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Preparing for Enrollment Season – 5 Tips for Employees

Preparing for Open Enrollment

For millions of people across the U.S., enrollment season is right around the corner. Each Fall, 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.

It’s important to be prepared! After all, these decisions affect both your health and your wallet. With the following tips, you can make enrollment season a success.

Enrollment Season Tips

1. Know your open enrollment dates

Depending on where you get your insurance from (through an employer, insurance exchange, or other) open enrollment isn’t the same or at the same time for everyone. You don’t want to miss the enrollment date.

Here are some key dates to remember:

  • For the 177 million Americans who have coverage through their employer, many companies set aside a short two to four week period between September and December when you can review and select health benefits for next year
  • If you get insurance through a State exchange or federal health insurance marketplace, the 2020 open enrollment period begins November 1 and ends December 15
  • Medicare open enrollment runs from October 15 to December 7 each year

For most people, the plan year begins January 1, 2020.

2. Review your current health plan

Before you compare options for new coverage during enrollment season, review your current plan. This will help you figure out what you need and use most. You should also think about your overall costs.

A common mistake people make is signing up for a cheaper plan without realizing their network has changed or the new deductible is higher than the previous one. They realize this when they visit their doctor only to discover that the physician is now out-of-network, or they owe more out-of-pocket than expected.

Another potentially costly mistake is defaulting to last year’s plan. It may not have the coverage you need for this year.

To make sure this doesn’t happen to you, take a look at your current plan details. These details include your network, premiums, deductible, co-insurance and out-of-pocket maximum. Here’s a quick refresher:

Common health plan terms

Network: The group of doctors your insurance carrier is contracted with; you usually pay less to see these providers.

Premium: The monthly payment for your health plan membership. If you qualify for a subsidy, some premium costs may be offset.

Deductible: The amount you pay in full before your insurance starts covering part of your medical bills. If your annual deductible is $2,500, you’ll have to cover all bills until you reach $2,500. After your reach your deductible, you’re still responsible for your co-insurance 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, you’ve met your deductible and receive an additional $1,000 bill. If your co-insurance is 20 percent, you owe $200.

3. Review your options

Let’s face it: there is no one-size-fits-all approach to choosing a health plan. Every person or family has unique health and budget needs. Carefully review your options so you can find the coverage and cost that works best for you:

  • Check if your current coverage still meets your needs and if your benefits will change next year
  • Determine if the plan fits your budget. Be sure to pay attention to the monthly premium, deductibles, co-pays and co-insurance.
  • Make sure your medications are covered. Even if you don’t expect to change plans, it’s important to ensure your prescriptions will still be covered next year.

4. Sign up for an FSA or HSA

In addition to health insurance, your employer may also offer additional benefits like tax-advantaged benefit plans. 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; HSA enrollment requires a qualified high deductible health plan. If your employer offers an HRA – take it! HRAs are funded by the company and do not count towards an employee’s 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 (with an HSA), prescription medications, and more. Be sure to find out if your employer’s plan offers a debit card; it’s much easier to pay with a card which can reduce how many reimbursement claims 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 plan can help you pay for commuter fare and parking expenses.

5. Gather your receipts

During enrollment season, it’s important to have your healthcare receipts as a point of reference. With so much to keep in mind, your receipts and Explanation of Benefits (EOBs) from last year can help you estimate your expenses for next 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 will be a breeze. You can also check out this video for more enrollment tips.