Frequently Asked Questions

We recommend that employers take their annual open enrollment period to make necessary adjustments to their
employee benefits. Benefit information changes from year to year, and may require a change to your company’s
benefit strategy. If your company admin has decided to "plan map" they you will automatically be enrolled in the
same (or most similar) health plan as the one you originally selected. If they do not have this automated process
set up, you must re-select your health plan or you will be denied coverage.

There are many factors that contribute to rate changes, such as plan designs, legally mandated benefits, ACA
taxes, and more. The normal trend for medical insurance rates is an increase between 10-12% while dental and
vision rates trend around a 2-4% increase.

• This actually depends on how your specific company has chosen to set up its open enrollment process. If you
  have selected an option that's referred to as "plan mapping," then the company will make automatic selections for
  employees who fail to alter their health plans during the open enrollment period. Without alteration on the part of
  the employee, the company will keep the individual in the same health plan or in the most similar health plan to
  the individual's original selection. If that employee had previously declined coverage, the company will
  automatically decline coverage once again.
• However, if administrators at your company have not selected to "plan map," then any employee who does not
  actively make a selection during the open enrollment period will be
  declined coverage. This is even true for employees who had previously been enrolled in a health plan. These
  employees would need to re-select their health plan to continue using it. If the employee fails to do so during the
  open enrollment period, they can only enroll in health insurance if they experience a qualifying life event. It's
  possible that the employer could submit an "exception request" for an employee who missed open enrollment;
  this would be done through the employer's broker.

Carriers send ID cards about 7-14 days after the application has been approved. When a group is going through
open enrollment, it is common to receive ID cards around 30 days after the effective date.

This depends on how the administrator sets up other benefits packages. Sometimes the employers include other
benefits, such as commuter benefits or wellness programs, in the same period as health insurance open
enrollment. However, the main selection employees will be making is regarding health, dental, and vision
insurance plans and carriers.

All benefit changes should be made during open enrollment. Changes outside of this period can only be
processed if you've experienced a sufficient qualifying life event.

Yes, if the effective date of the company's open enrollment is after the effective date of the new hire enrollment,
you will be required to enroll in coverage again.

Yes, as long as the change is made before the last date of the open enrollment period, or during the period after a qualifying life event.

A copay is the amount paid out-of-pocket at a doctor's appointment or when purchasing a prescription. A
deductible is the collective amount of money that is paid out-of-pocket before health insurance carriers begin to
cover medical expenses. The deductible is typically calculated on an annual basis, either according to the
calendar year or the plan year. It's important to verify which time frame your deductible adheres to before making
selections.

Yes, Open Enrollment gives you the freedom to make any changes to your coverage such as adding or removing dependents.

Yes, it is recommended that all employees make their plan selection during open enrollment, even if you're on
paid time off, vacation, or any kind of parental leave. If an employee is unable to make the selection at this time,
the administrator should work with their broker or carrier to determine their options for enrollment.

A qualifying life event (QLE) is a significant lifestyle change that is either unexpected or unavoidable. In the case
of a QLE, employees are able to make changes to their insurance plans outside of the open enrollment cycle.
Examples of QLEs are having a baby or divorcing a spouse.