After all the time and attention that HR pros give open enrollment, it can be hard to imagine how an employee could miss the window for electing their benefits. However—even when it's for their benefit(s)—your priorities are not always their priorities, and some workers may put it off, thinking they'll have more time to ask questions and get clarification later.
So, open enrollment can easily pass some by. Here's what can happen and how HR can help.
Before diving into what happens when employees miss the deadline, let’s revisit what open enrollment is. Open enrollment is the annual period when employees can elect or make changes to their employer-sponsored benefits, such as health insurance, dental and vision coverage, and retirement plans.
This time is critical because, outside of open enrollment, employees generally cannot adjust their benefits unless they experience a qualifying life event (QLE).
Missing the open enrollment window can have significant consequences, especially for employees who rely on their benefits for essential healthcare coverage. Here’s what could happen:
No Coverage:
If your organization does not offer auto-enrollment, employees who miss the deadline may lose their opportunity to secure coverage for the upcoming year.
Limited Options:
Employees may need to explore alternatives such as short-term health plans, Medicaid, or CHIP, which may not offer the same level of coverage as employer-sponsored benefits.
Out-of-Pocket Costs:
Without proper coverage, employees could face steep out-of-pocket expenses for healthcare services.
Employees who experience a QLE may still have an opportunity to adjust their benefits. Common QLEs include:
Change in Household: Marriage, divorce, childbirth, adoption, or a death in the family.
Change in Residence: Moving to a different ZIP code, county, or state.
Other Situations: Loss of coverage due to aging out of a parent’s plan (e.g., turning 26) or starting/ending AmeriCorps service.
2. Short-Term Health Plans
Employees can consider short-term health insurance plans, which offer temporary coverage for a few months to a year. These plans:
3. Medicaid or Children’s Health Insurance Program (CHIP):
Employees who meet income requirements may qualify for Medicaid or the Children’s Health Insurance Program (CHIP), both of which allow year-round enrollment. Eligibility criteria vary by state.
HR professionals play a key role in guiding employees through benefits challenges. Here’s how HR can help:
2. Check for Administrative Errors: Verify that the missed enrollment wasn’t due to an error, such as incomplete submissions or system glitches. Tools like BerniePortal’s HRIS can reduce errors and streamline benefits administration.
3. Improve Communication: Evaluate your communication strategies to ensure employees fully understand the open enrollment process. Consider sending:
4. Offer Auto-Enrollment: Implementing auto-enrollment can prevent employees from losing coverage. With tools like BerniePortal, employers can use passive enrollment strategies to roll over prior elections, reducing the risk of missed deadlines.
You can stay informed, educated, and up to date with important HR topics using BerniePortal’s comprehensive resources: