If there’s one thing I’m passionate about, it’s the open enrollment process.
Over the years, I’ve spent hours and hours meeting with employers, department heads, employees and brokers to personally deliver my message about how open enrollments work, why they are important and why each employee should go through the enrollment process even if they may not be interested in enrolling in any benefits.
As you read below, I will of course review the basics of how open enrollments work. But, more importantly, I’ll also share my perspective on how open enrollment should work and why it should work that way.
Alright, let’s dig in.
What is Open Enrollment?
Open enrollment is the annual time of year when each benefit eligible employee can enroll or decline each of the employee benefits offered to them for the upcoming plan year.
When is Open Enrollment and How Long Does it Last
Open enrollment usually occurs in the last couple of months or so of the plan year. For most employers this is either the last couple of months of the calendar year or a month or so before July 1 if it’s a midyear plan. Open enrollment will last from one to four weeks depending on the company.
What to Expect Before Open Enrollment Begins
You’ll know open enrollment is around the corner when you receive a letter, email, text or enrollment platform alert announcing it. This open enrollment announcement will usually have the important information you’ll need to know about the upcoming enrollment.
- What’s new or changing about the benefits Employee benefits are always changing. Your employer will potentially change any number of things about the benefits being offered. They could change the employee benefits themselves or change the insurance carriers who offer those benefits. It’s possible some benefits could be discontinued and no longer payroll deducted. A new wellness initiative might be rolled out. These are just some of the types of changes you might see.
- Whether employees are required to enroll for benefits to continue Some employers require employees to make their benefit elections each and every year. If you don’t enroll, your benefits end at the end of the current plan year. Other employers may not require you to enroll if you don’t want to make any changes. If you don’t want to make any changes, your current elections will roll over.
- Pre-enrollment meetings Meetings may be scheduled to review some or all of the benefits. These could be group meetings onsite, live webinars or recorded videos.
- Open enrollment dates The enrollment dates are when employees can begin enrolling and the deadline to enroll. It’s important to not wait until the last minute to enroll and potentially miss the deadline.
- An employee benefit guide The benefit guide is your key tool to understanding your benefit options available. While you won’t find every complete detail in the benefit guide, you’ll learn the highlights.
- Separate, more detailed benefit summaries and information Each benefit provider may give additional more complete information about each benefit. I personally always look for the summary of benefits and coverages for the health insurance but those aren’t always available at open enrollment time.
- Instructions on how to enroll You’ll learn about how to complete your enrollment so you’ll have the benefits you want.
Every employer is different about what materials they provide and how detailed they are. More detailed information can always be obtained if you don’t see what you are looking for.
What you’ll want to do is make sure you pay careful attention to what is sent out and take the time to review it – especially the deadline to enroll.
Preparing to Enroll in Benefits
Once you have received all of the open enrollment information, it’s time to sit down and review all of the information you’ve been given. I personally think it’s a good idea to go through these steps.
- Read the benefit guide and other information Carefully read the benefit guide and other information provided.
- File any claims you might be eligible for Some benefits have wellness benefits you can claim just for completing a wellness screening. You’d be surprised, but it not uncommon for employees to forget they have certain benefits and completely forget to file a claim. I’ve seen employees show up at open enrollment with a broken arm before and totally forgot they had an accident plan that would pay them a benefit. And this employee was the HR director so it can happen to anyone. I’ve seen employees or their spouses find out they had cancer and then not even realize they could have filed a critical illness claim.
- Review last year’s benefit confirmation statement If you kept last year’s confirmation statement, have a look at it to refresh your memory on what you enrolled in.
- Review your paystub Compare the deductions for what you enrolled in last year to the new per pay deductions this year.
- Compare this year’s benefits to last year’s I typically keep last year’s benefit information so I can see for myself what is different. Believe it or not, I’ve been told before that nothing’s changing if you don’t enroll only to discover the deductibles on the health insurance changed.
- Decide which benefits you’ll enroll in for this year Identify which benefits you would like to enroll in.
- Write down any questions you have Make a list of questions if there is missing information so you can be sure and get that information.
- Be on the watch for guaranteed issue offers Guaranteed issue is the one of the most important underwriting concessions your employer can get for you. When it is offered, look at it and evaluate if it make sense to you.
- Get dependent information To enroll dependents, you’ll need spelling of names, dates of birth and social security numbers.
If you follow these steps, you’ll be prepared to enroll in your benefits when open enrollment starts
How to Enroll in Benefits
Once open enrollment begins, you’ll need to follow the enrollment instructions. As far as actual enrollment goes, you’ll probably be given one of the following methods to enroll.
- Paper Yes, believe it or not, some employers still have their employees enroll on paper.
- With the help of your Human Resources department Some Human Resources departments will enroll you in the benefits you want to elect.
- Onsite benefits counselor Benefits counselors may schedule times to be onsite to help facilitate your enrollment in person.
- Call center benefits counselor Using a call center to help people enroll is increasing in popularity. The call center can be used to answer benefit questions, enroll you in your benefits or help provide a backup method to employees who were unable to enroll with an in person benefits counselor.
- Self-elect your benefits Many enrollment platforms give employees the option to self-enroll in their own benefits.
It’s not unusual to be given a choice from several different enrollment methods.
Completing Your Enrollment
Open enrollment has now started and it’s time to do the most important part and that’s actually complete your open enrollment.
The Importance of the Enrollment Process
I spend most of my time explaining the importance of having each employee go through the open enrollment process even if an employee doesn’t think they will enroll in any benefits.
Employers and employees alike often don’t realize how important it is that all employees complete the process.
Here are a few reasons why:
- Updated personal, dependent and beneficiary information If each employee enrolls or declines their benefits, then the employer can clean up their data and make sure each employee has named a beneficiary for any employer paid life insurance.
- Document each employees enrollment There are always employees that either claimed they enrolled or claimed they didn’t enroll. If each employee goes through the enrollment process, there’s a record of what every employee enrolled or declined.
- Communicate important wellness or other initiatives Open enrollment is also a time for messaging. Having each employee complete their enrollment provides the opportunity to get that message out.
- Obtain better underwriting offers from insurance carriers Open enrollments are a partnership between employers, employees and insurance companies. When everyone participates in that process, the underwriting offers get better from the insurance companies.
- Help subsidize ben admin technology & enrollment services Employers need ben admin systems to manage the benefits and enrollment resources to help employees better understand their benefits. The cost of these services can be reduced or eliminated with one simple step – asking each employee to enroll or decline each of their benefits.
Aside from these reasons, employees that complete the enrollment process will often enroll in benefits after they hear about them.
Communicating the Right Enrollment Message
I always find it amazing that employers will spend so much time planning open enrollment only to then discourage employees from going through the enrollment process. Employees are often told that they if they don’t want anything they can just ignore the process or they’ll tell the employee they need to go waive their benefits.
This kind of message sets up a wall that makes it difficult for those communicating the benefits from properly walking each employee through an educational enrollment process.
The right enrollment message is this.
Please go complete your open enrollment even if you think you might not want to enroll in any benefits so that you at least hear how each benefit works and why it’s being offered.
This simple change in messaging will improve your open enrollments and reinforce the importance of open enrollment I discussed above.
Benefit Confirmation Statement – Your Proof of Coverage
At the end of your enrollment, you’ll want to get a benefit confirmation statement. Your benefit confirmation statement is your proof of enrollment. It shows what benefits you enrolled in, who you covered in each benefit, the amount of your payroll deduction and the effective date of each of your benefits.
When you get your benefit confirmation statement, you want to review to make sure that the benefit elections you made match what you really wanted to enroll in.
The reason this is important is because if later there is any question about what you enrolled in, you’ll essentially have a receipt of what benefits you elected. Remember though, that while your benefit confirmation statement is your proof of coverage, the actual policies of the benefits that you enrolled in will govern how your benefits work.
I always prefer a pdf copy of my benefit confirmation statement. Paper is sometimes to easy to misplace. I always print out a copy but I have a digital back up.
If you do your enrollment on paper, you won’t get a confirmation statement. In that case, I’ve always just made copies of each of my enrollment forms.
What if You Miss Open Enrollment?
If you miss open enrollment, you’ll have to wait until the next open enrollment to make changes to your benefit elections unless you have a qualifying life event. A qualifying life event is like getting married, getting divorced or having a baby. A qualifying life event opens up a special enrollment that allows you a 30 day window to change your benefits.
If it’s not too far past the deadline, you may be able to get an exception but this is at the employer discretion.
What if You are a New Hire?
If you are a new hire, your new hire enrollment might be shortly before open enrollment or coincide with open enrollment. Be sure to check with Human Resources to make sure that you complete your new hire enrollment.
After Open Enrollment Closes
Once open enrollment closes, there will a few weeks before your benefits become effective and your payroll deductions begin. Here are a few things you’ll want to make sure you do.
- Consider getting prescriptions refilled If you have a change in health insurance carriers, you might want to get your prescriptions refilled. There’s no guarantee that the new insurance carrier will treat your prescriptions the same way as the old one.
- Review your paystubs These days, with direct deposit, very few people review their actual paystub. However, after your first payroll deduction of the plan year, you want to make sure you review your paystub to make sure the deductions match up with your benefit elections. It’s amazing how employees wait 6 months and then find out their payroll deductions don’t match up.
- Watch for insurance ID cards While cards are sent out every year, you want to keep an eye out for them if they are.
- Visit carrier websites Set up profiles for new carriers that have them. If they have smart phone apps, also consider downloading those as well. You can sometimes get a temporary ID card if you need it and find network providers for your plans.
I also suggest that you keep a record of all the benefit materials until the next open enrollment.
Conclusion
I hope that gives you a better understating of how open enrollment works.
Open enrollment is a very important time. It’s a time for you to review the employee benefits. If you miss open enrollment, you’ll need to wait until the next open enrollment to make changes unless you have a qualifying life event.
I always recommend that all employees go through the enrollment process even if you might not be interested to at least hear how each benefit works and why it’s offered.
