Special Enrollment

If you are in need of health insurance coverage due to an unanticipated qualifying life event you may be eligible to enroll in one of our health coverage plans through Special Enrollment.  

Examples of Qualifying Events include:

  • Getting married or entering into a domestic partnership.
  • Dependent status change such as having a child or adopting a child, receiving a child into foster care, or placing a child in adoption or in a foster home.
  • Change in place of residency.
  • Losing employer-sponsored health coverage.​​​

​​​​For a more complete list of qualifying life events and acceptable documentation, please refer to the Covered California Special Enrollment page.

Applying After a Qualifying Life Event

You have 60 days from the date on which the qualifying life event happens to enroll. For example, if you have a child on June 1, you have until July 31 to complete an application for the new child. If 60 days pass and you do not sign up for health coverage, you will have to wait until the next open enrollment period.

Application Submission - Individual & Family Plan

  • To apply using our on-line application (coming soon) you will need an email address to sign the application electronically. 
  • To apply using a fillable and printable application, or a paper application, please submit a completed application by using one of the following options.  

        Valley Health Plan
        Attn: Sales & Broker Relations Department
        2480 North First Street, Suite 160
        San Jose, CA 95131

[email protected]

*Please DO NOT send an unencrypted application to VHP via E-Mail. If you prefer to submit your application via e-mail, please encrypt the document before sending, otherwise please use our Secure Fax line or mail the application via U.S. Postal Service. ​​​

For more information about VHP's benefits, please see Summary of Benefits and Coverage (SBC).  If you are ready to enroll or have more questions, VHP has partnered with brokers in your neighborhood who can help you choose the right plan for you and your family. Or call us directly at 1.888.421.8444 (toll-free).​​

*For information about Covered California plans or to see if you qualify for a subsidy, you can apply online or call 800.3001506.


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