Prepare Your Employees for Open Enrollment

What Is Open Enrollment? 

Open enrollment is a window of time when you can enroll in a health insurance plan, make changes to coverage, add anything you need, or even cancel your coverage. During an Open Enrollment Period, individuals cannot be turned down for Affordable Care Act-compliant health insurance because of their health status, so it’s a great time for people to sign up. 

Why do we have open enrollment? Basically, without open enrollment, it could be difficult to spread insurance risk around to actually provide coverage for people who are sick. If people could get coverage whenever they’re sick and drop it when they’re not, there wouldn’t be enough money to cover people who are seriously ill or chronically ill. Open enrollment encourages everyone to have health insurance to make sure they’re always covered and to make sure there’s enough to go around for everyone. 

When Is Open Enrollment for 2023 Health Plans?

Open enrollment dates actually depend on where you are. Most states use the same ACA open enrollment period: Nov. 1, 2022, to Jan. 15, 2023. but there can be a few variations. Check out this chart to see when your state has open enrollment for 2023: 

How to Maximize Open Enrollment Periods

The Affordable Care Act requires a certain amount of coverage, but your employees’ plans can still vary a lot depending on 

• Plan design
• Premium costs
• Copays for doctor, urgent care and emergency room visits (and prescription drugs)
• Deductibles
• Coinsurance
• Provider networks
• Prescription drug benefits

It also can depend on what you offer as a benefit or as part of your fringe benefits. 

To really take advantage of the open enrollment periods, it’s key to communicate with your employees about what things they should be considering during this brief period of time. Here are some things to make sure your employees know and are considering: 

• Possible health care needs for the next year (will you need more or less coverage? A big surgery coming up or anything like that?)
• Compare health insurance costs
• Explore plan design differences 
• Check out the health plan’s provider network (health insurance can be part of a benefits strategy, so employees should check out what that entails)

Managing Different Types of Health Insurance During Open Enrollment

Not every type of insurance is equal or has the same open enrollment details. In general, the ACA insurance options are the ones that follow the open enrollment policy. What about different types of health insurance? 

• Employer-sponsored. Companies decide when people become eligible as part of employee benefits programs. 
• Medicare. The Medicare enrollment period is usually from October 15 to December 7. 
• Medicaid. Medicaid doesn’t require an enrollment period and is available year-round. If you’re eligible, you can sign up for it whenever you want. 

Can Employees Make Changes Outside of Open Enrollment?

Time to ask the million dollar question: can employees make changes to their health insurance plan outside of open enrollment? Unfortunately, changes are not possible outside of enrollment. You also can’t get coverage or cancel an ACA plan outside of open enrollment. Except for a few exceptions. You can make changes if you have a qualifying life event, including: 

• Marriage
• Divorce
• Birth or adoption of a child
• Death of a family member (like a spouse)
• Becoming a US citizen
• Moving to a new place permanently
• Loss of previous coverage (like turning 26 and losing a parent’s plan)

So if you have a qualifying life event, you can adjust your plan. Otherwise, hold tight until the next enrollment period. 

The Bottom Line

Open enrollment is an important thing to know about and to communicate to your employees. Ensure that your employees know the deadlines for open enrollment and how they can take advantage of the time to adjust their health insurance plans. 

Many benefits are required to be selected during the open enrollment period, but your company can onboard new wellness programs at any time of year. Talk to a Wellbeing Specialist about how to make that a reality.