Open Enrollment 101

benefits specialist speaking with employees during open enrollment

Whether you’re a seasoned pro or this is your first Open Enrollment rodeo, one thing is certain: benefits enrollment season is stressful! Between tight deadlines and an onslaught of employee questions, it’s not surprising that HR professionals view this time of year as one of the most draining.

In this article, we’ve put together a brief crash course in Open Enrollment. Read on for upcoming deadlines and answers to common questions we hear from employers just like you.

Definition

Open Enrollment is the official period when workers across the United States can enroll in a health insurance plan. It occurs annually and usually lasts for about 2-4 weeks at the end of Fall.

2022 Open Enrollment Period (OEP)

Although Open Enrollment for 2021 is over, enrollment will begin for the 2022 plan year on Monday, November 1, 2021. For most states, the Open Enrollment Period (OEP) ends on December 15, 2021, for coverage to begin on January 1, 2022.

However, some states with their own ACA exchanges have set different date ranges for the 2021 Special Enrollment Period in response to COVID-19 and the 2022 OEP.

Okay, but… Why?

Does forcing all employees to enroll in insurance coverage in the same 2–4 week period at the end of the year seem like a recipe for disaster? Turns out, there’s a method to the madness, and it all comes back to health insurance companies.

You see, health insurance providers are businesses, too. And to be successful, they must invest more in premiums than they pay out.

Creating a single open enrollment period ensures that both healthy and sick workers sign up, rather than only sick employees.

What if I’m late?

Generally, if an employee does not enroll before the OEP deadline, they must wait until the following year to get coverage. However, there are a few other options.

Employees who qualify for a Special Enrollment Period may be able to enroll in or change health plans outside of the annual OEP. Qualification is based on certain life events such as losing health coverage, moving, getting married, or having a baby. Employees can find out if they qualify using the Screening Survey here.

Additionally, employees who are eligible for Medicaid or CHIP benefits may also qualify.

Enrolling your new hires

If you expect your new employee to work on average 30+ hours per week or 130+ per month, you must treat the new hire as a full-time employee under the ACA. Instead of waiting until the next OEP, you must instead offer benefits by the first day of the fourth calendar month at the latest.

Beyond this deadline, many employers choose to set their own new hire enrollment periods in their Employee Handbook. Some of the most common new hire enrollment periods we see include:

  • Within 30 days of the employee’s hire date
  • Before the effective date of benefits
  • During a 30 day grace period
  • After the first day of the month following the employee’s 30th day of employment

What do you think?

Are you ready for Open Enrollment? During this especially stressful time of year, what are you doing to streamline your processes for 2022 enrollment? Let us know in the comments below!

If you’d like some help automating benefits administration and Open Enrollment at your organization, then let’s talk! Our software is paperless, automatically adds deductions, and can significantly reduce the burden on your team.

Plus, our HR Services Department is always available to answer any additional questions you may have. Finally, don’t forget to follow us on FacebookTwitter, and LinkedIn for even more business tips and news.

Photo by Kampus Production from Pexels

Disclaimer: This article is intended to provide open enrollment tips for employers so they can have a successful open enrollment process. It is not intended to provide advice on benefits offerings or legislation. If you need assistance with evaluating benefit offerings and compliance with legislation, please contact your broker or HR consultant.

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