Open Enrollment: A Step-by-Step Guide for Employers and Employees

Open Enrollment is a big deal for everyone involved—whether you're an employee, an employer, a benefits broker, or vendor. For employees, it’s that time of year when they have to make decisions that could affect their health and finances for the next 12 months. Employers are juggling the challenge of clearly communicating options to a diverse group of people, each with their own needs and questions. Benefit brokers are working to ensure implementations are on time and communications are ready. And for vendors, this is crunch time to stand out and show how their offerings can make a difference.

In this guide, we’ll walk you through what Open Enrollment means and offer practical advice to help you navigate the process smoothly. Whether you’re selecting a health plan, explaining benefits to your team, or pitching your services.

SKIP TO A SECTION

- What is Open Enrollment

- How Employers and Brokers Can Prepare for Open Enrollment

- Special Considerations for Different Employee Groups

- Key Steps for Employees, Employers, and Vendors During Open Enrollment

- Common Pitfalls to Avoid During Open Enrollment

- Special Enrollment Periods: What Employees Need to Know

What is Open Enrollment?

Open Enrollment is an annual window, typically in the fall (between October and November), when employees can make changes to their health insurance and benefit plans. It's designed to streamline benefits decisions for both employers and employees, ensuring that everyone has a set period to review their options. But there’s another reason this period exists— it helps insurance companies to manage risk. 

Without Open Enrollment, employees could wait until they need care—say, before a surgery—sign up for insurance, and then drop coverage afterward. This would create an imbalance in the insurance market (AKA a ‘bad risk pool’), leading to higher costs for everyone. Open Enrollment helps avoid this by balancing the risk pool, keeping premiums more manageable.

How Employers and Brokers Can Prepare for Open Enrollment

Understand Your Current Benefits 

• Thoroughly review your current benefits, and identify what’s working and what’s not. Adoption and usage data, as well as surveys surrounding employee preferences, priorities, and top concerns are always valuable data to inform your current state.
• Assess the benefits landscape and inform yourself on new options and technologies that have newly emerged or grown in demand since your last OE period. Need help getting the lay of the land? BenefitPitch houses detailed profiles on over 1,400 benefits vendors to make this step a breeze.
• Consider any updates in healthcare regulations or shifts in employee needs that could impact your offerings.

Use Effective Communication Strategies

• Multi-Channel Approach: Utilize various channels such as emails, newsletters, posters, and social media to reach employees. Don’t forget about the non-digital methods—put information in bathrooms and break rooms to catch the eye of employees who might not check emails regularly. A great option is holding after work sessions for spouses who may be the ones making buying decisions related to benefits and health insurance.
• Interactive Sessions: Host Q&A sessions, webinars, and workshops to keep employees engaged. Interactive formats can help clarify complex benefits options and encourage participation.
• Tailored Messaging: Customize your communication to different employee demographics. For example, you might need to provide more detailed information to employees with families, while younger employees might be more interested in wellness benefits.
• Incentives for Early Enrollment: Offering small rewards or incentives for employees who complete their enrollment early can help avoid last-minute rushes and ensure that employees have enough time to make informed decisions.

Consider Language and Accessibility

• Professional Translation Services: To avoid miscommunication, invest in professional translation services. This ensures that non-English-speaking employees fully understand their options, rather than relying on potentially inaccurate automated translations.
• Accessible Materials: Make sure all materials are accessible to employees with disabilities. This could include providing large print materials, screen reader-compatible documents, or offering ASL interpretation during live webinars and Q&A sessions. Accessibility is key to making sure every employee has a fair chance to understand and participate in Open Enrollment.

Special Considerations for Different Employee Groups

Different employee groups have unique needs that must be addressed. Here’s how you can ensure that your offerings resonate with everyone:

Full-Time vs. Part-Time Employees:

• Eligibility Differences: Full-time employees may have access to a broader range of benefits compared to part-time employees. Ensure that your communications clearly outline what each group is eligible for.
• Customized Communication: Use targeted communication strategies to address the specific concerns of each group. For example, highlight the benefits that part-time employees can access, which may differ from those available to full-timers.

Engaging Remote Employees: When addressing remote employees, it's crucial to differentiate between those who are locally remote and those who are internationally remote, as they may have access to different benefits.

• Locally Remote Employees: Ensure that digital communications are clear and comprehensive, providing easy access to all necessary resources and support channels.
• International Remote Employees: For employees working through international hiring partners like Remote or Deel, it’s important to understand and communicate the specific benefits and perks available through these partners. Consider organizing dedicated sessions or communications for these employees to highlight unique benefits and how to access them. This ensures that all employees, regardless of their location, receive tailored information that is relevant to their specific situations. 

Key Steps for Employees, Employers, and Vendors During Open Enrollment

To make the most out of Open Enrollment, each party—employees, employers, and vendors—needs to take specific actions:

For Employees:

1. Review Options Carefully: Compare various plans and coverage options. Use online tools to get a clear understanding of what’s best for you.
2. Attend Information Sessions: Attend HR-led webinars or meetings. For spouses who are key decision-makers, consider attending sessions together. Engage in Q&A sessions to clarify doubts.
3. Ask Questions: Reach out to HR or benefit providers if something isn’t clear and prepare a checklist of must-ask questions regarding coverage, costs, and changes from last year.

For Employers:

1. Facilitate Easy Access to Information: Organize webinars, Q&A sessions, and interactive workshops. Provide clear, accessible information, making sure to cater to non-desk workers with physical reminders.
2. Encourage Early Enrollment: Offer incentives for employees who enroll early. Monitor and respond quickly to questions or concerns.

For Vendors:

1. Provide Clear and Concise Information: Simplify complex benefits jargon for easier understanding. Offer comparison tools to help employees make informed decisions.
2. Engage with Employers: Work closely with employers and their brokers to tailor offerings to their specific employee demographics and employee groups. Be ready to provide support for questions and issues as they arise.

Common Pitfalls to Avoid During Open Enrollment

There are many steps employers can take before and during open enrollment to set their employees up for success. Watch out for these common missteps and consider going the extra mile instead!

Employer Pitfalls

Not Leveraging Technology for Personalized Support

Employers sometimes rely too much on general announcements, leaving employees to navigate the enrollment process on their own. Using personalized tools like online enrollment platforms allows employees to explore options specific to their needs. For example, consider implementing decision-support software that walks employees through their personal benefits options. This can be paired with an online chatbot for quick, real-time responses to questions.

Lack of Targeted Communication

Rather than waiting until the last minute or sending out blanket information, employers should develop a targeted communication strategy tailored to different employee groups. For example, younger employees might be more interested in wellness programs and student loan assistance, while those with families may want to know more about dependent coverage and flexible spending accounts. Segment your workforce by needs and send tailored emails or hold focused webinars to address each group’s specific concerns.

Neglecting Manager and HR Training

Sometimes, employers forget that managers play an important roll in open enrollment and need to be fully up to date on benefit offerings, or at least have resources on hand to share if they’re approached. Make sure that team leaders are trained to handle common questions and know how to escalate more complex inquiries. Hosting an internal pre-enrollment training session for HR partners or managers, especially those dealing with international remote teams or employees hired through third-party providers can ensure consistency in the benefits information shared.

Employee Pitfalls

Procrastination
Waiting until the last minute to enroll is a common mistake that can lead to rushed decisions and missed opportunities. Encourage employees to act early by sending periodic reminders as the deadline approaches.

Overlooking Details
Employees often gloss over the fine print, which can result in unexpected costs or inadequate coverage. For example, they might not notice changes in coverage limits, out-of-pocket maximums, or network providers. To combat this, provide clear, concise summaries of plan changes, and encourage employees to ask questions. Offering walkthrough sessions or Q&A webinars can help clarify these details.

Assuming Coverage Stays the Same
Plans and coverage options can change significantly from year to year, yet many employees assume their current plan is still the best fit. Remind them to review their current plans carefully, paying special attention to any changes in premiums, deductibles, or covered services. You might also highlight any new plan options that could better meet their needs, such as high-deductible health plans with HSAs or plans with improved mental health coverage.

Forgetting About Special Enrollment Periods (SEPs)
Employees might assume they need to wait until the next Open Enrollment if they miss the current window, but employers should highlight the availability of Special Enrollment Periods (SEPs). If an employee experiences a qualifying life event, such as marriage or the birth of a child, they are eligible to make changes outside of the regular Open Enrollment period — Read on for a detailed explanation of SEPs and a full list of qualifying events. Employers should clearly communicate this option via reminders or dedicated SEP resources on the enrollment portal. This not only helps employees avoid gaps in coverage but also keeps benefits plans aligned with their life circumstances.

Special Enrollment Periods: What Employees Need to Know

While Open Enrollment is the primary opportunity for employees to adjust their benefits, life doesn't always align with the calendar. That's where qualifying events come into play, allowing employees to make necessary changes outside of the Open Enrollment window through Special Enrollment Periods.

What Are Qualifying Events?

Big life changes allow employees to enroll in, change, or drop their health insurance plans outside of Open Enrollment. These events trigger a Special Enrollment Period, during which employees typically have 30 to 60 days to make changes to their benefits.

Here are some common qualifying events:

• Marriage or Divorce: Getting married or divorced can impact an employee's need for health coverage, making them eligible for a Special Enrollment Period.
• Birth or Adoption: Welcoming a new child into the family, whether through birth or adoption, is a significant life change that allows employees to adjust their health insurance to cover their growing family.
• Loss of Other Coverage: If an employee loses other health insurance coverage—such as being dropped from a spouse’s plan or losing job-based coverage—they can enroll in a new plan during a Special Enrollment Period.
• Relocation: Moving to a new area where different health plans are available can also trigger a Special Enrollment Period. This is particularly relevant for employees who may be moving to or from areas with different healthcare providers or networks.
• Death of a Dependent: If an employee loses a dependent, such as a spouse or child, this event may qualify them for a Special Enrollment Period to adjust their coverage.

Qualifying events provide flexibility and ensure that employees aren’t left without coverage due to life changes. For employers, understanding and communicating these events is essential to help employees maintain the coverage they need year-round.

Don’t let Open Enrollment catch you off guard. Take the time to plan, engage, and educate your employees. For more resources and support during Open Enrollment, visit BenefitPitch today.