Adult Qualifying Events

Who Needs to Qualify For Plan Year 2020?

    • All members, regardless of age, except those with a Benefits Effective Date of 1/1/19 or later.

    • Members with Diabetes and/or are Nicotine Exposed must complete specific qualifying events annually for the Ultimate and Best Plan Levels.

 
Refer to the CHILDREN section for their qualifying guidelines.
 

Qualifying Lab Work

Fasting Lab Work must be completed at one of the designated Lab Draw...

Qualifying Wellness Exam

Schedule your exam with your Primary Care Physician (or...

Qualifying Event Age Based Screenings

Age Based Screenings are included in the criteria needed to qualify for...

Nicotine Exposed: Qualifying Requirements

A summary of the required Qualifying Events for each plan level are...

Diabetes Qualifying Requirements

In order to qualify for the BEST or ULTIMATE Health Plan Levels, members...

How to Find a Primary Care Physician (PCP)

Finding a physician you trust, have rapport with, who has reasonable...

QE Instructions and Forms

Qualifying Event instructions and related forms

Qualifying FAQ

Qualifying Events - Frequently Asked Questions

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