What You Need to Know About Open Enrollment

Open enrollment is a time in which you are required to enroll in or opt-out of health, dental, and vision insurance coverage for the upcoming year. It is also the time of the year where you can make changes to your current plan or choose an entirely different option altogether.

When Is Open Enrollment?

The time for open enrollment typically depends on how you get your insurance. For example, many people get their insurance through an employer. In this case, the company decides when open enrollment will be. To find out when your open enrollment is, contact your health resources department.

If you get individual insurance or obtain insurance through the Affordable Care Act (ACA), open enrollment is between November 1 and December 15. However, there are a few states that have their own open enrollment period.

What Are Your Options?

No matter what kind of insurance you have, you want to review all the options available to you. Review your current policy and see if everything you need is still offered in the upcoming year.

If you want to keep your current coverage, there might not be anything to do on your own end. However, some plans do change year to year, so be sure to review your plan.

When choosing the right health insurance options, make sure to consider your health needs and the needs of your family. Do you have a chronic condition that requires regular doctor visits? What kind of medications do you take?

On the other hand, if you are young and healthy, you probably use fewer medical services, so you may want to find a lower premium plan.

Whatever you do, keep in mind that you can’t change your plan outside of the open enrollment period, so you want to take your time to consider every angle before choosing an insurance plan for you and your family.

Special Enrollment

There are a few cases where you can sign up for healthcare outside of open enrollment, but these cases are limited. There is an exception if you recently got married or divorced, have a baby or adopt, lose your partner, lose your job and coverage through your job, your hours are cut, or you are in an HMO and move outside of your coverage area.

If you voluntarily drop your coverage, then you won’t qualify for the special enrollment periods.

Fully Insured vs Self-Insured

Now you also have to consider what kind of insurance plan you will get. Self-insurance is also known as a self-funded plan and is typically when an employer takes on most or all benefit claim costs. The insurance company manages the payments, and the employer is the one who pays the claims. With a  fully insured plan, the employer pays a certain amount of the premiums each month to the health insurance company.

Many employers are switching to self-funded plans because it provides them with more flexibility. Self-funded plans are also regulated by federal law and not state law.

For more information on health benefits and what you can expect, contact the insurance experts at National Insurance Partners.

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