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At this time, you can only quote and view benefits for 2021 coverage. You may sign up for 2021 coverage when open enrollment starts on November 1.
Open enrollment for 2021 coverage is November 1st through December 15th.
Extended open enrollment for 2021 coverage is December 16, 2020 through December 22, 2020. This extension is for Minnesota residents only.
You have some other life change that affects your plan availability, income, or changes in your family size.
Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) and Individual Coverage Health Reimbursement Arrangement (ICHRA).
You recently changed the location of your permanent residence. Now your current health coverage no longer offers network health care services or moving gives you access to new health plan options.
Your household or family composition has changed because you had a baby.
Your household or family composition has changed because you’re adopting a child.
Your household or family composition has changed because you’re getting married.
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products:
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products:
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products:
Your household or family composition has changed because you’re getting divorced or legally separated.
You recently lost your minimum essential health coverage. This may be due to things like job loss, divorce, turning 26, COBRA coverage ending or the health plan becomes decertified.
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products:
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products:
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products:
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products:
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products:
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products, do not use email quote and you must complete the enrollment on behalf of your applicant.
Attention brokers selling Nebraska Farm Bureau Employer Insurance Consortium products:
Note: Voluntarily ending your health coverage or being terminted for not paying your premiums are not considered involuntary loss of coverage.
Date of event:
Enter the applicant's date first eligible for employee benefits.
Coverage start date will be the first of the month following 60 days after Date of event.
Enrollment Reason:
Birth of child
Coverage start date:
Coverage is effective retroactive to the date of birth
Period to request special enrollment:
31 days following the date of event
Supporting Documentation Required:
Birth certificate
Enrollment Reason:
Court ordered dependent
Coverage start date:
Coverage is effective on the first day of the month following the date on which the enrollment request is received by Medica.
Period to request special enrollment:
31 days following the date of event
Supporting Documentation Required:
Court order with judge’s signature
Enrollment Reason:
Adoption or placement for adoption
Coverage start date:
Coverage is effective retroactive to the date of adoption or placement for adoption
Period to request special enrollment:
31 days following the date of event
Supporting Documentation Required:
Adoption decree or court order with judge’s signature
Enrollment Reason:
Marriage
Coverage start date:
Coverage is effective on the first day of the month following the date on which the enrollment request is received by Medica.
Period to request special enrollment:
31 days following the date of event
Supporting Documentation Required:
Marriage certificate
Enrollment Reason:
Other
Coverage start date:
Coverage is effective on the first day of the month following the date on which the enrollment request is received by Medica.
Period to request special enrollment:
31 days following the date of event
Supporting Documentation Required:
Certificate of creditable coverage or term letter with the date and reason coverage was lost
Enrollment Reason:
Loss of SCHIP/Medicaid coverage eligibility
Coverage start date:
Coverage is effective on the first day of the month following the date on which the enrollment request is received by Medica.
Period to request special enrollment:
60 days following the date of event
Supporting Documentation Required:
Certificate of creditable coverage or term letter with the date and reason coverage was lost
Enrollment Reason:
Loss of coverage
Coverage start date:
Coverage is effective on the first day of the month following the date on which the enrollment request is received by Medica.
Period to request special enrollment:
60 days following the date of event
Supporting Documentation Required:
Certificate of creditable coverage or term letter with the date and reason coverage was lost
Enrollment Reason:
Loss of SCHIP/Medicaid premium assistance eligibility
Coverage start date:
Coverage is effective on the first day of the month following the date on which the enrollment request is received by Medica.
Period to request special enrollment:
60 days following the date of event
Supporting Documentation Required:
Certificate of creditable coverage or term letter with the date and reason coverage was lost