employee_open_enrollment

Help Employees Make Better Decisions During Open Enrollment

During annual open enrollment, employees will face important decisions about their family’s healthcare coverage in 2020. Here are some ways to help make the process as successful and stress-free as possible.

According to a recent survey conducted by VSP Vision Care about how employees perceive open enrollment, 33 percent feel a sense of dread about the process and just 10 percent are confident in their benefits choices. Many individuals rate their employers low when it comes to providing help with selecting employee benefits for the coming year.

During this open enrollment season, it is important for companies to be transparent, clearly communicate the details of the benefits plans and share the reasons for any changes. Employees also need adequate time to process their health insurance choices and complete the required forms.

Even if they are happy with their current healthcare coverage, it is important for employees to review the details of their insurance plans in light of their current needs. For example, when choosing their coverage, they should consider any changes in personal finances, family health status, and preferred healthcare providers and hospitals.

Do you or a family member have a serious medical condition? Is there a new child entering your family? Do you prefer a particular provider or hospital? Is your child headed to college? Are you newly divorced? What were your out-of-pocket healthcare costs during the past year? These are important factors that may affect an individual’s choice of employee benefits.

Here are five open enrollment tips to help employees understand their rights to benefits, select the best coverage to meet their unique needs and make adjustments as life-changing events occur.

1. Content
Ensure your invitation for open enrollment has valuable content. You should invite employees to open enrollment at least 30-45 days in advance. The invitation should include:

  • A purpose statement to add dependents, change plans or waive coverage.
  • A list of the benefits provided by the employer, such as medical, dental, vision, chiropractic, life and accidental death and dismemberment, etc. Summaries of benefits and coverage plus a glossary of terms should be attached.
  • Documents needed for open enrollment, including doctors’ names and addresses, marriage certificate and social security number, or children’s birth certificates and social security numbers.
  • The open enrollment period and enrollment effective date.
  • The date and location of the employer’s open enrollment event.

2. Notices
Consider including the following enrollment and annual notices with the plan’s open enrollment materials, including the HIPAA Privacy Notice, Notice of HIPAA Special Enrollment Rights, Annual CHIPRA Notice, WHCRA Notice, MHPA Notice, Medicare Part D Notices, Summary Plan Description (SPD), and a Summary of Material Modification (SMM) or a Summary of Material Reduction in Covered Services/Benefits (SMR).

3. Eligibility
Clarify eligibility requirements or loss of eligibility at open enrollment for each classification of employees, including collective-bargaining vs. non-collective bargaining, salary vs. hourly, distinct business entities, and geographic distinction employee populations that reside in different states.

4. Education
Explain basic insurance principles. For example, provide the answers to questions such as: What are the differences between PPOs and HMOs? What is the difference between copayments and coinsurance? What is an annual deductible and how can it impact monthly premiums and out-of-pocket expenses? What is a provider network and what happens if you use a doctor who is not in the network? What is a prescription drug formulary and why this may be an important factor in choosing a plan?

5. Communication
Offer multiple communication channels for employees to obtain information both during and after open enrollment. Calendar quarterly or semi-annual informational sessions to explain changes in benefit programs. Remind employees of available benefits, and verify and update employee and dependent information. Consider multiple communications channels for employees to obtain information such as email templates, video kiosks, webinars, and company bulletin boards or website portals.

While navigating open enrollment can be challenging, these tips will help employees review their current benefits, explore any new options and make the best choices based on their unique circumstances.


Pacific Federal is a subsidiary of Zenith American Solutions.