Open enrollment can be a source of stress and confusion for many, with only a small percentage of people feeling confident in their ability to choose the right plan. If your employees are feeling anxious about this process, they are not alone. Let's break down the essentials of open enrollment so your team can approach it with confidence.
What Is Open Enrollment?
Open enrollment is the designated time each year when employees can enroll in or make changes to their health insurance plans. Outside of this period, changes can only be made if you experience a qualifying life event (QLE), such as marriage, the birth of a child, or moving to a new location. These events allow for a special enrollment period, providing flexibility when significant life changes occur.
Choosing The Right Plan
Selecting the right health insurance plan involves evaluating your current and anticipated health care needs. Ask yourself if your current plan met your needs last year, whether your preferred doctors are within the network, and if your family circumstances have changed. Consider whether you expect to use more or fewer medical services in the coming year and whether you prioritize lower monthly costs or a broader network of providers. If you're uncertain, seeking advice from a third-party resource, like a health advocate, can offer valuable insights.
Understanding Health Insurance Terms
Health insurance terminology can be complex, but understanding key terms is crucial for making informed decisions. Here are a few important concepts:
- Deductible: The amount you pay out-of-pocket before your insurance begins to cover expenses.
- Copay: A fixed fee you pay for specific health care services.
- Coinsurance: The percentage of costs you share with your insurer after meeting the deductible.
- Out-of-pocket maximum: The maximum amount you'll pay in a year for covered services.
- Preferred provider organization (PPO): A type of health plan that offers a network of health care providers but allows for out-of-network care at a higher cost.
Can You Change Your Plan After Enrollment?
During the open enrollment period, you can make changes to your plan. However, once this period ends, changes are only possible if you experience a QLE. For new employees, benefits typically start on the first of the month following enrollment, while existing employees' coverage begins according to the employer's plan year.
Open Enrollment In 2024
Under the Affordable Care Act (ACA), employers with 50 or more full-time employees or the equivalent must provide health care to their team. Regardless of your team's size, health care is a leading benefit that can assist with hiring and retention efforts due to the rising cost of personal health expenditures. While businesses have different renewal periods throughout the year, Q4 is a common time for many companies to conduct open enrollment. It’s important to stay informed with your company’s schedule to know when it’s time to elect benefits. For 2024, the open enrollment period for HealthCare.gov begins on November 1st and extends until January 15, 2025, in most states. This timeframe allows individuals to enroll in or make changes to their health insurance plans for the upcoming year.
Navigate Open Enrollment With GMS
It can be difficult for employees to make informed decisions regarding benefits due to the complex array of options available. When you partner with GMS, we shoulder the responsibilities of the open enrollment period, allowing you to concentrate on other aspects of your business. Your dedicated benefits account manager closely collaborates with you and your team to offer top-notch benefit plans and educate your employees effectively. Gain access to a team of specialists who can train your employees on plan details and address challenging coverage inquiries. We understand the complexities of health insurance. Let us guide you on how to maximize your plans, ensure compliance, and stay updated on regulations. Connect with us today.