With open enrollment right around the corner, it’s time to review the health plan options available to you for the next year and prepare your workplace for signing up for the 2021 policy year.
The big decision for employers is finding a plan that fits not only their budget but also the budgets of their employees. And this is particularly important for “applicable large employers” under the Affordable Care Act, who must also ensure that the least expensive of their plans must not cost more than 9.83% of any of their health-plan-eligible employees’ household incomes.
This year, due to the COVID-19 pandemic, benefits advisors recommend that employers get an earlier than usual start on preparing for their upcoming open enrollments. The following are just a few issues you need to consider for this year’s open enrollment:
Determine how many employees will receive coverage – It’s to your advantage to try to get as many of your employees to enroll in your health plan as possible, particularly if you are a small employer. The more lives in your plan, the more the risk is spread for the insurer, which can translate into lower policy premiums for all of your workers.
Keep things simple – Try not to make open enrollment complicated. Your employees have enough on their minds during the pandemic. Your literature and meetings should provide easy-to-follow instructions that tell your workers:
- What they need to do to enroll or re-enroll.
- How they can choose the right health plan for themselves and their family, and
- When the deadline is.
Get an early start and provide employees with health plan information prior to open enrollment, so as to give them enough time to review and compare their insurance options.
Informing your employees – If you are planning to meet with your staff in person, you’ll need to plan for social distancing as well as offering employees that cannot or do not feel safe the option to join the meeting via video conferencing.
If you plan to have your staff enroll and choose plans electronically, you need to make provisions for the ones who may not have access to a good internet connection or the technology to do so.
Periodically remind your employees to submit their applications or make changes before the end of the open enrollment period. Have a mechanism in place for identifying and approaching laggards as the deadline approaches.
The COVID factor – Your employees will want to know if testing and treatment of COVID-19 will be covered, as well as any vaccine that may eventually become available. Federal legislation enacted in March required all private insurance plans to cover costs associated with COVID-19 tests. A number of insurers announced that they would also waive all cost-sharing for in-network medical visits related to COVID-19, as well as for telehealth visits.
Since there are no laws that require private insurance plans to waive cost-sharing for COVID-19 treatment, you will have to explore your plan options to see which ones may offer treatment without cost-sharing. Also check to see if the plans you have access to will waive out-of-pocket fees for a coronavirus vaccine should one become available.
Coverage questions for your employees – Encourage your employees to ask questions during your meetings, and ask them to consider re-evaluating their coverage in light of:
- Change in dependents – Will employees be adding or removing any dependents, such as children or a spouse, from their health plans? Will you the employer contribute to qualified dependent coverage and if so, how much?
- Health issues – Does any employee have evolving health issues that will require more medical services than they have used in the past. They should also check to make sure their plan network includes their personal physician, as well as covering the medicines they may be taking regularly.
- Affordability – How much are they willing to pay for coverage and what kind of deducible would be in their price range? What is the premium cost-sharing (how much the employee pays for their share of the premium)?
The takeaway
During the pandemic, you’ll need to get a head start on open enrollment by getting information on your offerings to your staff as early as possible. Be prepared to answer questions about coverage, particularly as it pertains to COVID-19.
You can work with us to make sure you have everything in place for a successful open enrollment.
