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Are You Ready For Open Enrollment?

Open Enrollment (OE) is just around the corner for many, and whether you are handling it on your own or with some guidance, making sure you are prepared for the task at hand will ensure that you have a smooth and seamless OE. Managing OE is extremely time consuming, and employer group health and welfare benefits are becoming increasingly more complex. It is challenging to keep up with continuously changing laws that impact benefits administration, making it easy to fall out of compliance. The following are key points to keep in mind to help you navigate these changes.

First, identify the plans you are going to offer for the new plan year.

  • Identify the benefit plans that will be new, changing or terminated. 
  • If you have rate changes, find out how rates need to be updated in your Human Capital Management System (HCMS) (ex. monthly or per pay period), so the appropriate deduction amounts are displayed to your employees. 
  • In some systems, FSA and HSA plans should be rebuilt each year for active re-enrollment.  Annual limits can change from year to year, so it is important to know how your annual limit gets updated in your HCMS.

Once you have the benefit offerings and rates determined, plan how employees will enroll in their benefits.

  • Determine when you are going to have employees elect benefits for OE. Best practice is to give employees about 10 days to complete the online enrollment process.
  • Identify what determines eligibility for benefits. If eligibility needs to change for the upcoming plan year, find out how to make those updates so that employees are viewing the appropriate benefit plans for their new eligibility during OE.
  • For plans that require Evidence of Insurability (EOI), consider how you will manage that process, whether it’s a workflow or through reporting.
  • Determine the areas in your system that allows you to provide plan documentation to share with your employees.

The next step to consider is the functionality of your HCMS, and how these changes affect other parts of your business.

  • Consider and plan for changes affecting your payroll set-up, such as adding a new deduction code, special taxing (pre-tax versus post-tax), setting up new goal amounts, your deduction schedule, etc. If you need to create new deduction codes, be sure to map them to your benefit plans.
  • Some systems allow for OE elections to be approved. If your system allows for approvals, be sure the appropriate workflow is in place.
  • Develop a test plan for your OE profile so there aren’t any surprises when it’s time for your employees to make their elections.
  • Once testing is complete, find out what you may need to do to make your OE profile live for your employees.
  • Consider the pay date/period ending date that you will transmit your first payroll that will include the new OE plans, elections, and/or rates. Will the OE changes update automatically or is there something you need to do to make that happen?

After open enrollment is complete, how are you getting the enrollments to your carriers? Consider the following:

  • Do you have new carriers which require new connection/Electronic Data Interchange (EDI) files? Some systems require service requests when requesting a new connection/EDI file. Be sure to submit this request as early as possible.
  • If you have existing carrier connections, are there any account structure changes that need to be provided to your HCMS provider?
  • What date do your OE files need to be sent to their respective carriers?
  • How do your OE files get scheduled? Find out if you are responsible for scheduling them or if you need to work with your HCMS’s connection specialist.
  • If you do not have carrier connections, how will you inform your carrier of the OE enrollments? Some carriers provide unique enrollment templates which are important to review early and determine how you can extract the information from your HCMS.
  • What happens with your regularly scheduled files after the OE files are sent? Your carrier may require your regularly scheduled file to be paused after the OE file is sent until the new plan year begins. Be sure to understand how that occurs in your system and work with your carrier on how you will provide updates for the existing plan year while the file is paused.

Occasionally, an additional pay period occurs based on the calendar and you may end up with 27 pay periods instead of 26 for a biweekly frequency or 53 pay periods instead of 52 for a weekly frequency. When this occurs, some organizations suppress deductions for the final payroll of the upcoming plan year so there will continue to be a consistent number of deductions each year. Some systems allow you to schedule deduction suppression in advance by updating your payroll schedule. Make sure you know your system capabilities to avoid a potentially costly mistake.

How HR Works Can Help

HR Works, Inc. is a total solutions provider of HR management and benefit services, including open enrollment planning and administration. Our trained benefits specialists can help educate and prepare your employees to make the right informed decisions every step of the way. Contact us today to learn more.

HR Works, headquartered in Upstate New York, is a human resource management outsourcing and consulting firm serving clients throughout the United States for over thirty years. HR Works provides scalable strategic human resource management and consulting services, including: affirmative action programs; benefits administration outsourcing; HRIS self-service technology; full-time, part-time and interim on-site HR managers; HR audits; legally reviewed employee handbooks and supervisor manuals; talent management and recruiting services; and training of managers and HR professionals.