An Employer’s Guide to Open Enrollment

Many group benefit plans renew January 1 so the last quarter of the year is the time when employers hold Open Enrollment.

While Open Enrollment usually competes for our time during the holiday season, it is a very important opportunity for employees to declare their election or waiver of coverage. Most importantly, if an employee is changing their election on the medical coverage from waiver (decline) to enrolled through Open Enrollment, the medical insurance company is required to accept their Open Enrollment application without underwriting or evidence of insurability.

If employees miss the company’s annual Open Enrollment, they likely will not be able to enroll in the employer-sponsored health insurance program until next year unless employees experience a life-changing qualifying event. To learn more about qualifying events, click here.

Here are some helpful tips to make Open Enrollment a meaningful time for your employees:

Use this as a time to educate.

Whether with paper or digital distribution, make sure your employees are provided plan materials in advance. The insurance carrier offers plenty of information, so take advantage of this resource. Perhaps a benefit booklet is more appropriate. Work with your ARC Advisor and assemble the details of your medical plan so your employees can review and make an informed decision.

Give your employees time to consider plan options.

Though one plan may have a higher cost, it may have a lower deductible, and another plan might have a lower cost but more out-of-pocket expenses. Employees should be evaluating their personal situation and match benefits to their needs and that type of consideration should not be done at the last minute and under pressure of a vanishing deadline. Most importantly, be sure to make arrangements with your ARC Advisor to help employees understand the costs and what the health plan will pay.

Quite often the Open Enrollment materials are not shared or discussed with family members. In addition, when both parents work and coverage is available through two employers, the family needs to decide on the best coverage option. Our suggestion is to encourage employees to have their spouses attend the Open Enrollment meeting.

Document your employee’s elections, whether it is by paper or electronically and include the employee’s signature and date signed.

Many companies think they just need to document those enrolling for coverage, but it is equally important to document a waiver/declination of coverage. There are many legal reasons that support a company practice to validate Open Enrollment elections.

Your ARC Advisor is prepared to help your company have a successful and meaningful Open Enrollment. Contact us today to set up a plan of action.