Eligibility Period

The eligibility period is the window of time during which an individual can apply for or enroll in an insurance plan after first becoming eligible. It ensures that applicants join coverage within a reasonable timeframe, helping insurers manage risk and prevent people from waiting until they need care to apply. Eligibility periods are common in both group and individual insurance and are especially important for guaranteed issue or conversion options.

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In group benefit plans, the eligibility period begins when an employee first qualifies for coverage - often after completing a waiting period such as 30, 60, or 90 days of employment - and usually lasts for 31 days. If the employee does not enroll within that timeframe, late entry rules may apply, which could require medical evidence of insurability. For individuals leaving a group plan, the eligibility period to convert to a personal plan without medical underwriting is typically 60 to 90 days.

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Example:

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If your employer’s benefits become available on May 1 after a 90-day waiting period, you may have until May 31 to enroll in the plan. If you miss that 31-day eligibility period, you may need to provide medical evidence to join later.

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What to Watch For:

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Mark your eligibility period on your calendar to avoid missing it. Failing to enroll during this time can result in delays, limited coverage options, or the need for medical underwriting. For guaranteed issue conversions, apply as soon as possible after your group coverage ends to maintain uninterrupted protection.