Employees have three potential enrollment periods. An enrollment period is when an employee can enroll in (or change) employee benefits.
These three enrollment times are:
- Initial enrollment period
- Annual open enrollment period
- Qualifying life event/special enrollment period
Let’s talk about each of these three enrollment opportunities and how they work.
Initial Enrollment Period
The initial enrollment period is the first time an employee can enroll in benefits.
An initial enrollment period may be open for:
- New hire A brand new employee who is eligible to enroll in benefits on their date of hire is a new hire.
- Newly eligible An employee who has a change in employment status is a newly eligible employee. Example: Employee changes from part time to full time or changing from union to non-union.
- Rehire A rehire may be eligible for an initial enrollment period with effective dates that differ from a normal rehire.
A typical initial enrollment period is 30 days. Some employers may allow a longer initial enrollment period.
Employees may need to meet a waiting period before coverage becomes effective.
The waiting period may be different for new hires, newly elgibles and rehires.
Annual Open Enrollment
Annual open enrollment occurs once per year.
During annual open enrollment, employees may:
- Enroll for the first time if they didn’t enroll before
- Make changes to or drop existing benefit elections
- Add or drop coverage for dependents
Annual open enrollment may last between one to four weeks depending on the number of eligible employees in the company.
If employees do not enroll during open enrollment, they will need to wait until the next annual open enrollment.
The only exception to this is if they have a qualifying life event.
Benefits elected during annual open enrollment go into effect at the beginning of the plan year.
A common plan year begins on January 1st. Some plan years begin mid year on July 1st. Others begin on different months such as February 1st or October 1st.
Qualifying Life Event/Special Enrollment Period
A qualifying life event opens up a special enrollment period.
Examples of a qualifying life event.
- Birth/adoption of a child
- Marriage/divorce/legal separation
- Death of a family member
Other events which may open up a special enrollment period are:
- Loss/gain of coverage
- Change in address
- Qualified medical child support order
Generally, you must notify your employer within 30 days of the qualifying life event. Most employers also ask for documentation proving the event took place.
An example of documentation might be a marriage certificate.
Conclusion
These are the three enrollment periods that allow employees to enroll in benefits.
With a few exceptions, benefit enrollments and changes aren’t allowed outside of enrollment periods approved by the insurance carriers.
