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Documents needed to confirm your eligibility for a Qualified Health Plan (QHP)

The links below highlight the documents needed to support your application and confirm eligibility:

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Qualifying Life Event for Special Enrollment

To be eligible for a Special Enrollment Period, you must have a Qualifying Life Event. If you received a letter from us asking you to verify your Qualifying Life Event, please select the applicable event below for more information on how to confirm your Qualifying Life Event and complete your Special Enrollment.

Quality Life Event

Provide a coverage termination letter from employer, HR department, or healthcare coverage administrator of your terminated coverage. Termination letters must include:
  • Your first and last name
  • An insurance coverage end date that happened or will happen within 60 days of your Access Health CT application date.
  • The last day of coverage in the termination letter must be the same as the coverage end date you list on your application.
  • Name of employer or healthcare coverage administrator
  • Name and signature of authorized person issuing the letter
Please note: If your coverage termination letter says that you did not pay your premiums or that you chose to terminate your coverage, you will not be eligible for Special Enrollment.
To confirm your marriage as a qualifying life event, please provide the following applicable documents:
  1. A marriage license or marriage certificate that includes:
    • Your full name
    • A marriage date consistent with your attested marriage date on your application.
      • Please note: Your marriage license does not need to be from Connecticut.
  1. Proof of prior healthcare coverage for at least one spouse during the last 60 days. Acceptable documents include a letter and/or invoice or any proof of premium payment from your healthcare insurance company or healthcare coverage administrator showing the following:
    • The first and last name of the person covered
    • Enrollment for healthcare coverage and a coverage date that was at least 60 days prior to the marriage date.
Important: If you or your new spouse were enrolled for in healthcare coverage through Access Health CT, proof of prior healthcare coverage is not needed. You only need to provide the marriage license or marriage certificate.
To certify your pregnancy as a qualifying life event, you must provide, within thirty (30) days of applying for healthcare coverage through AHCT, a letter from your healthcare provider that includes:
  • Your first and last name
  • Provider’s name
  • Provider’s office contact information (Street address, Phone number, email address)
  • Provider’s scope of practice
  • Please note: Your certifying licensed healthcare provider must practice in one of the following fields:
    • Obstetrics/Gynecology
    • Primary Care
    • General Medicine
    • Internal Medicine
    • Family Medicine
  • Provider’s National Provider Identifier (NPI).
  • Provider’s signature and date
Please note: Individuals who were enrolled in Minimum Essential Coverage (MEC) at the time of their certification will not be eligible for Special Enrollment due to pregnancy.

A sample of a letter of certification of pregnancy can be viewed here.
Please provide a birth certificate that includes:
  • Baby’s full name
    • Note: Baby’s full name must match the baby’s name on your application
  • Baby’s birth date
    • Note: The birth date must match the baby’s birth date on your application
    • Note: The birth date must be within 60 days of the date you applied for healthcare coverage through AHCT
Please note: The birth certificate does not need to be from Connecticut, but everyone applying for coverage must be a Connecticut resident.

A sample of a birth certificate can be viewed here.

Quality Life Event 2

Please provide a court-issued order that includes:
  • Child’s full name
  • The court-issued order date
    • Note: The order date must match the date on your application
    • Note: The order date must be within 60 days of the date you applied for healthcare coverage through AHCT
To certify your Permanent Move to Connecticut as a qualifying life event, you will need to provide the following three (3) documents:
  1. A dated document prior to your move to Connecticut containing:
    • Your name
    • Your address prior to your move to Connecticut
    • A document date within 60 days of the date you applied for healthcare coverage through AHCT
    Please see the list of Acceptable Documents to confirm your Previous Address:
    • Credit card bill
    • Utility bill, such as a gas or electric bill
    • Paystub from your employer with your previous addresses
    • Request for a change of address from the Department of Motor Vehicle (DMV)
    • Post office request to forward mail from the prior address
    • Proof of your previous address for renter’s insurance policy
    • Proof of your previous homeowner insurance policy
  1. A dated document after your move to Connecticut containing:
    • Your name
    • Your address after your move to Connecticut
    • A document date within 60 days of the date you applied for healthcare coverage through AHCT
    Please see the list of Acceptable Documents to confirm your Current Address:
    • Credit card bill
    • Utility bill, such as a gas or electric bill
    • Paystub from your employer with your current addresses
    • Request for a change of address from the Department of Motor Vehicle (DMV)
    • Post office request to forward mail to the new permanent address
    • Proof of your current address for renter’s insurance policy
    • Proof of your current homeowner insurance policy
  1. A document containing Proof of Minimum Essential Health Coverage prior to your move to Connecticut. The document must include:
    • Your first and last name
    • An active coverage date within 60 days prior to your move to Connecticut.
    Please see the list of Acceptable Documents to confirm your prior healthcare coverage:
    • Notice or documentation showing a processed payment to a health insurance issuer
    • Employer or Human Resources department confirmation of coverage
    • Notice of healthcare coverage from another state
Note: An insurance card does not confirm prior coverage
To certify your Permanent Move to Connecticut from a Foreign Country or U.S Territory as a qualifying life event, you will need to provide the following two (2) documents:
  1. A dated document prior to your move to Connecticut containing:
    • Your name
    • Your address prior to your move to Connecticut
    • A document date within 60 days of the date you applied for healthcare coverage through AHCT
    Please see the list of Acceptable Documents to confirm your Previous Address:
    • Credit card bill
    • Utility bill, such as a gas or electric bill
    • Paystub from your employer with your previous addresses
    • Request for a change of address from the Department of Motor Vehicle (DMV)
    • Post office request to forward mail from the prior address
    • Proof of your previous address for renter’s insurance policy
    • Proof of your previous homeowner insurance policy
  1. A dated document after your move to Connecticut containing:
    • Your name
    • Your address after to your move to Connecticut
    • A document date within 60 days of the date you applied for healthcare coverage through AHCT
    Please see the list of Acceptable Documents to confirm your Current Address:
    • Credit card bill
    • Utility bill, such as a gas or electric bill
    • Paystub from your employer with your current addresses
    • Request for a change of address from the Department of Motor Vehicle (DMV)
    • Post office request to forward mail to your new permanent address
    • Proof of your current address for renter’s insurance policy
    • Proof of your current homeowner insurance policy
Note: If you have been asked to provide additional documents to prove U.S. citizenship or lawful presence/immigration status, please click here for additional information:

Lawful Presence/Immigration Status

U.S. Citizenship or US National Status

How to Submit Documents

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Certification of Pregnancy Sample
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