Q: How Does Open Enrollment Work?

Open enrollment is the only pocket of time where anyone can sign up for a new health plan, whether they already have one in the bag or not.

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The open enrollment period for the individual market runs from November 1 to December 15 every year, although your specific timeframe may be a smidge different, depending on where you live. For employer-sponsored group health insurance plans, open enrollment dates can differ.

This list of 2020 open enrollment dates provides an overview of deadlines for state-run exchanges.

What do I need to do during open enrollment?

First, if you already offer health insurance, figure out when your plan’s renewal period is. That’s the perfect time to conduct an audit of your current plan.

For example, some plans bump up their prices, change the benefits they offer, or do something else entirely. Your employees’ needs will evolve, too. When you figure out what is and isn’t working, you can then go ahead and calibrate your needs so you’ll be ready for open enrollment.

During your renewal period, run through the following list of questions, either on your own or with your broker:

  • Have your medical, dental, or vision plans changed? If so, is the change positive (more coverage, better cost, etc.) or negative?
  • Have your employees’ needs changed? For example, do you have more families on your team? If that’s the case, what other benefits would help them out?
  • Have your needs as a company changed? Say you’re having trouble hiring. You might want to consider stepping up your benefits package.
  • Is your team satisfied with your current health insurance plan? If you don’t know off the bat, an anonymous employee survey will help you get a sense of how people are feeling.

Whittle down your list of what you need and what you can afford, then work with your broker or carrier to find a better plan — or keep the one you’ve already got. This is called a renewal, and if your current plan is no longer alive and well, your carrier will propose a similar plan instead.

To help your employees make the best choices possible during open enrollment, make sure they understand:

  • Any changes to their coverage or the available plans
  • How to make changes if they would like to select a different plan

What happens if my employees miss open enrollment?

All’s not lost. Your employees can still sign up for health insurance during a special enrollment period, which is activated if you have a qualifying life event, also called a QLE. Adopting a child, getting hitched, and other momentous occasions are all prime examples of a QLE.

QLEs are broken out into three areas:

  • Updates to your place of residence, also known as moving (but only if you move to an area that results in changes to your health insurance)
  • Updates to your household, like getting married or having a child
  • Losing health insurance, like your spouse’s coverage if they change jobs, or if you turn 26 and don’t qualify for your parent’s coverage

If any of the above has happened to your team, they’ll have a 30-day window after their QLE to enroll in another plan that better suits their needs.

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