Employer Guide to Open Enrollment 

The Affordable Care Act (ACA) mandates that companies with 50 or more full-time equivalent (FTE) employees offer health insurance to their employees. Data shows that while over 98% of companies with 200 or more employees offered health benefits, this number dropped to about 67% for businesses with 10 – 24 workers.  

Offering health insurance can help small and medium businesses attract and retain the best talent in the market. A competitive benefits package including quality health insurance can help set you apart from your competitors. In addition, adding your employees to a group health insurance plan can have tax advantages.  

For employees, an employer-sponsored healthcare plan means convenience as they do not have to endure the hassle of looking for private insurance. It can eliminate their worries related to medical expenses and thus, boost productivity at the workplace. Employees are likely to feel valued and this can promote loyalty to the organization. A survey by America’s Health Insurance Plans (AHIP) shows that around 68% of employees prefer to get health insurance through their employer.  

Understanding Open Enrollment in Nevada 

If you offer health insurance to your employees, the Open Enrollment Period (OEP) is when you can evaluate benefits offerings and weigh the contribution costs. Employees can evaluate their healthcare needs and enroll, renew, or update coverage. Making an informed decision is easy when they are aware of cost, deductibles, and available plan options. During open enrollment, there is no need to meet specific requirements known as Qualifying Life Events (QLE).  

In Nevada, the employer open enrollment period typically runs from November 1 to January 15. Nevadans who go through specific life changes are also allowed to adjust their healthcare plans at any time of the year and this is known as a Special Enrollment Period (SEP).  

Qualifying life events for the SEP include a change of job, the birth or adoption of a child, getting married or divorced, or moving to a new address. Persons with status change, such as becoming a U.S. citizen, and individuals who lose existing health coverage are also eligible. An employee who turns 26 will likely lose coverage under their parent’s plans and thus can qualify for a SEP. However, there may be category-specific criteria to be met, such as having prior health coverage, before eligibility is confirmed.  

Navigating Open Enrollment for Businesses 

Planning can ensure that things go smoothly during the small window of the OEP. This involves reviewing your existing health insurance plan regarding cost-effectiveness, the network coverage, and estimating satisfaction levels. Areas to focus on include renegotiating deductible levels, employee premium contributions, and various options to accommodate diverse employee needs.  

Effective communication about OEP to employees is of equal importance. Start getting the message out there at least a month before the open enrollment. Scheduling workshops or counseling sessions can help employees gain clarity about the process. An experienced PEO company with expertise in plan selection and employee needs assessment can help your team understand the nuances of employer open enrollment laws and optimize benefits.  

Helping Employees Navigate Open Enrollment 

A smooth open enrollment experience can help your employees make the right choices and leave no room for regrets. This can be achieved by addressing common employee concerns and questions on matters such as: 

• Insurance plan types – Getting all the information on available health plans is key to the decision-making process. Preferred provider organization (PPO), health maintenance organization (HMO), health savings account (HSA)-qualified and indemnity health insurance plans are some of the common plans available to small and medium businesses.  

• Cost considerations – A health insurance plan has various cost components and employees need to know the details. Being a healthcare plan subscriber involves paying a premium or monthly fee to the insurance provider. Most employer-funded insurance plans also have a deductible or annual limit to be paid by the employee before the insurance company begins paying.  
• Network coverage and in-network providers – Employer-sponsored insurance plans will typically have a list of in-network providers. This refers to healthcare professionals who have a contract with the insurance company to provide services at pre-determined rates. Healthcare providers who have not signed up with the insurance company are said to be out of network coverage.  
  

Resources on open enrollment, such as the informative Nevada Health Link, can provide plan details and enrollment assistance.  

A Reliable Partner for Your Healthcare Needs 

Choosing employee benefits can be challenging for SMEs. AdvanStaff HR has specialists who can simplify your health insurance shopping and help you navigate the open enrollment process.  Reach out today to see how we can assist your company with healthcare planning best suited to you and your employees.