Open Enrollment is Here – Don’t Miss It!
It’s that time of year where we make one of the most important decisions for the upcoming year as it relates to health insurance coverage. But what happens if open enrollment deadlines are missed?
For an employee, missing open enrollment can mean losing coverage or being unable to change benefit elections from the previous benefit year which can both have a significant financial impact for the employee. For employers, when employees miss the enrollment deadline, it can result in additional administrative burdens and unhappy or unproductive employees. Does this mean an exception can be made to make it “better?”
Legally, employers are not required to do anything for employees who have missed the open enrollment deadline. More often than not, the terms of a benefits plan may prohibit an employer from making exceptions for employees who do not make benefits elections within a certain time period, such as before the new plan year begins. Health plans limit enrollment to an open enrollment period in order to discourage adverse selection as it can impact the overall amount of risk a health plan takes on when insuring someone.
The only exception to these terms is if an employee qualifies for a special enrollment period (SEP). Employees who experience qualifying life-changing events (such as getting married, divorced or legally separated, having or adopting a child, or moving to a new residence or work location that affects benefits eligibility) are eligible to enroll in or make changes to their benefits elections outside of the open enrollment period.
It is important for employers to educate employees on the importance of the open enrollment period and to be available to answer the many questions employees often have in making important insurance coverage decisions. While the complexity may at times seem overwhelming, there are many resources available to help, including on-line tools and educational materials as well as your benefits advisor. Take advantage of the resources to help guide your employees through this process so they can make informed decisions about one of their most valuable benefits.