The Enroll Application offers both employee self-attested, and caseworker-managed, Qualifying Life Events and resulting Special Enrollment Periods. QLE types are fully configurable, with attributes including: title, tool tip, event label, relative order of appearance in QLE list, EDI code, effective on date kinds, SEP time period preceding QLE, SEP time period following QLE and self-attested flag. For example, following is a QLE definition for birth of child:

  • title: “Had a baby”,
  • tool_tip: “Household adds a member due to marriage, birth, adoption, placement for adoption, or placement in foster care”,
  • edi_code: “02-BIRTH”,
  • effective_on_kinds: [“date_of_event”],
  • pre_event_sep_in_days: 0,
  • post_event_sep_in_days: 30,
  • is_self_attested: true,
  • ordinal_position: 25,
  • event_kind_label: ‘Date of birth’

Self-attested QLE’s are available to Employees, and are governed by the configured attributes. The User Interface guides the employee the SEP creation process step-by-step, presenting appropriate options based on the selected QLE type.

Following successful creation, the family is eligible to make enrollment changes for the duration of the SEP.

All self-attested and non-self-attested SEPs will be available to caseworkers through the administrator portal to grant SEPs to employees. This is currently in pre-prod. Administration SEP types may be configured to provide caseworkers with flexibility to set non-standard start and end dates, and offer multiple effective date options to the employee.