The Top 5 Most Frequently Asked Questions About Open Enrollment and Health Benefits

The Top 5 Most Frequently Asked Questions About Open Enrollment and Health Benefits

October 27, 2022
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Open Enrollment 2022 begins November 1st, 2022 and ends on January 15th, 2023. In that time, you will be able to enroll in a health benefit plan or change your current plan.

We get a lot of questions around this time, so we’ve compiled a list of the top 5 questions that we receive with answers to those questions in hopes of helping our clients understand what their options are.

1. What if I miss the open enrollment period for benefits?

If you miss the open enrollment period for benefits, you will not be able to enroll in a benefits plan or change your current plan until the next open enrollment period unless you experience a qualifying life event that, under IRS rules, allows you to make benefit changes.

2. What is a qualifying life event?

Examples of qualifying life events are as follows:

  • Loss of health coverage, this includes employer-based plans, individual plans, or student-based plans. Also includes turning 26 years old and losing coverage under a parent’s plan, or losing Medicare, Medicaid, or CHIP eligibility.
  • Changes in household status. A death in the family, getting married or divorced, or having a baby all are examples of a change in household status.
  • Changes in residence. In most cases, if you move your residency to a new county or cip code, this qualifies as a change in residence.
  • Miscellaneous qualifying events: changes in income that may affect the type of coverage that you qualify for, becoming a U.S Citizen, leaving incarceration, and AmeriCorps members staring or ending their service.

3. Can I have other health coverage?

Yes, under most medical plans, you can be covered by another group health plan and still be covered by your employer plan. This is referred to as “dual coverage” and a coordination of benefits will kick in. This means that if you are enrolled in an employer-sponsored health plan, that coverage is primary, and you must file claims on that policy first. If some of your out-of-pocket costs are not covered on the employer plan, then you can file claims on your other group benefit plan.

4. Who is an eligible dependent?

Dependent eligibility varies by plan and employer, but typically your spouse and any children under the age of 26 are considered dependents.

5. What is an HDHP, or HSA plan?

HDHP stands for High Deductible Health Plan and is sometimes referred to as as an HSA (Health Savings Account) plan. An HSA plan works differently than a more traditional plan in that there aren’t any copays. You will pay everything out of pocket until you reach your deductible. After you reach your deductible, the plans coinsurance kicks in, and your insurer will pay for a percentage of the bills until you hit your out-of-pocket max.

An HSA is an actual bank account that you can optionally contribute to with every paycheck. These contributions are then used to pay for the out-of-pocket costs with every trip to the doctor.

We hope that this blog answered any questions you might have about the upcoming open enrollment period. If you have any questions that we didn’t cover here, please reach out to our dedicated team of experts at 888-504-0450 or visit our website at https://www.smartandsimple.com/partners/insurance-advisors/