Disenrollment

Termination may be voluntary or involuntary. Voluntary termination occurs when the client requests to discontinue coverage. Involuntary termination occurs when Covered CA or the health plan initiates termination. Following termination (voluntary or involuntary), the client will receive a notice of termination which describes the reason for the termination and information about the appeal process. The notification should occur at least 30 days prior to the last day of coverage.

Voluntary Disenrollment

Clients can request disenrollment if:

• The client obtains other coverage that meets the minimum essential coverage requirement.
• The client changes from one health plan to another during open enrollment or during a special enrollment period.
• Clients should not disenroll until new coverage is active to avoid medical expenses between coverage.

Involuntary Disenrollment

Involuntary disenrollment may occur if:

• The client is no longer eligible for coverage under Covered CA (deceased, divorced, moved out of the service area, etc.)
• The client did not pay the premiums. The health plan will send the client a notice of delinquency if the client does not pay the plan premium.
• The client commits fraud.
• The QHP terminates or decertifies.

Related Topics

Affordable Care Act

Plan Enrollment

Changes in Eligibility Criteria