2021 Open enrollment for health insurance coverage is in full swing. Below are some common questions employers asked about open enrollment with corresponding answers which will give an insight about open enrollment 2021.
When is Open Enrollment 2021?
Open enrollment for individual insurance and employer-provided under the Affordable Care Act starts on November 1, 2020, and ends December 15, 2020. Changes made within the enrollment period take effect from January 1, 2021.
The District of Columbia and 14 states have their state-based exchange for individual insurance coverage. Typically, these marketplaces may have lengthy enrollment periods.
What is Open Enrollment?
Open enrollment is a months period within which individuals can sign up for, drop, or make changes or state exchange health insurance coverage.
How Do I Get Started with Open Enrollment?
Planning is imperative to successfully managing open enrollment. It would be prudent to clearly communicate where on your healthcare provider’s website employees can locate forms required to enroll, make necessary changes, or drop coverage if you have a group health plan.
If you are utilizing an HRA to reimburse employees for personal coverage, you should make the following information easily available:
- Dates for the open enrollment period for their state
- The site where they can view plans and enroll in coverage
- The HRA allowance you will provide them so they can budget when selecting plans.
- If you are using an ICHRA, it is also good to let them understand that they will require documents to prove a purchase of Minimum Essential Coverage that makes reimbursements tax-free.
What do Employees Need to Know About Open Enrollment?
Employees should know that enrollment periods are limited. They will lose their chance to get new coverage or change their existing coverage until 2021, if they don’t make their elections during the window provided.
Communication should begin early and repeated often. You should notify employees that enrollment starts on November 1 and ends definitively on December 15.
Any employee who fails to make their elections or changes during that window will miss making changes to their existing coverage or miss out on getting coverage. You should not forget to send information to those on leave, or vacation.
What if an Employee Misses Open Enrollment?
Those who do not make elections or changes during the open enrollment window may see the following:
- the employee’s coverage will stay unchanged for the next plan year (2021) if they are already enrolled.
- they will not be permitted to join a health plan until 2021 unless they have an event that qualifies them for a Special Enrollment Period (SEP), especially if they were not enrolled for the 2020 Plan Year.
What if an Employee Does Not Want coverage?
Employees should be given the opportunity to opt-out of insurance coverage. However, they may only do so within the open enrollment or if there is a current qualifying life event. A qualifying life event may be, for example, divorce, marriage, or the birth of a child.
Employers are expected to document waivers of coverage and file that information for at least three years. your insurance carrier can give a waiver of coverage forms if you have a group plan. On the other hand, agents like health insurance plans keep records of employees’ opt-in and opt-out decisions for you if you are reimbursing coverage with an HRA. The opt-out/opt-in forms should be signed, dated, and submitted during open enrollment.
Tip: it is important to keep track of the total number of your employees who opt-in. That is because group health insurance plans have minimum participation requirements, like some ICHRAs, depending on your plan design.
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