Why Open Enrollment is Important

Why Open Enrollment is Important

Health insurance open enrollment is the time of the year when one can sign up for health insurance. If you fail to sign up for health insurance during this period, chances are few that you can sign up for health insurance coverage unless you produce a compelling reason or buy a policy off market like a short term health plan.

What Are The Dates for Open Enrollment 2019?

In the United States, Open Enrollment is carried out every year, where employees and individuals in the private market get the opportunity to make preferred changes to their health insurance policy for the next calendar year.

The Open Enrollment 2019 begins on Thursday, November 1, 2018, and ends on Saturday, December 15, 2018. If you miss the deadline of December 15, you cannot get your coverage for 2019 unless you are eligible for a Special Enrollment Period. The effective date for the plan sold during the enrollment is January 1, 2019.

Provided that you are qualified and apply for the health insurance during this period, you must be insured by the health plan. The company has no permission to ask for evidence of insurability or use underwriting, both of which can impede your chances of getting health insurance.

Health insurance was generally introduced to stabilize the health care system and health care costs by creating a balanced distribution between low and high users of health care system.

Insurance functions when everyone contributes at the same time into one risk pool regardless of an individual’s current health status. Initially, people would refrain from insurance until they became injured or sick. This situation only left sick people in the risk pool.

The emergence of open enrollment period ensures that everyone contributes to the risk pool at the same time to be part of it. This leads to a stable population of sick and healthy people in a given year.

Purpose of Open Enrollment

The two main reasons for the introduction of open enrollment is to create awareness to employees and individuals alike and to give them the opportunity to make changes.

1) Create Awareness to Employees and Individuals

During open enrollment, employers are required to educate their employees on the health benefits available. The goal of this is to give all employees a comprehensive overview of the benefits to ensure they make an informed decision that will work well for them and their families.

Only the employee can identify which marketplace plans is fit for their family’s medical requirements. With knowledge, employees can be in a better position to make good reviews and better decision. The employees can also be able to verify that their physicians or dentists participate in the network of their selected plans.

According to the 2014 Aflac Open Enrollment Survey, 73 per cent of 2100 consumers say that they rarely, never or sometimes don’t understand everything their policy entails. 64 per cent disagreed that they are prepared for the next open enrollment. 71 per cent regard their personal insurance status as becoming more confusing.

Lack of awareness contributes largely to waste of money and poor employees perception about their employers.

2) Time to Make Changes

Are you Ignoring your open enrollment period?

This is not just the opportunity you get to make changes to your health insurance but also allows you to check into your alternatives for switching policies. During this time, you can change other health insurance coverage or choose programs that can save more money.

The following are the changes you are eligible to make during open enrollment.

  • Changing coverage level. This could involve including your spouse, children or family.
  • Beginning or continuing Health Care or Flexible Spending Account participation.
  • When you want to increase your coverage level for Voluntary Short-Term Disability.
  • When you plan to waive health coverage altogether.
  • If you want to change between Regional HMO plan and Regular Health Plan.

Make mindful choices and be proactive to avoid getting stuck with defaults. Here is what you need to look at to do so.

a) Compare The Costs Of Health Plans

You have to look keenly into your coverage and costs annually and proactively switch to cost-effective coverages. This requires enough research for a marketplace plan.

While researching the health insurance marketplace, It is vital to understand what is offered by each type of plan, how their terms apply and what you will have to pay yearly in addition to premiums.

Additionally, you have to focus on the possible change in your life that might need more medical attention in future, like pregnancy. That should make you switch to coverage with higher premiums

b) Do You Need More Health Coverage Than What Your Employer Provides?

Many companies only provide fundamental life and disability policies to their workers. But this may not be all enough for you and you may want to have additional coverage.

Choosing a basic plan may be smart as it is better than nothing and it is extremely cheap but it offers minimal coverage, which may not cover anyone else who depends on your income.

If you have dependents; a partner who shares your debt, children who need part of your income to live, you are likely to look for an additional insurance policy to cover them and relieve yourself from the burden in case anything happens.

These changes can only be made during an open enrollment period. However, there are exceptions when you can be allowed to make changes outside open enrollment duration.

These exceptions include:

  1. When you have a qualifying event such as birth, adoption, marriage, court order or death.
  2. Changing between regional HMO and regular health plan is only accepted when a Health Maintenance Organization (HMO) participant leaves her or his HMO’s service area.
  3. Changing coverage level.
  4. Waiving health plan policy altogether is only allowed for those who pay for coverage on a basis of after-tax.

Final Thoughts

For people to reap the maximum benefits of open enrollment, they must clearly understand the benefits provided by their employers or marketplace plan. To understand, it is important that they participate in educational meetings to get more from benefit providers and insurance professionals.

This awareness can equip them with the necessary information and keep them from making costly mistakes in their health insurance coverage.