Why do I need to provide proof of a qualifying event?
- Certificate of Creditable Coverage (COCC)
- Marriage Certificate
- Birth Certificate
- Notice of birth from the hospital
- Domestic partner affidavit
- Date of loss of coverage
- Marriage date
- Date of birth
Example of an acceptable document
The Certificate of Creditable Coverage (COCC) below is a good example of a loss of coverage document because it has the official insurance carrier logo at the top of the page and includes the name of the member to whom it applies as well as the coverage effective date and cancellation date.
Example of an unacceptable document
The document below is a medical insurance card and would not be accepted as it does not include the coverage effective date or cancellation date.
Inadmissible example document #2
The image below is a bad example of a loss of coverage document as none of the information is legible.
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