Open Enrollment at Work: 3 Must-Knows About Health Benefits
Filed under: Health Care, Health Insurance
More than 43 percent of Americans get health insurance through a current or former employer. For most of them, the open enrollment period — the one time each year that they can change insurance coverage for the following year — is approaching. Here are three things to keep in mind.
1. Your Employer Probably Changed Your Choices
According to the National Business Group on Health, employers expect a 6.5 percent increase in health care benefit costs in 2015, and to reduce those cost increases, they’re looking at ideas like consumer-driven health plans to help give workers more incentive to control their own health care costs. In addition, private health-insurance exchanges are becoming more popular, and some companies are changing pharmacy benefits and other specialty areas.
Most employers offer extensive education when they make big plan changes, understanding that most people will be reluctant to change the coverage they already have. By taking advantage of that education, you can not only learn more about the reasoning behind any changes but also better understand whether you can reap some financial benefits from using the new plan options. At the same time, you can also make sure that benefits you were counting on for the future aren’t going away — and if they are, you still have a couple of months in 2014 to try to take advantage of existing provisions in this year’s coverage.
2. Think Seriously About the Nature of Your Health Care Needs
Typically, you can choose different levels of coverage. One choice might offer extensive coverage of nearly every conceivable health care expense — with high-ticket monthly premiums. Another might save you on upfront premiums but require larger copays, higher deductibles and more out-of-pocket costs.
Obviously, you can’t always anticipate a major health care expense a year in advance, but looking at your past health experience can help guide you. Healthy individuals often do better choosing low-cost plans that require them to pay more of their costs if problems do crop up. Those who expect greater use of medical services often end up doing better with more comprehensive plans, but again, it’s worth it to take a look at your policy for the direct answers.
3. Sometimes, You Can Make Changes at Other Times
The open enrollment period is so important because most of the time you can’t change coverage in the middle of a year. But there are some exceptions during “special open enrollment periods.”
Most of the qualifying events involve changes in family status, with marriage, divorce, domestic partnership or the birth of a child being the most common instances in which you’ll have an opportunity or obligation to change coverage. In addition, if you have coverage through multiple employers, a change in coverage under one employer might trigger the ability to make changes with others. Similarly, becoming eligible for other benefits such as Medicare and Medicaid allows changes outside the usual open enrollment period.
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