Open enrollment for 2021 health insurance plans is in full swing. Following are some common questions employers ask us about open enrollment.
What is open enrollment?
Open enrollment is a few months period during which individuals can sign up for, drop, or change their Healthcare.gov or state exchange health coverage.
When is open enrollment?
Open enrollment for employer-provided and individual insurance under the Affordable Care Act begins November 1, 2020, and ends on December 15, 2020. Elections or changes made during the enrollment period go into effect January 1, 2021.
14 states and the District of Columbia have their own state-based exchange for individual insurance. These marketplaces may have extended enrollment periods.
Check the enrollment period for your state in our Ultimate Open Enrollment State-by-State Guide.
How do I get started with open enrollment?
Planning is key to successfully managing open enrollment.
If you have a group health plan, clearly communicate where on your healthcare provider’s website employees can find forms needed to enroll, make changes, or drop coverage.
If you are using an HRA to reimburse employees for individual coverage, you should make the following information easily available to them:
- Open enrollment dates for their state
- The website where they can view plans and enroll in coverage (either Healthcare.gov or a state exchange).
- The HRA allowance you will offer them so they can budget when choosing plans.
- If you are using an ICHRA, it’s also good to let them know they will need documents to prove and attest to a purchase of Minimum Essential Coverage, which makes reimbursements tax-free.
If you offer an HRA with PeopleKeep, we will assist you with this effort, sending employees automated communication. Also, our in-app chat can help answer employee questions.
What do employees need to know about Open Enrollment, and how should I communicate it?
Employees need to know that enrollment times are limited—if they don’t make their elections during the window provided they will lose their opportunity to get new coverage or change their existing coverage until 2021.
Communication should start early and repeat often. At least 1 month before enrollment opens (October 1) notify employees that enrollment begins November 1 and closes definitively on December 15 (modify these dates if your state exchange’s dates differ). Any employee who doesn’t make their elections during that window will miss out on getting coverage or making changes to their existing coverage.
Don’t forget to send information to remote employees, those on leave, or vacation.
What if an employee misses open enrollment?
Employees who do not make changes or elections during the open enrollment window might see the following:
- If they are already enrolled, the employee’s coverage will continue unchanged for the next plan year (2021).
- If they were not enrolled for the 2020 Plan Year, they will not be allowed to join a health plan until 2021 (during 2021 open enrollment) unless they have an event that qualifies them for a Special Enrollment Period (SEP).
What if an employee doesn’t want coverage?
Employees have the right to opt out of insurance coverage, but may only do so during open enrollment or if there is a qualifying life event (for example, marriage, divorce, or birth of a child).
Employers must document waivers of coverage and keep that information on file for at least three years. If you have a group plan, your insurance carrier can provide waiver of coverage forms. If you are reimbursing coverage with an HRA, vendors like PeopleKeep keep records of employees’ opt-in and opt-out decisions for you.
The opt-in/opt-out forms must be signed, dated, and submitted during open enrollment.
Tip: Keep an eye on the total number of your employees who opt in. Group health plans have minimum participation requirements, as do some ICHRAs, depending on your plan design.
Can you help my employees find insurance?
If you are a PeopleKeep customer, we sure can! We’ve partnered with KindHealth who are licensed expert advisors to help you find the right plan for you and your family. They can walk you through every step of the way. You’ll find a connection to them by clicking on the blue “Shop for a Policy” button in your PeopleKeep account.
Note: There are a few states in which KindHealth cannot help individuals purchase insurance including RI, MA, and VT and have limited options in other states like DC, ID, MD, NV, and NY. In cases where KindHealth cannot help, individuals can check out the resources section for their state in our Open Enrollment guide or visit their state exchange to find a plan that works for them.