Human Resources

What To Do If An Employee Misses Open Enrollment

Any employer knows that when an employee misses open enrollment, it can be stressful for everyone. Missing open enrollment means losing health coverage — and this can have serious impacts on the employee’s life. For example, it can add financial and emotional burdens that may affect the employee’s well-being and productivity at work.

 

At the same time, the employer is often put under pressure to explain why they can’t re-open enrollment for the employee after the deadline has passed. This can lead to tense conversations — or, worse, employees may lose morale or become disgruntled. In some cases, employees may leave the company as they seek the opportunity to enroll in healthcare coverage elsewhere.

 

Fortunately, there are ways employers can help their employees who missed open enrollment to navigate some of these issues — and even potentially find alternative health coverage options.

 

First, express genuine empathy and concern over the employee’s situation and offer help

 

Employers are not able to re-open enrollment for an employee who misses open enrollment. However, to help offset loss of morale, HR should respond to the employee quickly, personally, and with empathy and understanding.

 

The employee may be panicking and feel at a loss for what to do next. Offering them dedicated time to meet with HR to discuss their coverage options for the next year will let them know you sincerely care and want to help. In addition, you can provide further information and support around the topics below.

 

Check to see if the employee qualifies for Special Enrollment Period (SEP)

 

Potentially, there could be a quick fix for the employee if they experience a qualifying life event that changes their eligibility status for benefits. There is a window outside of the standard open enrollment period — called the Special Enrollment Period (SEP) — that allows employees to use a qualifying life event to change or update their insurance plans, even if they missed open enrollment. Qualifying life events that make an employee eligible for SEP include:

 

Loss of health coverage

Losing job-based, individual, and student-plan healthcare coverage — as well as losing eligibility for Medicare, Medicaid, or CHIP — or turning 26 and losing coverage through a parent’s plan all qualify.

 

Changes in household

These include marriage or divorce, childbirth or adoption, a death in the family, or spousal abuse requiring a move from the abuser’s insurance plan.

 

Changes in residence

One could qualify for SEP if they move to a different county or ZIP code; are a student who moves to or from the place they attend school; are a seasonal worker moving to or from their place of work, or someone moving to or from a shelter or other transitional housing.

 

Other qualifying events

 

These include income changes that affect the coverage someone currently qualifies for; becoming a U.S. citizen; becoming a member in a federally recognized tribe or gaining status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder; AmeriCorps members starting or ending service; or someone leaving jail or prison.

 

Identify coverage options that can help the employee until the next enrollment period

Unless they qualify for SEP, employees who missed the 30-day open enrollment period will have to wait until the next one to register for their benefits again. However, this may not be practical for some people — especially employees with growing families, or who have current health conditions that need ongoing attention.

 

To help them, you can offer resources about other healthcare options — such as telehealth, programs designed to protect people from expensive medical costs, and alternative health

insurance products including:

 

  • Short-term medical plans that provide health insurance for 30 to 364 days for emergencies only, although usually only healthy individuals will qualify
  • Low-income programs like CHIP or Medicaid
  • Becoming self-insured, although this can be quite expensive

 

How employers can help prevent employees from missing the open enrollment deadline

 

The best way to help employees deal with missing open enrollment is to prevent it from happening in the first place. Here are a few key steps employers can take to ensure employees take part in a successful open enrollment period:

 

  • Require waivers of coverage that verify that employees reviewed and declined benefits options during the open enrollment period
  • Educate employees by providing information channels during open enrollment that ensure they are well-informed and have the resources to make smart decisions about their benefits
  • Gather employee feedback on the best ways to structure benefits enrollment to ensure maximum participation
  • Offer auto-enrollment to help employees avoid missing open enrollment

 

Want help with ensuring your employees don’t miss any open enrollment periods, or in making the next open enrollment period your most successful yet? If so, Enrollme can help. Enrollme makes it easy for your employees to shop for and purchase health plans that fit their needs and budget. What’s more, Enrollme manages employee communications to ensure staff stays on top of deadlines, decisions, and documents. Schedule a consultation or demo now.

 

SOURCES

https://www.paychex.com/articles/human-resources/employee-misses-open-enrollment#1Optionsfor

https://www.lhdbenefits.com/blog/hr-tips/what-happens-if-an-employee-misses-open-enrollment/

https://blog.bernieportal.com/missed-open-enrollment

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