If you’re here, you offer your employees some kind of health insurance. Congrats! You’re off to a great start with providing your employees with good benefits and watching out for their health. But there’s an important thing to remember for your employees and their health insurance: open enrollment.
What is open enrollment? We’ll walk you through the details about how it works, the details for 2023 health plans, and a few other important questions.
What Is Open Enrollment?
Open enrollment is a window of time when you can enroll in a health insurance plan, make changes to coverage, add anything you need, or even cancel your coverage. During an Open Enrollment Period, individuals cannot be turned downfor Affordable Care Act-compliant health insurance because of their health status, so it’s a great time for people to sign up.
Why do we have open enrollment? Basically, without open enrollment, it could be difficult to spread insurance riskaround to actually provide coverage for people who are sick. If people could get coverage whenever they’re sick and drop it when they’re not, there wouldn’t be enough money to cover people who are seriously ill or chronically ill. Open enrollment encourages everyone to have health insurance to make sure they’re always covered and to make sure there’s enough to go around for everyone.
When Is Open Enrollment for 2023 Health Plans?
Open enrollment dates actually depend on where you are. Most states use the same ACA open enrollment period: Nov. 1, 2022, to Jan. 15, 2023. but there can be a few variations. Check out this chart to see when your state has open enrollment for 2023:
|California||November 1, 2022 – January 31, 2023|
|Colorado||November 1, 2022 – January 15, 2023|
|Connecticut||November 1, 2022 – January 15, 2023|
|Idaho||October 15, 2022 – December 15, 2022|
|Kentucky||November 1, 2022 – January 15, 2023|
|Maine||November 1, 2022 – January 15, 2023|
|Maryland||November 1, 2022 – January 15, 2023|
|Massachusetts||November 1, 2022 – January 23, 2023|
|Minnesota||November 1, 2022 – January 15, 2023|
|Nevada||November 1, 2022 – January 15, 2023|
|New Jersey||November 1, 2022 – January 31, 2023|
|New Mexico||November 1, 2022 – January 15, 2023|
|New York||November 16, 2022 – January 31, 2023|
|Pennsylvania||November 1, 2022 – January 15, 2023|
|Rhode Island||November 1, 2022 – January 31, 2023|
|Vermont||November 1, 2022 – January 15, 2023|
|Washington DC||November 1, 2022 – January 31, 2023|
|Washington||November 1, 2022 – January 15, 2023|
How to Maximize Open Enrollment Periods
The Affordable Care Act requires a certain amount of coverage, but your employees’ plans can still vary a lot depending on
- Plan design
- Premium costs
- Copays for doctor, urgent care and emergency room visits (and prescription drugs)
- Provider networks
- Prescription drug benefits
It also can depend on what you offer as a benefit or as part of your fringe benefits.
To really take advantage of the open enrollment periods, it’s key to communicate with your employees about what things they should be considering during this brief period of time. Here are some things to make sure your employees know and are considering:
- Possible health care needs for the next year (will you need more or less coverage? A big surgery coming up or anything like that?)
- Compare health insurance costs
- Explore plan design differences
- Check out the health plan’s provider network (health insurance can be part of a benefits strategy, so employees should check out what that entails)
Managing Different Types of Health Insurance During Open Enrollment
Not every type of insurance is equal or has the same open enrollment details. In general, the ACA insurance options are the ones that follow the open enrollment policy. What about different types of health insurance?
- Employer-sponsored. Companies decide when people become eligible as part of employee benefitsprograms.
- Medicare. The Medicare enrollment period is usually from October 15 to December 7.
- Medicaid. Medicaid doesn’t require an enrollment period and is available year-round. If you’re eligible, you can sign up for it whenever you want.
Can Employees Make Changes Outside of Open Enrollment?
Time to ask the million dollar question: can employees make changes to their health insurance plan outside of open enrollment? Unfortunately, changes are notpossible outside of enrollment. You also can’t get coverage or cancel an ACA plan outside of open enrollment. Except for a few exceptions. You can make changes if you have a qualifying life event, including:
- Birth or adoption of a child
- Death of a family member (like a spouse)
- Becoming a US citizen
- Moving to a new place permanently
- Loss of previous coverage (like turning 26 and losing a parent’s plan)
So if you have a qualifying life event, you can adjust your plan. Otherwise, hold tight until the next enrollment period.
The Bottom Line
Open enrollment is an important thing to know about and to communicate to your employees. Ensure that your employees know the deadlines for open enrollment and how they can take advantage of the time to adjust their health insurance plans.
Many benefits are required to be selected during the open enrollment period, but your company can onboard new wellness programsat any time of year. Talk to a wellbeing specialistabout how to make that a reality.
- Masterson, Les. (October 11, 2022). When Is Open Enrollment For Health Insurance? Forbes. Retrieved November 29, 2022 from https://www.forbes.com/advisor/health-insurance/when-is-open-enrollment/.
- Porretta, Anna. (October 18. 2022). Annual Open Enrollment Period: Everything You Need to Know. eHealth. Retrieved November 29, 2022 from https://www.ehealthinsurance.com/resources/affordable-care-act/everything-to-know-about-the-annual-open-enrollment-period.
- What Is Open Enrollment? United Healthcare. Retrieved November 29, 2022 from https://www.uhc.com/understanding-health-insurance/open-enrollment.
- When Is Open Enrollment for 2023? (November 4, 2022). Health Markets. Retrieved November 29, 2022 from https://www.healthmarkets.com/resources/health-insurance/open-enrollment.
The Gympass Editorial Team empowers HR leaders to support worker wellbeing. Our original research, trend analyses, and helpful how-tos provide the tools they need to improve workforce wellness in today's fast-shifting professional landscape.