How brokers can prepare for open enrollment

For most brokers, preparing for open enrollment starts early. Whether your client is doing an in-office open enrollment or using a virtual method, you must prepare for the process. This includes knowing the latest benefit trends, barriers your clients are facing, and which benefits are most important to them.

Getting a jump on these tasks means you can consult with your clients on their priorities and financial situations. To help you out, this article will cover how open enrollment works, why early preparation is essential, and post-open enrollment responsibilities.

In this blog post, you’ll learn:

• How open enrollment works and its deadlines.
• Why it’s important for brokers to prep their clients for open enrollment early.
• Essential tasks for preparing for open enrollment.

How does open enrollment work?

Under the Affordable Care Act (ACA), open enrollment is the dedicated annual period for Americans to enroll in, renew, or change their health coverage on the individual market. For companies offering a group health insurance plan, disability, life insurance, vision, or dental coverage, open enrollment can take place at any point in the year. But, most organizations select or change their employee benefits during the fall to prepare for the new year.

The federal government recently changed the open enrollment dates for the individual market in some states. Beginning fall 2024 for the 2025 enrollment period, all states must begin open enrollment on November 1 and end on January 15 or later. This applies to states using the federal Health Insurance Marketplace or their own health insurance exchanges. States that began open enrollment earlier than November 1 can continue to do so if they choose¹.

A special enrollment period can also occur on a case-by-case basis. Suppose a person has a qualifying life event that triggers a special enrollment period, such as getting married or having a baby. In that case, they can enroll or change their health insurance plan outside the standard open enrollment period.

To make it easy, the health insurance enrollment deadlines are as follows:

• Open enrollment period for the ACA marketplaces
  • All state and federal marketplaces must begin open enrollment by November 1.
  • Open enrollment must end on or after January 15.
• Special enrollment periods for the ACA marketplaces
  • Generally, a person has 60 days after a qualifying life event to enroll in a new health insurance plan. They can do so through the federal or state marketplace.

Open enrollment is an excellent time for your clients to review their benefits package to ensure they’re offering perks to help recruit and retain talent. Evaluating their benefits and making small annual changes can be vital to a company’s success.

Why early preparation for open enrollment is important

Employee benefits have changed significantly over the past few years. As a broker, open enrollment is about effectively communicating with and educating your clients on their health coverage and other employee benefit options to create the best package for their employees. Therefore, ensuring you’re prepared well before the start of open enrollment is essential.

Here are some reasons why early preparation is important:

• You can give your clients enough time to review all their options. This helps them make an informed decision based on specific business needs instead of a gut reaction.
• Taking a personalized approach to your client’s benefits needs can lead to more benefit renewals, reduced benefit costs, and improved employee satisfaction.
• Brokers who get a jump start on open enrollment can better serve their clients by reducing their frustrations and confusion during the application process.
• Early preparation helps clients understand group and individual healthcare plan changes and provides better support.

By understanding those needs early, you can recommend solutions to your clients and answer any questions they may have.

If your clients want to switch from offering one type of health benefit to another, like a health reimbursement arrangement (HRA), it is especially important that they do so before open enrollment. That way, they can communicate the benefit change to their employees and prepare them for any changes in the process.

While an employer offering a group plan will typically just give their employees the option to opt in or out of enrolling in the plan, with an HRA, employees are able to choose their own individual health insurance plan. You’ll want to be ready to assist the employer and their employees with finding individual health insurance coverage during this time.

Tips to help you prepare for open enrollment

To help you get organized, the following list contains tasks and tips to help you stay on track and prepare for your client’s open enrollment:

• Complete your Federally Facilitated Marketplace (FFM) certification.
• You need this certification to sell healthcare coverage through the Marketplace.

• Familiarize yourself with changes in the health insurance industry. This includes health reform legislation, rates, health insurance carriers, and plan offerings.

• You should also research the current benefits employees want most, such as wellness services, additional medical care options, family planning assistance, and mental health benefits.
• “To get the best results, brokers should thoroughly understand the specifics of each insurance plan they're recommending,” said Jon Morgan, CEO & Editor-in-Chief of Venture Smarter. “Creating comprehensive comparison documents that highlight important features, like coverage limits, out-of-pocket costs, and any changes in provider networks, is essential. This ensures brokers provide clients with a clear, comparative view of their options, helping them understand how different plans affect their healthcare and finances.”
• Schedule check-in meetings with your clients and remind them of important dates.
• Prepare enrollment forms, resources, and other materials.
  • This includes set-up documents, acknowledgment-of-benefits forms, online applications, and other authorization forms to make the enrollment process run smoothly.
• Start researching and pulling quotes so your clients can review their options early.

You’ll also want to learn about alternatives to group health insurance like HRAs. If your client is facing a steep annual rate increase, switching to an individual coverage HRA (ICHRA) could save them time and money. Likewise, if you’re an individual broker looking to get into the group market or have small clients looking to offer health benefits, a qualified small employer HRA (QSEHRA) is often a better option than small group health insurance.

A stand-alone HRA is an employer-funded health benefit that allows employers to reimburse employees for their qualifying medical expenses and individual health insurance premiums tax-free. This makes an HRA an excellent alternative to buying group health plans.

HRAs can seem confusing to those who’ve never heard of them. Thankfully, brokers can partner with PeopleKeep to solve their small clients’ biggest problems.

Learn how working with PeopleKeep can help you offer HRAs to your clients while earning commissions.

Post-open enrollment tasks

Your responsibilities don't stop when the open enrollment season ends. Before you can wrap up the season, you still have responsibilities to your clients.

Follow these post-open enrollment tasks to ensure your clients have everything they need:

• Reach out to your clients to ensure they have all the necessary resources, such as benefit plan details, vendor contact information, payroll deduction instructions, and other relevant information.
• Remind them that you are available year-round to answer any questions. You may also assist with compliance, tax, and reporting concerns.

Once your clients are all set, review what went well this open enrollment season and determine what you can improve for the following year. You should also conduct an audit of the materials you used this year. From there, you can see what you can reuse next year and what will need to be updated.

Conclusion

The health insurance industry is always changing. It’s never too early to start planning for open enrollment. Securing the right kind of benefits for your clients takes time and research. You don’t want to be left feeling like you’re racing against the clock when helping your clients make crucial decisions for their business.

Health insurance brokers must have the proper tools to assist clients quickly and efficiently but with a personal touch. With proper preparation, you can get your clients through open enrollment season with fewer hassles and delays.

This article was originally published on September 14, 2022. It was last updated on August 30, 2024.

1. https://public-inspection.federalregister.gov/2024-07274.pdf