The Affordable Care Act transformed many aspects of our health care system, not the least of which is the open enrollment period.
As we move closer to the general health care enrollment period there is no better time to review how to prepare as an employee or an employer.
Quick Overview to Open Enrollment
Open enrollment officially starts on November first, but many businesses have open enrollment periods throughout the year. Of course, any employee who has just been hired for a new position can sign up for their employer’s health insurance open on boarding.
This period allows employees to elect or change their benefit options as well. This includes health, dental and life insurance plans they may hold through their employer. Open enrollment takes place a few months before the new year to prepare for enrollment forms that must be submitted by January 1.
Interestingly, employers do not have to meet a standard for the length of their open enrollment. Most open enrollment cycles last at a minimum of two weeks and maximum of four weeks.
Employers are responsible for submitting information about their employee’s health care plans, and employees are responsible for deciding which plan option is right for them if they choose an employer-sponsored plan. Preparation, therefore, is required on both sides.
How Businesses Can Prepare for Open Enrollment
Open enrollment is a hectic time for HR team members. Analyzing health care updates, sorting through multiple plan options, and determining what, if any, new budget has been imposed is overwhelming. To keep your calm and prepare, here are a few important tips to keep in mind.
Plan Ahead
Don’t wait until the last moment to plan for open enrollment. Employees want to know what changes are being made to their benefits packages in advance. Your company wants to stay competitive and your benefits package plays an important role in doing so. Give yourself at least two weeks to plan and organize upcoming health plans for your employees.
Ask Employees Questions
A great way to get a feel for what your employees expect from their benefits package is to simply ask them. Run a survey company-wide that covers the basics of your plan options and see which ones resonate most with your team. Then move forward organizing your plan based on their response.
Be Transparent about High Deductible Plans
If you’re thinking about a major plan change, like switching to a High Deductible Plan option, be very clear with employees about what that involves. Explain their plan options so they know exactly what to expect.
Pursue Compliance
The Affordable Care Act (ACA) is far from simple. Implementing compliant plans can be even trickier. Make sure you are fully aware of deadlines for communicating enrollment options. Make sure you have all information about compliance ready to go before you start informing your team about enrollment. Compliance isn’t something you want to wait to get together.
Highlight the Value of Your Plan Options
Employees often don’t have time to sort through their options. Most want to know a) what the plan costs them b) what’s covered under the plan, and c) when and how to use it. It’s your job to highlight those answers so employees aren’t left out to dry.
What to Keep in Mind
- Make your benefits package competitive. Competitive benefits packages play an important role in capturing talented employees.
- Either learn how to or find someone who can explain benefits to employees who aren’t concerned about them.
- Give employees the support they need to sort through the confusion of open enrollment season. If open enrollment is confusing to you, it certainly will be for employees. Set up training programs or conference meetings where you can go over the benefit options so everyone is on the same page.
How Employees Can Prepare for Open Enrollment
As an employee, open enrollment might seem more like another thing you have to do, rather than something to be excited about. The good news is that open enrollment is the best time of year to switch up your plan options and get what you want from your health care. Before you sign up for the plan, however, get prepared.
Analyze your family needs.
Is dental important? Do you plan on having a child in the next 12 months? What about dental and vision coverage, is that needed? Figure out what you might need before you start browsing your company’s plans.
Educate yourself about what type of plans provide the coverage you need.
For example, if there are high deductibles, what alternatives are available if and when you need expensive medical care? Do you need a plan option that offers maternity or select care? Isolate what plan would be best suited for your needs.
Determine your budget for healthcare.
Your employer will pay most of your insurance premiums, but you may be expected to pay out-of-pocket for certain coverage. It’s a good idea to sit down and determine an appropriate budget for both your premiums and any extra expenses you may have to cover.
Prepare questions to ask your company’s HR department up front.
If you’re unsure of any aspect of your company’s health care plan, write your questions down and present them to your HR department. You have a right to know your options.
What to Keep in Mind
- Check with your employer to make sure your plan from last year is still available. If it’s not, then you need to focus on what your plan options are now.
- Your employer can renew your plan automatically if you don’t inform them of any changes you’d like to make. Be proactive to get a plan that best suits your needs.
- If your employer sticks with a once a year enrollment period keep your ear to the ground and read any emails about health care changes.
Get the Help You Need
If you need assistance as an employer or employee, we can help. We know how confusing open enrollment can be, but we have over twenty years of experience helping small to medium-sized businesses prepare their company’s insurance plan and we can help you too. Feel free to contact our team for more information about how to get started this open enrollment period.
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