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Fact Sheet
June 2009

What Is a “Special Enrollment Opportunity” and Why Should I Care about It?

If you turned down your employer’s health plan (or your spouse’s) in the past but now would like to enroll in it, you may have another chance to enroll. 

A federal law known as the Health Insurance Portability and Affordability Act (HIPAA) creates a special right for you and your dependents to enroll in your employer’s health plan when

  • you or your dependents lose eligibility for other health coverage
  • a new dependent is added to your family through marriage, birth, or adoption
  • your state Medicaid or CHIP program decides to pay a portion of the premium for such plans 

This right applies only to people who are eligible for coverage under the employer’s plan. 

This special enrollment opportunity gives people who are losing coverage a chance to sign up immediately in an employer’s group health plan—even if it is outside of the plan’s specified times for enrollment, such as when you are starting a job.

This fact sheet explains how such a special enrollment opportunity works and who is eligible for it.