’
  • Death of primary subscriber

To report your change, you must provide documented proof. Accepted documents include:

If you lost qualified health coverage

These documents prove eligibility:

  • Dated termination letter from your employer (letter must clearly state that termination resulted in a loss of coverage and include the coverage end date)
  • Dated letter of fund exhaustion from PERSI (sent three months prior to exhaustion of funds)
  • COBRA notice of termination of employer contribution to enrollment
  • Employer letter of exhaustion of contribution to COBRA enrollment
  • COBRA cancellation letter
  • Termination letter from your health insurance company
  • Termination letter from a government provider (e.g., Medicaid)

If you turned 26 and aged out of your health insurance coverage.

  • Provide documentation of previous coverage and of age.

If you lost coverage because the primary tax filer in your household is deceased.

Provide documentation of previous coverage and one of these documents to prove eligibility:

  • Copy of death certificate
  • Signed affidavit
  • Newspaper obituary
  • Mortuary notice

If your hardship exemption was cancelled

  • Provide a copy of the Health and Human Services exemption certification.

For most QLEs, you have 60 days from the date of your event to enroll in coverage. This means you must report your change, provide documentation, and select a plan and enroll by the end of the 60 days.

If you have questions, or would like more information, contact Your Health Idaho at 855-944-3246 or email Support@YourHealthIdaho.org.

How you report your QLE depends on if you already have coverage or receive a tax credit to help cover the cost of your insurance premium.

For existing accounts, please visit the Report a Change page to learn more about how to report your QLE.

For new customers, please complete the form below to submit your QLE to Your Health Idaho for review.


Request for Special Enrollment


Instructions

**Please keep a copy of all forms for your records**

If you believe you have a Qualifying Life Event that might be eligible for a Special Enrollment Period, you have 60 days from the date of your event to complete the following:

  • Report your Qualifying Life Event.
  • Provide documentation to prove the event and enrollment eligibility.
  • Select and enroll in a plan.

To Report your Qualifying Life Event

1. Report your Qualifying Life Event by filling out the form below.
2. Submit the form to YHI with any contact method described in “YHI Contact Information.”



Type of Qualifying Life Event

A Qualifying Life Event could be eligible for a Special Enrollment Period. To see a brief description and required documentation visit our Special Enrollment Page.


If your event is not listed please call Your Health Idaho at 855.944.3246.

Explain Your Qualifying Life Event

Please provide detailed information about your Qualifying Life Event.

Verification documents may be requested after enrollment is approved. Failure to provide verification may impact the enrollment status or effectuation of the policy.



Documentation Upload

To see a brief description and required documentation visit our Special Enrollment Page.


Do you need assistance completing this Qualifying Life Event Report?

You may appoint an authorized representative.

You can give a trusted person permission to communicate about this report with us, see your information, and act for
you on matters related to this appeal, including getting information about your appeal and signing your appeal on your
behalf. This person is called an “authorized representative.” If you ever need to change your authorized representative,
contact YHI.


Notice of Privacy Practices

Your Health Idaho is committed to maintaining the privacy and security of personally identifiable information. Your
Health Idaho will use personally identifiable information only as permitted by Your Health Idaho's policies and as
required by law.

More information about Your Health Idaho's privacy and security practices and your rights is available on Your Health
Idaho's website at YHI Privacy Policy

If you need help understanding this form in another language, or if you are disabled and need help to use this form, please contact Your Health Idaho. There is no cost for assistance.


Read and Sign Below - Electronic Consent


A copy of this submission will be emailed to you and any designated authorized representatives.


Translate »