Open Enrollment – Group Benefit Solutions

Your Last-Minute Open Enrollment Checklist

Chris Wolpert — Fri, 08 Nov 2019 18:02:32 +0000

By now you should be prepared and ready to go for your 2020 employee benefits open enrollment. You should have all your plan documents and have prepared or held presentations for your staff to explain the benefits package and any major changes to the plans that you offer.

Employees should be familiar with how to use the enrollment portal and who they should talk to if they have questions.

To be on the safe side, there are a few things you should do to make sure you maximize enrollment, that your employees have the correct materials and that you are in compliance with the law.

Take an active role — Most of the policy selection is done online, but that doesn’t mean you can’t support your employees and let them know you are there in case they have any questions or are confused about any aspect of the benefits package.

You should want all of your employees to choose the package that best fits their individual needs. To ensure they make the best possible choices and have a successful experience, motivate them to take an active role in their education by encouraging questions and showing them where they can find answers in the online enrollment platform.

Last-minute blasts — You’ve probably sent a few e-mail reminders to your staff, but most certainly some of them still missed those communications. Make sure you send a few extra blasts at different times of the week, like Tuesday at 10 a.m. and another on Thursday at 2 p.m.

You should also have all of your employees’ mobile phone numbers, and sending them reminder text messages is a sure-fire way to get in front of the ones who may not be as diligent about monitoring their e-mail.

 Double-check your plan materials — Do a final review of your plan documents for any necessary updates regarding member eligibility, plan benefits, new vendors and name changes to ensure that the current state of your benefits offerings is complete and accurate.

Also, do a final review of your summary of benefits and coverage (SBC) and your summary plan description (SPD) to make sure they reflect any changes from the prior year. This is crucial as both documents are required under the law.

The SPD may include the elements necessary to meet the requirements of the SBC, but it also needs to be a separate document that can be handed out with respect to each coverage option made available to the participants.

To account for the annual open enrollment window, double-check your open enrollment schedule, deadlines, documents and forms, coverage options and changes, phone numbers, and website and mobile information for contacting resources, statement of current coverage, and plan-specific summaries and rates.

Identify staff that didn’t enroll last year — To make sure you maximize participation and that nobody misses out, run a list of all your staff who didn’t sign up for benefits last year so you can approach them individually and convey the importance of securing health coverage.

While you’re at it, make sure that all of your new hires in the past year have also signed up for coverage and that you didn’t miss them when sending out reminders about open enrollment.

Check compliance with ACA — If you are an “applicable large employer” under the Affordable Care Act, meaning that you have more than 50 full-time or full-time equivalent employees, you are obligated under the law to provide health coverage to your staff that is “affordable” and covers 10 essential benefits.

There is a figure for what is considered affordable, which changes every year. For your plan to be considered ACA-compliant, it must not cost an employee more than 9.78% of their household income.  

ACA refresher — The ACA remains as controversial and misunderstood as ever and most people only know what they have heard about it from their favorite news outlet, which can result in a skewed, and often incorrect understanding of the law.

Also, there have been a number of changes to the law during the last few years, the biggest of which is the elimination of the penalties associated with individuals not securing health insurance as required by the individual mandate portion of the law.

Give your staff a last-minute refresher to help them understand how the ACA affects their health insurance — and what the employer’s and their obligations are under the law.

Get an Early Start on Open Enrollment

Chris Wolpert — Tue, 24 Sep 2019 13:12:45 +0000

As open enrollment is right around the corner, now is the time to make a plan to maximize employee enrollment and help your staff select the health plans that best suit them. You’ll also need to make sure that you comply with the Affordable Care Act if it applies to your organization, as well as other laws and regulations. Here are some pointers to make open enrollment fruitful for both your staff and your organization.

Review what you did last year

Review the results of last year’s enrollment efforts to make sure the process and the perks remain relevant and useful to workers. Were the various approaches and communication channels you used effective and did you receive any feedback about the process, either good or bad?

Start early with notifications

You should give your employees at least a month’s notice before open enrollment, and provide them with the materials they will need to make an informed decision. This includes the various health plans that you are offering your staff for next year. Encourage them to read the information and come to your human resources point person with questions.

Help in sorting through plans

You should be able to help them figure out which plan features fit their needs, and how much the plans will cost them out of their paycheck. Use technology to your advantage, particularly any registration portal that your plan provider offers. Provide a single landing page for all enrollment applications. Also, hold meetings on the plans and put notices in your staff’s paycheck envelopes.

Plan materials

Communicate to your staff any changes to a health plan’s benefits for the next plan year through an updated summary plan description or a summary of material modifications. Confirm that their open enrollment materials contain certain required participant notices, when applicable – such as the summary of benefits and coverage.

Check grandfathered status

A grandfathered plan is one that was in existence when the ACA was enacted on March 23, 2010, and is thus exempt from some of the law’s requirements. If you have a grandfathered plan, talk to us to confirm whether it will maintain its grandfathered status for the next plan year. If it is, you must notify your employees of the plan status. If it’s not, you need to confirm with us that your plan comports with the ACA in terms of benefits offered.

ACA affordability standard

Under the ACA’s employer shared responsibility rules, applicable large employers must offer “affordable” plans, based on a percentage of the employee’s household income. For plan years that begin on or after Jan. 1 of next year, the affordability percentage is 9.86% of household income. At least one of your plans must meet this threshold.

Get spouses involved

Benefits enrollment is a family affair, so getting spouses involved is critical. You should encourage your employees to share the health plan information with their spouses, so they can make informed decisions on their health insurance together. Also, encourage any spouses who have questions to schedule an appointment to get questions answered.

Ask the Experts: Benefits Changes After Open Enrollment Ends but Before Plan Year Begins

Chris Wolpert — Wed, 06 Feb 2019 14:12:56 +0000

Question: Can an employee change a pretax plan election after the employer’s open enrollment window has closed but before the plan year has begun? Are there any potential downsides for allowing this?

Answer: Yes, an employee may make a change to his or her benefit election after open enrollment has ended but before the plan year begins. However, there are potential downsides for allowing such a practice.

In general, open enrollment is a period of time set by the employer for employees to enroll, terminate, and/or make changes to their existing benefit elections for the following plan year. The purpose of the deadline is to ensure timely and accurate administration of such elections, and to treat employees similarly.

In deciding how to handle this situation, the employer would want to consider:

Does the insurance carrier or the group policy have specific requirements?
If an exception is made, other employees must also be allowed to change their elections after the open enrollment deadline. Employees must be treated similarly; the employer cannot make an exception for one person.
How clear were the open enrollment written communications in stating changes could not be made after the deadline (except in connection with a qualifying event)? Employers must make sure their communications clearly state when and how changes may be made after the deadline.

Allowing changes after the deadline typically involves more work on behalf of the administrator, subjects employees to coverage and claims errors, and leaves employees with the understanding that exceptions will be allowed. Employers should review their policies carefully and make sure they are clearly communicated.

This article originally appeared on ThinkHR.com.

Looking Backward to Plan Forward | Seattle Benefit Advisors

Chris Wolpert — Thu, 18 Oct 2018 20:03:55 +0000

We have entered Open Enrollment season and that means you and everyone in your office are probably reading through enrollment guides and trying to decipher it all. As you begin your research into which plan to choose or even how much to contribute to your Health Savings Account (HSA), consider evaluating how you used your health plan last year. Looking backward can actually help you plan forward and make the most of your health care dollars for the coming year.

To learn more, watch this short video!