What is Open Enrollment?

Open enrollment is the period of time each year in which eligible employees may enroll in your health plan. Some plans may stay the same from year to year, with adjustments for any changes in the law, while other plans may feature significant new benefits. Much of what is offered is up to the employer. Health plan options often include traditional medical coverage, but may also include other health benefits, such as:

• Health savings accounts (HSAs);
• Flexible spending arrangements (FSAs); and
• Health reimbursement arrangements (HRAs).

Understanding Options

Except in certain circumstances prescribed by law, employees and their families must enroll in your plan during the open enrollment period set by the plan; they will not be able to change their mind and sign up for coverage in the middle of the plan year. Thus, it is important for employees and any of their eligible family members to understand all of their options for the coming year during enrollment season. Your employees may also want to confirm that their doctors are in the network provided by the plan.

Your health plan can make this process easier by promoting employee engagement in open enrollment, and making resources available online or through your company intranet. You may want to contact your insurance carrier for promotional materials.

The following important tips will help employers plan a successful open enrollment period.

Tip #1: Design a Clear and Concise Open Enrollment Announcement

Make sure your open enrollment announcement clearly summarizes key information, including:

• Open enrollment period dates for all benefits
• Pre-tax contribution rates by specific benefit
• Post-tax contribution rates by specific benefit
• Premium increases (if any)
• Any benefit changes

Tip #2: Create and Follow a Schedule for Communicating Open Enrollment Information

Create a timeline for distributing the required communication materials to help ensure a successful open enrollment. The following is an example of a potential timeline:

• Email and/or mail your open enrollment announcement 7-14 days prior to the open enrollment period
• Send email reminders 1-3 days before the open enrollment period begins, and include FAQs
• Send a reminder on the 1st and 2nd days of open enrollment to all employees, which includes information such as open enrollment requirements and deadlines

Tip #3: Determine Employee Eligibility

If your company is subject to the “pay or play” provisions of the Affordable Care Act (which generally applies to those with 50 or more full-time employees, including full-time equivalent employees), be sure you have used proper methods for determining whether an employee has sufficient hours of service to be considered full-time, and therefore eligible for health benefits. Even if your company is not subject to the “pay or play” provisions, it would be prudent to confirm the eligibility requirements for particular benefits.

Tip #4: Distribute Required Benefits Notices or Disclosure Statements

Ensure that required notices are distributed, such as a Summary of Benefits and Coverage (SBC), Summary Plan Description (SPD), and Notice of Special Enrollment Rights.

Tip #5: Don’t Overlook the Human Touch

Make sure that there is a company representative accessible to employees throughout the enrollment period who can answer questions and serve as a resource. Allocating staff time to this is a wise investment that will limit frustration and create a better experience for employees as they enroll.

Emplova is a unique Professional Employer Organization (PEO) that helps small to medium sized businesses grow and prosper by providing benefits, payroll, technology, compliance, and HR administration. To learn how we can create a winning HR strategy for your business contact us today.

*Information in this article is general in nature and not intended to replace legal advice in any particular manner.