The end of the year is the most common time for employer groups to enroll employees in their core benefits like health, dental and vision insurance. But as much as employers try to prepare their employees for enrollment time, many employees don’t put as much time as they should into the benefit selection process.
In fact, most employees don’t read benefit information that’s sent out, don’t attend benefit meetings and show up without important enrollment information to facilitate the process. Instead, many usually approach enrollment with the “just give me what I had last year” approach.
Because of that, I thought I would write down some important tips for employees to help get them ready to either self enroll in their benefits or be more ready to discuss their benefits with a benefits counselor who might assist them.
With that in mind, here’s my employee’s guide to be better prepared for open enrollment.
- Pay attention to the benefit information sent to you Prior to enrollment, you’ll probably receive information about any changes, updates and other related information. Read it so you know what’s going on.
- Attend any pre-enrollment benefit meetings These meetings are a great time to learn more about which benefits you should enroll in and why. Don’t assume you know everything. Even if you don’t think you will take advantage of an offer made to you, at least hear the offers.
- Review your spouses benefits Many employees don’t think to check into what benefits their spouse has enrolled in until they sit down with a benefits counselor. Make sure you review what your spouse has before you enroll so when you get to enrollment you’ll have a clear idea of what you want to do and don’t have to check and come back.
- Check for spousal carve out provisions Do either you or your spouse’s employer have a spousal carve out that prevents you from covering the other spouse at their employer?
- Consider continuing coverage on dependents Make sure that you consider your children into overall medical cost for your whole family.
- Review last year’s medical expenses Did you meet your deductibles? How much did you spend on prescriptions, copayments and coinsurance. Knowing this information will make it easier to determine which medical plan is right for you and your family.
- Compare the summary of plan benefits for each medical plan Read each plan’s Summary of Benefits & Coverages and pay close attention to the premiums, deductibles, copayments and coinsurance for each one.
- Don’t base your selection on lowest premium Most plans that cost less require more out of pocket when you use the plan. If you are a heavy user of your medical insurance, it might be better to choose a higher premium since you’ll most likely spend that amount anyway. Remember premiums are pretax benefits. If you don’t use an HSA or outspend your FSA, that’ll most likely be paid with after tax dollars.
- Check your networks Make sure the medical, dental and vision providers you use are in the networks of the plans you enroll in. Most insurance companies put their networks online for you to review. When you check for your providers, make sure you are looking at the correct networks. Insurance companies often have more than one network.
- Make an estimate of your medical insurance needs for next year Are you having any procedures in the upcoming plan year? Do you think the upcoming year will be basically the same as last year?
- Consider utilizing either the Flexible Spending Account (FSA) or Health Savings Account (HSA) If you are heavy user of your medical plan, an FSA might be a better option for you since you might end up not having enough to save. The idea behind an HSA is to be able to save money from year to year. So if you don’t ever go to the doctor an HSA will be more attractive to you.
- Check your FSA balance Since an FSA contribution can be lost if you don’t claim it, you want to see if your FSA is use it or lose it or has a carry over provision so make sure you check your balance.
- Get your wellness screenings done Does your plan give a rate reduction for completing your wellness screenings. Be sure and take advantage of it.
- File wellness claims Some benefits offer annual wellness benefits. Make sure you file those claims to receive any wellness cash you have a right to claim.
- Get your tobacco surcharge removed If there are any tobacco users in your family and the medical plans have a tobacco surcharge, see if a tobacco cessation program will get that surcharge removed and enroll in it. Your plan might reduce the rate just by going through the program even if you don’t manage to quit.
- Don’t lie on insurance applications Your coverages are based on your truthful answers on applications. If you lie about smoking or other treatment related questions, your insurance may not pay out in those circumstances. Insurance companies do check things before they pay claims.
- Visit with benefit’s counsellors If there are representatives on site to help you enroll in your plans, be sure and go see them without people having to hunt you down.
- Don’t wait til the last minute to enroll Benefits counsellors are usually paid a flat daily rate no matter what you enroll in. Each day you drag out the process costs money. In addition, enrollments are on tight deadlines. If you miss the deadline, you might be out of luck.
- Have your family information Show up prepared with your families names, birthday’s and social security numbers ready. Insurance carriers often change from year to year. Your information often doesn’t carry over.
- Bring last year’s enrollment confirmation Remember, in most cases, these benefits are structured under what is called a “group contract”. Because carriers can change from year to year, benefits are sometime taken over by the new carrier. Your coverage might be an exception to the rules of the new company. These exceptions are often grandfathered in. But you’ll need to pay attention to your statement or you could lose that exception and might not know you did. I’ve heard of employees losing out on benefits because things slipped through the cracks. Benefits counsellors might not be provided with your selections from the previous year.
- Pay attention to pre-existing condition clauses Insurance plans are sometimes subject to a pre-existing condition clause. If you are pregnant and want to enroll in short term disability, there’s a good chance that will be considered a pre-existing condition and not covered. Pre-existing condition clauses are often grandfathered in when carriers change.
- Change beneficiaries if needed Make sure you verify your life insurance beneficiaries are who you want them to be. Otherwise, your ex-spouse might be very happy when you die.
- Convert or remove child term life riders Children covered under term life insurance riders will expire at certain ages. Premiums will continue in many cases unless you remove it even if your children are to old to be covered. If you are interested in converting a child term rider, you want to make sure you don’t miss the opportunity before it expires.
- Understand age reduction schedules if you are 65 Group term life insurance often reduces once you reach age 65. Every plan is different. Don’t be surprised if no one knows what happens but check into it and find out.
- Understand the difference between attained age and issue age plans Group plans are set up with specific rate structures. Some are set up to change as you get older. Review these benefits annually to see if it still makes sense to keep it. Issue age plans keep you at the age you were when you signed up. If you get offered issue age plans when you are young, this can really save you money down the road. Keep in mind that group coverage isn’t guaranteed to never change. Plans can and do change so you have to verify whether things are based on your attained age or your issue age each year. Each benefit could be different too!
- Enroll in your retirement plan Insurance isn’t your only concern at enrollment time. Don’t forget about your retirement contributions. Make sure to take advantage of any company match and consider increasing your contribution each year.
- Consider each benefit option carefully Make sure you understand how each benefit being offered works before you turn it down. I’ve seen employees turn down options without even knowing how much it costs. Depending on your age, some of these benefits are cheaper than you think. I try and make sure each employee knows how much their benefit options cost. After finding out the cost and how something works, many employees I’ve talked to sign up for things they would have skipped because they didn’t want to know.
- Take advantage of guaranteed issue If you have any medical problems, make sure you take advantage of any guaranteed issue offers that come your way. The “no one ever told me about it” excuse doesn’t work once that enrollment closes.
- Are you retiring soon? Understand which benefits you can keep when you leave and how much they cost.
- Read your confirmation carefully Everybody does their best to make sure your elections are what you requested and that grandfathered coverages carried over but sometimes mistakes can happen. Your benefits confirmation statement is your proof you enrolled if there are any questions.
- Make sure you can afford your selections It’s easy to sign up for stuff and not pay attention to how much you are spending. The last thing the insurance companies want you to do is sign up for stuff and then cancel it. That costs everyone money. Sign up for what you know you will keep.
- Keep a list of your insurance companies and agents Make a list of all insurance companies, register for online access, and get agent names and phone numbers.
- Make a folder of all benefit elections Keep all enrollment confirmation, plan documents, agent phone numbers in one place so you can refer to it during the year.
- Download mobile apps for insurance companies you have benefits with Many insurance companies have apps that make it easier to determine in network providers, flexible spending account balances and more. Take the time to download these.
- Confirm your deductions Once your deductions start, make sure they match what you signed up for.
- Keep an eye out for ID cards Any ID cards you’ll need to confirm your benefits should arrive later. Some are mailed to you but some have to be looked up online and printed out.