Open enrollment is a time of the year when you can enroll in, or make changes to a health insurance plan. At this time, employees may decide to enroll in a plan, drop their existing plan or switch to a different coverage. This enrollment typically covers the health, disability, dental, vision, and life insurance plans the business offers.
The open enrollment window has been a feature of employer-sponsored coverage for many years. Failure to sign up for health insurance during this window means an employee would be unable to sign up until the next open enrollment period, except for any qualifying events.
What Sources Use Open Enrollment Windows?
Open enrollment windows are in place for the following health insurance sources:
- Employment-based coverage
- Individual market health insurance (powered by the Affordable Care Act)
When is the Open Enrollment Window?
The open enrollment opens at different times of the year, depending on your chosen health care plan:
The annual open enrollment period for the Medicare plan runs from October 15 to December 7. At this time, enrollees in the plan can reevaluate their coverage – whether this be Medicare Advantage or Original Medicare – and effect any changes you desire. You may decide to switch from Medicare Advantage to Original Medicare, or vice versa. You may also switch from one Medicare Part D plan to another, or from one Medicare Advantage plan to another during the open enrollment period.
- Job-based Insurance
Open enrollment periods for job-based health insurance are determined by your employer and this can be at any time of the year. However, it is usually set it the autumn, so the period begins on January 1 every year.
- The Individual Market
The open enrollment period for 2020 in the individual market runs from November 1 to December 15 2019 in most states, and the Affordable Care plan takes effect on January 1, 2020. If you missed the open enrollment period, you may only enroll for a plan under special qualifying events. However, some states run their own open enrollment marketplace, so the open enrollment window will depend on the state. Seven states that have their open enrollment period marketplace include New York, California, Massachusetts, Rhode Island, and Colorado; these states have their open enrollment period extended beyond December 15, 2019.
Preparing for the Open Enrollment Period
The open enrollment window presents an opportunity for employees to either sign up for, or make changes to the Affordable Care insurance. If you are an employer, it also presents a time for you to evaluate your options to ensure the needs of your employees are met.
To ensure proper preparation, ask yourself the following questions:
- Have your medical needs changed?
- Do your employees need any changes to their health insurance plan? For instance, are there more families in your team? If so, which additional coverages could help them?
- Have your company needs changed? Improving your company’s medical package is a great way to stay competitive.
- Are your employees satisfied with the current health insurance plan? If you are in doubt, an anonymous survey may help you determine how members of your team feel.
What Happens if I Miss the Open Enrollment?
If you have missed the open enrollment window or just forgot to sign up, you may be wondering how to purchase a health insurance plan. Some insurance carriers allow a 30-day grace period for employees to update their coverage. But if you are outside this window and grace period, you can only sign up for a health insurance plan during a special enrollment period, which is triggered following a qualifying life event.
Qualifying life events are generally categorized in four areas:
- Lost health insurance: a person may have changed jobs or turned 26 and no longer qualifies to be part of his/her parents’ coverage.
- Updates to the Household: a person may get married, have a child, or get insurance through the spouse’s plan.
- Updates to the place of residence: moving can impact your health insurance plan if your county or zip code changes.
Meeting up with the open enrollment period may seem overwhelming, especially as it runs for a short period of time. But with proper planning ahead of the window, you can make the best decisions specific to your situation.