What is Open Enrollment?

As each year nears its end, employers and employees must start planning for the new year — and choosing their health coverage is no exception. November through mid-January is generally the annual window for Americans to enroll in or change individual health insurance plans for the upcoming year. This time is known as the Open Enrollment Period.

If you offer a health benefit that lets employees choose their own coverage on the individual market, you and your employees must know the enrollment deadlines and procedures.

In this blog post, you’ll learn:

• What Open Enrollment is, including important dates for 2027 health coverage.
• What employers must do to prepare for Open Enrollment when offering a health reimbursement arrangement (HRA).
• What options are available if employees miss open enrollment or want to opt out.

What is Open Enrollment?

Open Enrollment is the annual period during which Americans can enroll in, renew, or change their individual health insurance coverage. The federal government implemented the Open Enrollment Period as part of the Affordable Care Act (ACA). The ACA also created public health exchanges, including the federal Health Insurance Marketplace and state-based exchanges, so that individuals can easily enroll in coverage.

An open enrollment window ensures that individuals and families don’t wait until they get sick to get health insurance. It also prevents people from switching to a more comprehensive plan before undergoing an expensive medical procedure.

Instead, it streamlines the health insurance shopping process by giving consumers a guaranteed time to change their marketplace plans.

Other reasons individuals may want to review their coverage choices include:

• They want to switch to a new plan to better control rising healthcare costs.
• They want to change their provider networks.
• They need greater prescription drug coverage or specialized medical services.
• They’re applying for an advanced premium tax credit and other subsidies.

Employees looking to enroll in supplemental health insurance — like dental benefits, cancer insurance, life insurance, or vision benefits — can do so on a private exchange at any point during the year. They don’t need to wait until the annual Open Enrollment window.

When is Open Enrollment?

For 2027 coverage, Open Enrollment on the federal Health Insurance Marketplace runs from November 1, 2026, through January 15, 2027.¹ State-based exchanges set their own Open Enrollment dates, so consumers should check their state Marketplace for the exact deadline. Some states offer shorter or longer enrollment windows.

Consumers who want coverage to begin January 1, 2027, must enroll by December 15 and pay their plan’s first monthly premium. Coverage for those who enroll between December 16 and January 15 will start on February 1 in most states as long as they’ve paid their premium.

The 2027 federal Marketplace dates are also subject to an ongoing legal dispute. A 2025 CMS rule would have shortened the Open Enrollment Period to end on December 15.² However, a federal court vacated the shortened-period provision in June 2026.³ The federal government appealed, so the rules for future years could change again.

For now, consumers should use the dates published by HealthCare.gov or their state Marketplace when planning to enroll.

What do employers who offer an HRA need to do during Open Enrollment?

Many small and medium-sized businesses (SMBs) don’t offer a group plan because of annual rate hikes, participation requirements, and costly monthly premiums.

If you don’t meet the minimum participation rate (which is typically 70% of employees), you may have to explore alternative options to group plans. In many states, small organizations can buy a small group health plan through the Small Business Health Options Program (SHOP).

Or, small employers can opt for a health reimbursement arrangement (HRA) as an alternative to group health insurance. By choosing an HRA, SMBs can better control their budget and give employees more flexibility in their healthcare.

If you offer a stand-alone HRA as part of your benefits strategy, you can avoid a one-size-fits-all group plan. Instead, they choose the qualified individual health coverage and other out-of-pocket medical expenses that work best for them, and you reimburse them tax-free up to a set monthly allowance amount that you predetermine.

An employer’s greatest responsibility during Open Enrollment is keeping staff informed about key dates and details for their employee health benefits. If your staff doesn’t make their elections and enroll in an individual plan during the annual window, they can’t get new coverage or change their existing coverage until the following year, unless they qualify for a special enrollment period.

You should send targeted communications to your staff about Open Enrollment early and often. For example, it’s good practice to notify employees at least one month before the annual enrollment window opens so they have time to prepare and review their coverage.

All you need to do is make the following information readily available to your employees:

1. Open Enrollment dates
2. The enrollment system where they can review coverage options and buy a health plan.
1. This could be the federal Health Insurance Marketplace, a state-based marketplace, or letting them know they can buy a plan directly from insurance companies.
2. If your company works with a health benefits consultant or licensed broker, share that information with your employees.
3. The HRA allowance you’re offering them so they can choose a health plan and budget for their monthly premium.
4. Remind employees to secure proper documentation so they can attest they have qualifying health coverage.
1. Employees with a qualified small employer HRA (QSEHRA) must buy a health plan that meets minimum essential coverage (MEC) to participate in the benefit. This includes ACA-compliant individual health plans and group coverage through a spouse or parent.
2. The CHOICE Arrangement, formerly known as an individual coverage HRA (ICHRA), requires employees to have qualifying individual health coverage. Eligible coverage includes ACA-compliant individual policies, student health plans, Medicare Part A and B together, Medicare Part C, or catastrophic coverage (for those who qualify).
5. What qualifying life events trigger a special enrollment period.

If you offer an HRA through PeopleKeep by Remodel Health, our award-winning customer support team and user-friendly HRA administration software will help you keep your employees informed through automated communication channels, in-app messages, and live chat sessions.

Staff participating in the HRA can also compare and shop for individual health plans from their PeopleKeep accounts, keeping things simple and streamlining the employee experience.

What if an employee misses Open Enrollment?

If an employee misses the annual enrollment window, a few things may happen. If they already had coverage, their insurance provider may automatically enroll them in the same plan for the following year. HealthCare.gov may also automatically enroll them in a similar marketplace plan if their current policy is no longer available². Only some state-based exchanges do this automatically.

If the employee never had coverage, they can’t enroll in a health plan until the next Open Enrollment Period. The only exception is a qualifying life event. In this case, the employee would trigger a special enrollment period, giving them 60 days from the qualifying event to enroll in a new plan or change their current policy outside of Open Enrollment.

Employees without permanent coverage who miss Open Enrollment can also buy a short-term health insurance plan on a private health exchange, such as from a benefits consultant or directly from insurance companies. However, short-term health plans are temporary, have limited coverage, and don’t meet the standards that ACA marketplace plans must provide. They also don’t qualify for CHOICE Arrangement participation or QSEHRA reimbursement.

Offering new employee health benefits, like an HRA, is a major life change that triggers a special enrollment period, no matter what time of year. Employees have 60 days starting from when you first offer them the HRA to enroll in an individual health plan so they can participate in the benefit. So, if you offer an HRA outside of Open Enrollment, your employees still have a chance to compare their options and enroll in a plan.

What if an employee wants to opt out of coverage?

Open Enrollment also allows those who no longer want coverage to cancel it. This is similar to an employer-sponsored group plan’s annual enrollment period, where employees already covered by a spouse’s or parent’s plan, older workers enrolling in Medicare, or those who simply don’t want health coverage can opt out. However, they can only opt out during the annual enrollment period or if they have a qualifying life change.

With a CHOICE Arrangement through PeopleKeep, we keep records of employees’ opt-in and opt-out decisions. But keep in mind, employees can’t opt out of a QSEHRA.

Conclusion

Deciding on health insurance can be time-consuming and confusing for employers and employees. That’s why it’s essential to do your research before Open Enrollment, review your company’s coverage, and ensure you’re offering the best benefits package possible to keep your staff happy.

If you’re an SMB interested in offering an HRA, PeopleKeep by Remodel Health can help! We can set you up with an easy-to-manage health benefit for your business that doesn’t break your budget. Ready to get started? Schedule a call with us today to learn more about designing a personalized HRA for your employees.

This article was originally published on November 9, 2020. It was last updated on October 12, 2026.

References

1. A quick guide to the Health Insurance Marketplace

2. Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability

3. City of Columbus et al v. Kennedy et al