Best Practices During Open Enrollment to Ensure Smooth Sailing

There are so many things to keep up with leading up to and during your open enrollment process this fall. We have developed a guide to help you along the way that covers everything from the basics about open enrollment and a timeline to educating your team and employees about the process.

Two important things for your HR team to not overlook are the audit process to ensure your employees are enrolled properly and timing with the carriers who are providing the benefits.

Audit Process

Employee benefit data is probably one of the most critical and visible functions of the HR department. Open enrollment season is that time each year when it all changes, and with that comes an opportunity for things to go wrong. One of your strongest defenses against that is a good audit plan.

This starts during your open enrollment. Make sure that you are monitoring your employee’s activity through the process and can follow-up with employees who aren’t doing what they need. This is much easier if you are using an electronic enrollment system that can provide you with real-time reporting and automated reminder, but even if you are using paper a spreadsheet to track what has come back in can save time and headaches later.

Lastly, I always strongly recommend that you review your first carrier invoice in January, or possibly the second invoice, depending on when you’re are billed. Typically a carrier will only allow retroactive changes 60-90 days after the effective date, so if you uncover an employee who should have a different plan or doesn’t have the right dependents covered, it’s important to make those corrections early in the year before your employee finds themselves without the coverage they expect or costs they didn’t anticipate.

Timing with Carriers

As you work through open enrollment it is important to understand the timing with your carriers. There are three main timing issues you want to understand:

  1. when your final rates will be available
  2. when enrollment data is required and
  3. when Summary of Benefits (SBC) or Summary Plan Description (SPD) are available.

Let’s start with rates. When you’re making decisions about what plans you are offering and what your employees will pay, you will rely on the rates from the carriers. It’s important to be clear with your carrier or broker about when you will receive these rates. This is going to depend a bit on your company’s size. Larger employers typically can receive final rates earlier. Small employers may not receive final rates until October or November. Discuss this with your carrier, broker, and enrollment partners to make sure there no confusion on when information will be finalized.

The next most critical date is when enrollments are due, this is doubly important to know if you are changing carriers or adding plans because you want to allow enough time for carriers to produce and mail ID cards for the upcoming year so that employees have them in hand prior to January 1.

In general, medical and prescription carriers will want to have all of your enrollments the first week of December, vision and dental tend to be a little more flexible and may not need enrollments until later in December. As you are planning your open enrollment dates, make sure that you are allowing yourself or your vendor enough time to gather the open enrollment data and transmit it to the carriers.

The last critical date is knowing with SBC and SPDs are available. This is less critical if you are renewing existing plans, but if you are offering new benefits or new carriers, make sure you know when they plan to distribute these.  SBCs are typically due at the time of enrollment or when enrollment materials are distributed. SPD can stretch into the next plan year, but you are still responsible to make sure they are ready when needed so make sure to ask your carrier about both the timing and their distribution methods.

Taking care of these behind-the-scenes tasks in a timely manner will help ensure your employees have accurate information and will give you peace of mind that you are administering the benefits appropriately. We’ve developed a timeline to help you stay on track.

Our team at BerganKDV can help guide you through the process. Start here.

CATEGORIES: Uncategorized | Workforce Management
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