Each Fall, typically between mid-October and mid-December, companies set aside a period of two to three weeks to allow employees to pick and choose which benefits they want for the upcoming year. This is called “annual enrollment” or “open enrollment.”
During the enrollment period, it’s important for you to be ready to make decisions that will affect you and your family throughout the whole next year. The decisions you make can impact both your health and your wallet. In other words, it can literally pay to be prepared!
Enrollment Season Tips
Know your open enrollment dates
Annual enrollment varies by employer type, provider type, marketplace, etc. You don’t want to miss out on enrolling for the first time or making needed changes. If you haven’t heard from your HR department or plan provider yet, don’t be afraid to ask when you’ll be receiving information.
For those who participate in Medicare, Federal Employee Health Benefits (FEHB), or the Health Insurance Marketplace, here are some key dates for 2022 enrollment:
- Medicare open enrollment: October 15, 2021 to December 7, 2021
- Open enrollment for Federal plans: November 8, 2021 to December 13, 2021
- Health Insurance Marketplace open enrollment for individual plans: November 1, 2021 through January 15, 2022
- State-specific open enrollment plan dates may vary.
Review your current health plan
As we’ve all come to learn especially well during the pandemic, a year can bring big, unanticipated changes. That’s why it’s so important to know what benefits you had, the related costs, and what was in it for you. How much of those benefits did you use? Did out-of-pocket expenses cause you to struggle? Were you able to pay for all necessary medications and procedures?
While you look at what you had, think about some specific details. These include your network, premium costs, deductible amount, co-insurance levels, and out-of-pocket maximum. Here’s a quick refresher of common health plan terms:
- Network:The group of doctors and other health care professionals that your insurance carrier is contracted with. You usually pay less to receive care from providers in your network.
- Premium: The monthly payment for your health plan coverage. If you qualify for a subsidy, some premium costs may be offset.
- Deductible: The amount you pay before your insurance starts covering part of your medical bills. If your annual deductible is $2,500, you’ll have to pay all medical bills until you’ve paid out $2,500. After that, the insurance company begins paying. If you have co-insurance, you’ll still pay your co-insurance amount until you reach the out-of-pocket maximum.
- Co-insurance:This is the amount that you pay after meeting your deductible but before meeting your out-of-pocket max. For example, if you receive a $1,000 medical bill after meeting your deductible, and your co-insurance level is 20 percent, then you will be responsible for $200 of the bill and your insurance company will be responsible for the rest.
Review your options
Over the past year, you may have gotten married or started a family. You may be in a higher tax bracket and are looking for more tax savings. Or, as you get older, you may be prioritizing retirement savings.
It’s important to know what your employer is offering this year. To save money, the deductibles may be higher, the coverages may be less, or they may not be offering as many benefits as they did last year. If more of the cost-sharing will fall on you, can you afford it for you and/or your dependents?
So, after looking at what you used last year, compare it to what you think you need for this year. Look at the doctors you used and see if they are in-network or if they’ve moved out-of-network. If you know you will need a specialist, see who is in your area that will accept your coverage. Will your new plan options cover your medications? Procedures you may or will need?
Sign up for an FSA or HSA
In addition to health insurance, your employer may also offer additional benefits like tax-advantaged healthcare benefit accounts. With a Flexible Spending Account (FSA), Health Savings Account (HSA), or Health Reimbursement Arrangement (HRA), you can save money on out-of-pocket healthcare spending with pre-tax money.
Some benefits have a health insurance plan requirement. For example, you can’t have an HSA without a qualified High Deductible Health Plan (HDHP). If your employer offers an HRA – take it! HRAs are funded by the company and do not count towards your income.
With an HSA or FSA, you can pay for a wide-range of IRS approved healthcare expenses with your tax-free dollars. These include co-pays, deductibles, COBRA premiums (HSA only), prescription medications, and more.
Be sure to find out if your employer’s plan offers a benefits debit card. It’s easier to pay with a card and can reduce how many manual claims for reimbursement that you have to file. Learn more about eligible expenses.
Your employer may also offer other tax-advantaged benefit plans such as a Dependent Care FSA, which covers before and after school care (or daycare) costs for children up to age 12. If you live near a big city or have a long commute, a Transit/Commuter account can help you pay for commuter fare and parking expenses.
Gather your receipts
During enrollment season, have your healthcare receipts on hand for reference. With so much to decide, your receipts and Explanation of Benefits (EOBs) from last year can help you estimate expenses for the upcoming year. Receipts should include visits to the doctor, pharmacy, hospital, and other health-related costs. Not only will receipts help you assess your insurance plan needs, but can also help you figure out if you need an FSA or HSA.
Keep these tips handy and enrollment season can be a breeze. You can also check out this video for more enrollment tips.