Preparing for mid-year open enrollment
We've partnered with Zenefits, a Chamber member company that offers cloud-based software as a service to companies for managing their human resources, with a particular focus on helping them with health insurance coverage. Written by the Zenefits team, the blog below shares great insight into everything you need to know about open enrollment, and additionally provides a deeper dive into the content through an informative webinar.
If you’re like most of us, the term open enrollment makes you think of the end of the calendar year, when many lines of business get squared away. However, open enrollment can actually occur at any point; March, October, May — you name it. Regardless of when your business undergoes this process, running a smooth OE is imperative to creating a supportive workplace environment for your employees. Open lines of communication and ample time to review new plan options allow your people to make careful decisions without feeling rushed – a huge perk if you ask us! If your business is undergoing renewals at anytime in the coming months, continue reading for a refresher on how to prepare for mid-year open enrollment.
What is open enrollment?
Open enrollment, or OE, is a collaborative event that occurs annually prior to the effective date of the employer sponsored benefits renewal period. This is anniversary date is unique to each company. During this timeframe, the employer (or HR leader) and employee exchange ideas on how to improve, modify, repair, change or add benefits to their current plan. Did the employee undergo a qualifying life event (QLE) in the last calendar year? This is a great time to make those modifications if the employee hasn’t yet already. QLEs include significant life changes including marriage, birth of a baby, divorce, or move. The ultimate goal during this collaborative time is to choose the best benefits for the employee and their family for the upcoming year.
A timeline to get started:
- Stage 1: 90 - 120 days prior to OE anniversary date: Sponsoring employer discusses the wants, needs and corrective actions between the company and benefit advisor.
- Stage 2: 60 - 90 days from anniversary date: Benefit advisor harvests renewal packet from insurance carriers.
- Stage 3: 45 - 60 days from anniversary date: Benefit advisor gathers, compares, illustrates and presents proposals, quotes, findings and recommendations to the employer.
- Stage 4: 30 - 45 days from anniversary date: Sponsoring employer considers recommendations and makes decisions.
- Stage 5: 35 - 40 days from anniversary: Benefit advisor prepares for employee open enrollment.
- Stage 6: 30 days prior: Employees make selections and benefit advisor submits these selections to the insurance carriers.
What role does my benefit advisor play?
The benefit advisor is a key component in open enrollment, regardless of the time of year. Their duties encompass the following tasks:
- Interpreting employer requests for coverage
- Requesting quotes from appropriate carriers
- Comparing, contrasting and evaluating quote plans to the employer
- Advising on compliance rules and issues
- Negotiating renewal rates
- Assisting employees during the selection process
What will a great benefits advisor do?
- Ensure the employer/employees get the plans designs, networks, & lines of coverage desired
- Shop the market to ensure the best plans are received for the lowest premiums
- Check once, twice and continuously to make sure the employer is compliant with all aspects of the state and federal laws governing benefits and mandates
- Provide an easy to use benefit selection method for employees
- Provide responsive feedback to employer and employee questions. Remember, this is a stressful time of year for employees, so the benefit advisor’s support throughout this process is critical
What about the insurance carrier?
The insurance carriers that your business partners with are involved in open enrollment in a variety of ways, but their principal responsibilities include the following tasks:
- Conducting negotiations on rates for large groups (small group rates are approved and fixed by state DOI) with brokers)
- Receiving and processing employee/employer selections after OE
- Issuing ID cards and notices of coverage
- Generating invoices