Covered California Certified Enroller Practice Exam

Can a consumer change their health plan outside of the open enrollment period?

1. Yes, if they request it

2. No, unless they experience a qualifying life event

3. Only if they are eligible for a subsidy

4. Yes, for a limited time

The correct answer is: No, unless they experience a qualifying life event

A consumer can change their health plan outside of the open enrollment period only if they experience a qualifying life event. Qualifying life events are significant changes in an individual's situation that may affect their health coverage, such as marriage, divorce, the birth of a child, loss of a job, or moving to a new state. These events allow individuals to gain access to a special enrollment period during which they can enroll in a new plan or change their existing coverage without having to wait for the next open enrollment period. Options suggesting that a consumer can change their health plan simply by requesting it or for a limited time do not align with the rules set forth by the Affordable Care Act or Covered California guidelines. Additionally, eligibility for a subsidy does not in itself provide the basis for changing plans outside of the designated enrollment periods. Therefore, the accurate understanding is that outside of open enrollment, a change in coverage is contingent upon experiencing a qualifying life event.