Open Enrollment for Brokers – The Most Wonderful Time of The Year*
Congratulations friends, we’re halfway through the fourth quarter and right in the thick of that joyful time known as open enrollment season! Here at the Friends…With HEALTH Benefits Blog, we’ve been discussing five ways open enrollment reminds us of the upcoming holidays:
There’s A Reason for Open Enrollment Season
We mean it – we look forward to open enrollment all year. Agents and brokers get to be a light for people, guiding clients towards beneficial choices. Health insurance is the center of attention. We can showcase our value to the world. It’s the perfect time to get to know clients better too. If you are intentional about open enrollment, you can observe client needs. Take notes on demographics and preferences and then use them to do a better job all year. Yes, sometimes, the fourth quarter is exhausting. It’s also the reason health benefit professionals exist, so we embrace it.
Open Enrollment Requires A List You Check Twice
Just like the holiday season, some mandatory obligations come with open enrollment. We are talking about notice distribution obligations, though, not cookie-making with the in-laws. There are some notices group health plans must give plan participants during the enrollment process and some situational requirements. That’s why a checklist is helpful, so we made a quick one for you!
Mandatory Distribution During Open Enrollment:
- Summary of Benefits and Coverage and the Uniform Glossary
- Women’s Health and Cancer Rights Act Notice
- Special Enrollment Rights Notice
Mandatory Distribution During Open Enrollment, If the Situation Applies:
- Grandfathered Plan Notice (If a group wants to maintain grandfathered status)
- Health-Contingent Wellness Plan Notice (If a group offers a wellness program with rewards contingent on meeting a health goal)
- EEOC Wellness Notice (If a group provides a wellness program that asks medical questions or requires participants to engage in therapeutic services or tests)
- CHIP Premium Assistance Notice (If a plan participant lives in a state that offers premium assistance)
- HIPAA Privacy Notice (Self-funded plans, including health reimbursement arrangements and health flexible spending arrangements)
Within 90 Days of Coverage:
Open Enrollment Tools Can Help If You Use Them Wisely
There’s a lot to do during the open enrollment season, and tools and tricks can be helpful. Just make sure that you don’t hurt yourself or your clients when taking advantage of shortcuts and tools. Just as you are cautious when using that new wrapping paper slicer, you and your clients need to be careful with enrollment platforms and benefit administration services. There are always going to be small errors, so make audits of the enrollment process a standard operating procedure. If your clients are providing benefit information and required notices electronically, make sure they understand the related disclosure rules. For example, the requirements for distributing a SBC online are different than for other types of required disclosures.
Open Enrollment Allows for Planned Generosity
Employers that offer and fund employee benefit programs are being generous, and they should get credit, not harm from their generosity. So, make sure generosity comes on the front end, not the back! During open enrollment, sometimes plan administrators deviate from written policies to help an employee or two out. It’s a kind impulse to want to extend a deadline for one employee or turn a blind eye to eligibility criteria for another. Unfortunately, notions like that can come with serious legal and cost-consequences!
To put it another way, when you don’t plan carefully and realize last-minute, you only have six Chanukah gifts for one kid but eight for the others, it’s a solvable problem. With a group health plan, the stakes are much higher. You can’t be making last-minute accommodations and still run the plan in a legal and fiscally responsible way. So, help your clients think through their ground rules ahead time, taking into account situations where flexibility may be needed. Document their choices in all benefits communication and plan documents, and remind them to stick to their plan!
Open Enrollment Brings the Fun of a New Plan Year
You don’t get the clean slate of a new plan year without going through open enrollment first. Many significant parts of health plan administration happen during the open enrollment period, but effective plan management is a year-round endeavor. Compliance responsibilities and needs come up throughout the plan year, so put them on the calendar now. With a little bit of forethought, you can schedule a time to reach out to your clients on different critical topics throughout the year ahead.
The new year also brings a chance to improve on what you’ve done in the past. Schedule de-briefs with your clients to assess how things went and what you want to change for the future. A friend of this blog does a little bit of planning for Christmas on the 25th of each month, year-round. What if you and your team picked a consistent day or two each month to check up on each client’s compliance needs and to prepare for next year’s renewals. On those days, could you challenge yourself to think, “what can I do now to make open enrollment easier later?”
The financial security that sound health insurance coverage brings is a true gift. Being able to help millions of Americans realize those protections is a gift too. So, during the open enrollment season, celebrate it!
*With our apologies to Andy Williams.