Best Practices to Ensure a Seamless Open Enrollment Season

With the fall season kicking off soon, open enrollment for most organizations is fast approaching. Leading up to benefits season, there are always so many things to keep track of to ensure you are properly prepared for team members to begin enrolling. To assist with the numerous to-do items, our team has developed a guide to better navigate this timeframe. It covers everything from the basics about open enrollment and a timeline to educating your team and employees about the process.

In addition to the guide, there are also two best practices that your HR team should keep in mind for a seamless benefits season. These two crucial factors are the audit process to ensure your employees are enrolled properly and timing with the carriers who are providing the benefits.

Audit Process

Employee benefits 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 reminders. At the least, use paper spreadsheets to track the returned information; this will save time and headaches later.

Lastly, it is best practice to review your first carrier invoice in January, or possibly the second invoice, depending on when you 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.

At BerganKDV, our clients use K-Pay, an all-in-one software solution that offers several reports to assist with the auditing process. Our support team can also help create customized reports for clients so they have exactly what they need for a smooth audit process during benefits season.

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 is no confusion on when the 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 benefits appropriately. If you are unsure where to start with evaluating your organization’s open enrollment, our team can help. Contact us today to learn more about our robust human capital management software, K-Pay that can help streamline your HR processes.


Subscribe for More

CATEGORIES: Featured | Human Capital Management
TAGS: | |
Notify of

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Inline Feedbacks
View all comments


Let us know a little about yourself! We’ll deliver timely news straight to your inbox.