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It’s Never Too Early to Prepare for Open Enrollment Season!

Open enrollment is the period of time each year in which eligible employees may enroll in your group health plans. During this time—typically a couple of months prior to the new plan year—employees must review your offerings and decide which benefits to select. Some plans may stay the same from year to year, with adjustments for any changes in the law, while other plans may feature significant new benefits. Much of what is offered is up to the employer. 

Understanding Options

Except in certain circumstances prescribed by law (qualifying life events, etc.), employees and their families must enroll in your plan during the open enrollment period set by the plan; they will not be able to change their mind and sign up for coverage in the middle of the plan year. Thus, it is important for employees and any of their eligible family members to understand all of their options for the coming year during enrollment season. Employees should consider how frequently they expect to use doctors’ services, drug prescriptions and other health care items or services. Your employees may also want to confirm that their doctors are in the network provided by the plan. 

Your health plan can make this process easier by proactively promoting employee engagement in open enrollment, and making resources available online or through your company intranet. To seek assistance in this regard, you may want to contact your insurance carrier or broker for promotional materials.     

Required Notices

Open Enrollment is also a great time to distribute all required annual notices to employees.  These notices vary depending on benefit plans.   Most employers will need to distribute the following notices* to eligible employees:

  • Summary of Benefits and Coverage (SBC) and Uniform Glossary
  • Notice of Special Enrollment Rights
  • Health Insurance Exchange Notice
  • Notice of Patient Protections
  • Notice of Privacy Practices
  • Women’s Health & Cancer Rights Act (WHCRA) Notices
  • Employer Children’s Health Insurance Program (CHIP) Notice
  • Newborns’ and Mothers’ Health Protection Act Notice
  • Medicare Part D Creditable Coverage Disclosure Notice or Medicare Part D Non-Creditable Coverage Disclosure Notice
  • General Notice of COBRA Rights

*employers may need to provide additional notices to employees depending on benefits offered and plan provisions

Top 5 Open Enrollment Tips

The following important tips will help your company plan a successful open enrollment.

Tip #1: Design a Clear and Concise Open Enrollment Announcement
Make sure your open enrollment announcement clearly summarizes key information, including:

  • Open enrollment period dates for all benefits
  • Pre-tax contribution rates by specific benefit
  • Post-tax contribution rates by specific benefit
  • Premium increases (if any)
  • Any benefit changes

Tip #2: Create and Follow a Schedule for Communicating Open Enrollment Information
Create a timeline to distribute the required communication materials to help ensure a successful open enrollment. The following is an example of a potential timeline:

  • Email and/or mail your open enrollment announcement 7-14 days prior to the open enrollment period
  • Send email reminders 1-3 days before the open enrollment period begins (include FAQs as an effective way to respond to the most commonly asked questions)
  • Send a reminder on the 1st and 2nd days of open enrollment to all employees, which includes information such as open enrollment requirements and deadlines

Tip #3: Determine Employee Eligibility
If your company is subject to the “pay or play” provisions under Health Care Reform (generally those with 50 or more full-time employees, including full-time equivalent employees), be sure you have used proper methods for determining whether an employee has sufficient hours of service to be considered full-time, and therefore eligible for health benefits, to avoid penalties. Even if your company is not subject to the “pay or play” provisions, it would be prudent to confirm the eligibility requirements for particular benefits.

Tip #4: Distribute Required Benefits Notices or Disclosure Statements
Ensure that required notices are distributed, such as a Summary of Benefits and Coverage (SBC), Summary Plan Description (SPD), and HIPAA Notice of Special Enrollment Rights.

Tip #5: Don’t Overlook the Human Touch
Make sure that there is a company representative accessible to employees throughout the enrollment period who can answer questions and serve as a resource. Allocating staff time to this is a wise investment that will limit frustration and ensure a better experience for employees as they enroll.

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HR Works, Inc., headquartered at 200 WillowBrook Office Park in Fairport (Rochester), New York, with an office in East Syracuse, is a human resource management outsourcing and consulting firm serving clients throughout the United States. 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.