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What is Open Enrollment?
Open Enrollment is the only time of year you are allowed to make enrollment changes. Some exceptions or “qualifying events” allow benefit election changes to be made mid-year. These are are marriage, divorce, birth or placement of a child, losing or gaining eligibility for other coverage, etc.
Health and wellness needs change over time. Annually evaluating the employee benefit plans and options offered by your employer is very important to your well being. Your employer takes great pride in offering valuable benefit programs to you and your family, many of which are employer-paid (for full-time employees.)
During Open Enrollment, you should consider the benefits you have today and ask yourself if they will serve you and your loved ones well in the coming plan year.
Open Enrollment Schedule
Payroll Deduction Timing for Benefit Enrollment Adjustment and the Target Enrollment Deadline
Benefit deductions are collected a month in advance so 100% of the premium is available to pay out to the associated carrier or vendor on the first of the month of coverage.
Both Mary and Mike are notified of their (5/1 – 6/30) open enrollment period in May for benefit changes that will take effect July 1.
Mary completes her open enrollment elections on May 23rd for a July 1st effective date.
AdvanStaff HR start benefit deductions in June for July coverage. This is not an issue because the Mary enrolled more than a month in advance of the effective date. Nice work Mary!
Mike waits until June 23rd to make his open enrollment elections for a July 1st effective date (not good Mike).
Because benefit deductions needed to start in June for July coverage, Mike missed BOTH payrolls in June. Mike will have “catch-up” premiums in July for BOTH the missed June payments PLUS the regular July benefit payments. That means Mike will have double deductions in July to get caught up and back on track. Mike is not happy.
Read more on when payroll deductions begin and how “catch-up” deduction may be required if open enrollment changes are made past the soft deadline.
Frequently Asked Questions
Open enrollment takes place in the Employee Portal. It only takes a few minutes to complete and you get a 360 degree view of all the benefits available to you.
During open enrollment, you will be able to see all benefit plan options available to you, download all your plan summaries, see how the benefit deductions will specifically affect your take home pay, view enrollment confirmations, and more.
The first step is to log into your employee portal account -> Benefits -> Benefits Enrollment.
Benefit deductions are collected in the month PRIOR to the coverage start date. This “pre-collection” is required because insurance carriers require payment the 1st day of the month of coverage. So payroll deductions will look like this:
- April deductions pay for May coverage
- May deductions pay for June coverage
- June deductions pay for July coverage
- July deductions pay for August coverage
- August deductions pay for September coverage
- and so on.
Because premiums are collected a month prior, if you enroll later than a month before the effective date, then you will most likely see “catch up” deductions take place.
What are “catch up” deductions?
A normal paycheck usually would have equal, partial-month benefit deductions that correspond with the NEXT month’s deductions. With late or untimely enrollments, we will need to “catch-up” missed premium collections. This can become a financial burden as a greater portion of your paycheck may be allocated to cover missed benefit payments.
Reviewing your benefits and making annual changes has never been easier. The Employee Portal will show you all the benefit programs available to you, at what cost, and even compare your options.
There are no paper forms to complete, nothing to sign and mail in. Just a few clicks and you are ready to go.
What can I do during open enrollment?
- Review the current benefit options offered by your employer.
- Review and update your Life Insurance beneficiaries
- Review the benefits’ co-pays, deductibles, providers and more.
- Compare plans and cost, side-by-side, to make decisions easier.
- View your per-pay check deductions in real-time, based on your choices.
- Assign or update your insurance beneficiaries.
- Learn more about the latest plan features and perks.
- View & print your personalized Benefit Election Summary Confirmation Statement.
- Plus more! Check it out today!
Not planning to enroll?
- Simply log in, and walk through the Benefit Wizard to opt-out.
- Review everything that is available, you may change your mind!
- Have other coverage? Make sure we have a copy of your alternative coverage on file.
- Learn when your next opportunity to enroll will be.
- Fast, easy and confirms that you have opted-out!
Use your unique username & password credentials to log in to your secure, AdvanStaff HR Employee Self-Service portal 24/7. ess.advanstaff.com
From the Navigation Bar, select: Benefits, and then Benefits Enrollment
Need more help? Contact our office weekdays, 8:30a to 5:00p for live assistance!
As you prepare to enroll in benefits this year, know that proper preparation may help alleviate some of the concerns that you have. Consider the following tips when preparing for and completing open enrollment this year:
- Reassess the health care needs of you and your dependents. Health care needs change year to year, and open enrollment offers you a chance to reevaluate your health coverage. As you prepare for open enrollment this year, make sure to evaluate whether you’ve had any changes in the past year, or if you anticipate changes in health care needs in the upcoming year. Questions to consider include:
- Have you added any dependents?
- Do you anticipate changes in the health care needs of you or your dependents this year?
- Do you anticipate any changes in how regularly you or your dependents will be seeing health care providers?
- Do you or your dependents anticipate changes in the use of prescription medications?
- Take time to review benefits offerings thoroughly. Benefits offerings often adapt and change, so make sure to take time to review all offerings and open enrollment resources. As plans and costs can change year to year, ensure you thoroughly review open enrollment resources that are provided to you, and ensure any questions you have are addressed before making any choices.
- Reevaluate medical coverage offerings. There isn’t one plan that is best for everyone. Health care needs change over time, so don’t be afraid to review a health plan that might be different from what you enrolled in last year. As you consider medical coverage plans, evaluate costs you may incur outside of purely premiums—including deductibles, copays, coinsurance, out-of-pocket maximums and prescription coverage.
- Check your network and preferred health care providers. Notably, the coronavirus has led to closings and many changes within health care. Find time to check whether your preferred health care providers are in your chosen network. Changes in health care providers can take place abruptly, and now is an excellent time to double-check the status of your preferred providers.
- Review voluntary insurance options. After selecting your health coverage, make sure to consider voluntary insurance options. Common voluntary insurance options include dental and vision benefits. If offered, consider whether these may be for right for you. For dental care, consider factors such as whether you are planning regular cleanings, or whether you anticipate using orthodontics services—as these factors may influence the appropriate level of coverage for you and your dependents. For vision coverage, know that vision insurance can be either a vision benefits plan or a vision discount plan. A vision benefits plan grants you coverage and often includes an allowance for frames and lenses. A discount plan typically has a lower premium and offers discounts for vision services within a network. Also, take time to review other voluntary benefits, as options that you may have previously overlooked can expand your coverage during this challenging time. Consider whether life insurance, disability insurance, accidental death and dismemberment (AD&D) insurance and any other voluntary insurance options offered could be right for you.
- Be aware of all available resources. Take time to make sure you are aware of all offered resources, including mental health resources, an employee assistance program (EAP), telemedicine services and any other benefits that are available.
- If you haven’t started one, consider a FSA. If you haven’t started a flexible spending account (FSA), consider whether these options are a good fit for you. While each plan is unique and offered as an option depending on what medical coverage you enroll in, both allow you a tax-advantaged way to set aside pre-tax funds to be used for health care expenses.
- Revisit your retirement plan. Open enrollment is a good time to revisit your retirement plan. Review your contribution rate, investment options and whether your current plan aligns with your retirement goals. Open enrollment is also a good time to ensure that your beneficiaries are up to date. While there may be no change within the last year, consider using this time to double-check your designations and adjust if necessary.
An open enrollment period is a short period of time when you can enroll in or make changes to your employee benefits elections. Possible changes include adding or dropping coverage, adding or removing dependents, or enrolling in benefits for the first time.
Open enrollment is your opportunity to take advantage of important benefits, such as health, vision, dental and life insurance, a flex spending account (FSA), and a retirement plan.
The decisions you make during the open enrollment period can have a significant impact on your life and your finances, so it is important to weigh your options carefully and to make your decisions during the open enrollment period.
Failure to comply with the open enrollment deadline could result in a loss of coverage for you and your loved ones. Missing this deadline also means that you could be unable to make changes or enroll in benefits until the next open enrollment period.
One exception to this rule is if you experience a life-changing qualifying event that would trigger a special enrollment period (SEP). Events such as getting married or divorced, having or adopting children, or losing eligibility for other health coverage can trigger special enrollment rights. In some cases, you can also qualify for special enrollment if you become eligible for a premium assistance subsidy under Medicaid or a state Children’s Health Insurance Program (CHIP).
If you think you might qualify for a SEP, contact your HR manager. If you have not recently experienced a life event, but have missed the open enrollment deadline, you should also contact your HR manager to find out whether you have any other options.
Options for Obtaining Health Coverage
If you miss your employer’s open enrollment deadline, there are a number of ways in which you can try to obtain health insurance; however, the availability of some options will depend on their enrollment deadlines.
- Spousal Benefits—If your spouse receives benefits from his or her employer and the open enrollment period is still open (or coming up), you may be able to enroll in coverage through your spouse’s plan.
- Young Adult Benefits Under a Parent’s Plan—If you are younger than 26 years old, you may be able to be added as a dependent on your parent’s plan. If your parent’s plan offers dependent coverage, this option should be available to all children under 26, regardless of whether or not you are employed, married, have children or are a student. However, this option is likely available only if your parent’s work-based plan offers coverage for family members and if the open enrollment period for that plan has not yet closed.
- State Insurance Marketplace—Depending on the timing, you can consider buying health insurance from the Health Insurance Exchange Marketplace. Marketplace coverage is only available for purchase during an annual open enrollment period, unless you qualify for a SEP. (See the SEP section of www.healthcare.gov to check). Similar to employer-based plans, a SEP can be triggered if you experience a qualifying life event. If the health insurance your job offered was affordable and covered the majority of your health care costs, you will not be eligible for a health insurance subsidy to help you pay your monthly premiums for a Marketplace plan. However, you may have more health plan options to choose from, including some lower-priced plans that would provide coverage for you until your employer’s next open enrollment period. For more information, or to enroll in a Marketplace plan, please visit www.healthcare.gov.
- Medicaid—Medicaid provides health coverage to low-income adults. Medicaid does not have open enrollment periods, which means that you may apply at any time. Eligibility for Medicaid varies from state to state, so be sure to check www.medicaid.gov or your state’s Department of Health website to see if you qualify for this option.
- Short-term Health Insurance—If you are concerned about not having health insurance and are not eligible for any of the other options, you can consider purchasing a short-term health insurance policy from a private insurance company. These are temporary plans for those who are awaiting longer term, major health coverage. They generally do not cover pre-existing conditions, are not guaranteed-issue (meaning that you are not guaranteed coverage) and are subject to state and insurance company limits on how many times this type of insurance can be renewed. Most importantly, short-term insurance is not considered “minimum essential coverage” under the ACA, which means that even if you are able to enroll and maintain coverage until the next open enrollment period at your workplace, you may be subject to paying the individual mandate penalty (see below) with your federal tax return.
What Happens If You Don’t Take Any Action?
You could remain uninsured until the next open enrollment period opens up. However, accidents and diseases can strike at any time, so the cost of being uninsured can add up quickly.
As explained, there are other options for you to obtain health insurance if you have missed your open enrollment deadline. However, many of these are costly, not as beneficial as employer-provided benefits, have limited availability, are highly difficult to attain or are unattractive. In addition, many employers offer other benefits besides dental, vision and health insurance. If you miss the enrollment deadline, you could experience loss of these other benefits as well.
FSAs, HRAs and HSAs
Many employers offer one or more health spending accounts as part of their benefits packages. Depending on which type of account your employer provides, missing the open enrollment deadline will result in different consequences.
- Flexible Spending Account (FSA)—FSAs are tax-free and are only available with job-based health plans. As a result, if you missed your open enrollment deadline, you will not have ample funds in your FSA, and you will have to pay out of pocket for any costs your insurance does not cover. Also, if your employer usually makes a contribution to your FSA, you would miss out on that. Your taxable income will also be higher if you are not making pre-tax contributions.
- Health Reimbursement Arrangement (HRA)—An HRA is an account set up and funded by your employer. While some employers allow unspent funds to be carried over to future plan years, most do not. In the event that you have unspent money in your account and your employer allows carryovers, you would need to remain HRA-eligible (enrolled in the company health plan) to access those funds. Therefore, if you miss your employer’s open enrollment deadline, you will typically lose access to your HRA as well, and you will have to pay out of pocket for any costs your insurance does not cover.
- Health Savings Account (HSA)—An HSA is an account, owned by you, in which you can contribute either pre-tax or post-tax income. If you miss the open enrollment deadline to make contributions to this type of account, you will be unable to contribute pre-tax amounts to your HSA using payroll deductions, and your taxable income will be higher. Also, if your employer makes any contribution to the HSA, you would miss out on that.
However, you can still make contributions to an HSA if you are an eligible individual, and you can deduct any amounts contributed. If you missed the opportunity to set up an HSA through your employer, you can still set one up on your own with a bank or other HSA custodian if you are an eligible individual.
Although you can certainly pay out of pocket for additional health care costs, without tax-advantaged funds, these expenses can be overwhelming. If your employer offers either an FSA or HSA, it is true that you are typically the only contributor to these accounts. However, the money you are contributing is pre-tax. Missing out on either of these will result in your post-tax budget taking a hit. Be sure to enroll in a health spending account that your employer offers before the open enrollment period closes so that you can receive the health care that you need without having to empty your pockets.
Don’t Forget About Your Other Benefits
Additionally, if you’ve missed open enrollment, you will be missing out on a lot more than just health care benefits. Some other benefits that you may be losing out on include the following:
- Life Insurance—If you have lost coverage or do not have ample coverage for the next year due to missing the open enrollment deadline, consider buying a term life policy from a third-party to ensure that you and your loved ones will be taken care of if anything should happen to you. Talk to [b_officialname] for more information on this option.
- Retirement—Although it may seem like missing a year of contributions to an employer-matched plan is not a big deal, setting yourself up for a comfortable lifestyle after retirement should be a top priority. If you are worried about falling behind on saving for retirement after losing out on the ability to make contributions to your employer-sponsored retirement fund, consider setting up an individual retirement arrangement (IRA) or a Roth IRA on your own. You should also reference your tax withholding statement and make adjustments to your allowances accordingly as you will no longer be receiving the tax break on retirement deductions from your paycheck.
- Disability—Disability insurance replaces some of your income if an injury or illness prevents you from working, which can ease the financial burden on a household. Short-term disability (STD) pays you a portion of your income for a short period of time (generally between nine and 52 weeks) after you run out of paid sick leave. Long-term Disability (LTD) pays you a portion of your income after you run out of both paid sick leave and STD. If you have missed open enrollment and are unable to enroll or amend your work-based policy, consider purchasing coverage on your own. Talk to [b_officialname] for more information on this option.
Missing your employer’s open enrollment deadline can be costly. Be proactive—mark deadlines on your calendar and create reminders in your phone so that you do not miss your employer’s open enrollment period. If you do happen to miss the deadline, be sure to talk to your HR manager right away.
Open enrollment is the time of year reserved for you to make changes to your benefit elections, and unfamiliar terms can make this process confusing. Use these definitions of common open enrollment terms to help you navigate your benefits options.
- Coinsurance—The amount or percentage that you pay for certain covered health care services under your health plan. This is typically the amount paid after a deductible is met, and can vary based on the plan design.
- Consumer Driven Health Care (CDHC)—Health insurance programs and plans that are intended to give you more control over your health care expenses. Under CDHC plans, you can use health care services more effectively and have more control over your health care dollars. CDHC plans are designed to be more affordable because they offer reduced premium costs in exchange for higher deductibles. Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs) are common examples of CDHC plans.
- Copayment—A flat fee that you pay toward the cost of covered medical services.
- Covered Expenses—Health care expenses that are covered under your health plan.
- Deductible—A specific dollar amount you pay out of pocket before benefits are available through a health plan. Under some plans, the deductible is waived for certain services.
- Dependent—Individuals who meet eligibility requirements under a health plan and are enrolled in the plan as a qualified dependent.
- Flexible Spending Account (FSA)—An account that allows you to save tax-free dollars for qualified medical and/or dependent care expenses that are not reimbursed. You determine how much you want to contribute to the FSA at the beginning of the plan year. Most funds must be used by the end of the year, as there is only a limited carryover amount.
- Health Management Organization (HMO)—A type of health insurance plan that usually limits coverage to care from doctors who work for or contract within a specified network. Premiums are paid monthly, and a small copay is due for each office visit and hospital stay. HMOs require that you select a primary care physician who is responsible for managing and coordinating all of your health care.
- Health Reimbursement Arrangement (HRA)—An employer-owned medical savings account in which the company deposits pre-tax dollars for each of its covered employees. Employees can then use this account as reimbursement for qualified health care expenses.
- Health Savings Account (HSA)—An employee-owned medical savings account used to pay for eligible medical expenses. Funds contributed to the account are pre-tax and do not have to be used within a specified time period. HSAs must be coupled with qualified high-deductible health plans (HDHP).
- High Deductible Health Plan (HDHP)—A qualified health plan that combines very low monthly premiums in exchange for higher deductibles and out-of-pocket limits. These plans are often coupled with an HSA.
- In-network—Health care received from your primary care physician or from a specialist within an outlined list of health care practitioners.
- Inpatient—A person who is treated as a registered patient in a hospital or other health care facility.
- Medically Necessary (or medical necessity)—Services or supplies provided by a hospital, health care facility or physician that meet the following criteria: (1) are appropriate for the symptoms and diagnosis and/or treatment of the condition, illness, disease or injury; (2) serve to provide diagnosis or direct care and/or treatment of the condition, illness, disease or injury; (3) are in accordance with standards of good medical practice; (4) are not primarily serving as convenience; and (5) are considered the most appropriate care available.
- Medicare—An insurance program administered by the federal government to provide health coverage to individuals aged 65 and older, or who have certain disabilities or illnesses.
- Member—You and those covered become members when you enroll in a health plan. This includes eligible employees, their dependents, COBRA beneficiaries and surviving spouses.
- Out-of-network—Health care you receive without a physician referral, or services received by a non-network service provider. Out-of-network health care and plan payments are subject to deductibles and copayments.
- Out-of-pocket Expense—Amount that you must pay toward the cost of health care services. This includes deductibles, copayments and coinsurance.
- Out-of-pocket Maximum (OOPM)—The highest out-of-pocket amount paid for covered services during a benefit period.
- Preferred Provider Organization (PPO)—A health plan that offers both in-network and out-of-network benefits. Members must choose one of the in-network providers or facilities to receive the highest level of benefits.
- Premium—The amount you pay for a health plan in exchange for coverage. Health plans with higher deductibles typically have lower premiums.
- Primary Care Physician (PCP)—A doctor that is selected to coordinate treatment under your health plan. This generally includes family practice physicians, general practitioners, internists, pediatricians, etc.
- Usual, Customary and Reasonable (UCR) Allowance—The fee paid for covered services that is: (1) a similar amount to the fee charged from a health care provider to the majority of patients for the same procedure; (2) the customary fee paid to providers with similar training and expertise in a similar geographic area, and (3) reasonable in light of any unusual clinical circumstances.