The Most-Asked Questions About Open Enrollment — Answered!

Open enrollment for 2019 health care benefits is here, so if you’re like most people you probably have questions about enrolling for next year’s plan.   In most cases, your HR department’s benefits representative or insurer are your best sources of information for making the best decisions.  Although your first instinct may be to give enrollment little thought or effort, spending some time to understand your options can significantly affect your health care in the coming year, not to mention your medical expenses.

Let’s take a look at some common questions that HR professionals receive, and their responses to employees. Using these questions as a guide when speaking to your HR representative or insurance provider is always a smart idea to get accurate information.


What/when is open enrollment?

Open enrollment is a specified time period when employees are given a chance to elect or make changes to their benefit options available through their employer — such as health, dental and life insurance — for the coming year. Set by the employer, the enrollment period often takes place during the fall. Ask your HR benefits representative if you haven’t received information about your company’s enrollment.  Some companies will schedule employee meetings for HR and/or insurance representatives to answer questions before enrollment starts. Either way, you’ll want to allow plenty of time to gather information so you can make the most informed decisions when it’s enrollment time.   

Whatever you do, don’t miss the enrollment deadline! Speak with your employer or HR representative to learn when your deadline is. If you are shopping in the open marketplace for your health insurance, the deadline is December 15.


What can I do to make sure I pick the best plan for my family and me?

First, you should always look at more than just costs. What may look like the lowest-priced plan, for example, may ultimately cost you more in terms of copays, higher drug costs or other fees. In particular, take time to compare premiums, deductibles, in- and out-of-network doctors and health systems, and other out-of-pocket costs before you make your decision.

You may also want to consider your prior health care history to determine the best plan for you. For example, if you or your family tend to see a doctor more often, you may want to pick a lower-deductible option. Conversely, if you’re rarely sick, a higher-deductible option may be the better choice.


Are there benefits that can help me with stress or other personal issues?

Many companies are now offering programs that can help their employees navigate personal challenges that pop up in their daily lives.  Some plans now offer support for programs that help combat stress or provide counseling to help with sleep issues, among others.


How much will I pay toward my medical costs?

Your monthly premiums likely will be deducted — all or in part — from your paycheck. In some cases, employers contribute to the cost of their employees’ monthly premiums, but in other cases, employees pay for the entire premium. If you’re unsure, take time to speak with your HR benefits representative for clarification.


What are my options for handling expenses not covered by insurance?

Employees typically are responsible for paying most, if not all, of their own health care expenses not covered by insurance. But the good news is that many plans include options for employees to set aside tax-free funds to pay for those out-of-pockets. One of those options is the flexible spending account (FSA), which allows you to use pre-tax wages — usually a monthly deduction — to pay for eligible health care expenses like prescription drugs or eyeglasses.  It’s important to remember that FSAs typically are ‘use it or lose it’ funds, so you’ll want to carefully calculate your expected expenses for the next year, so you don’t leave unused funds in the account at the end of the year. Ask your HR department and insurers for a worksheet to help you with your FSA deduction calculation.

Another option offered by some companies for paying out-of-pocket medical costs is a Health Savings Account (HSA), typically made available for people enrolled in high-deductible insurance plans. HSA contributions are made by the employee before taxes are deducted. Unlike FSA plans, funds left in an HSA at the end of the year can be rolled over to the next year.


How do I find out if my doctor or hospital participates in my health plan option? What if they do not?

Your HR representative or insurer will provide you with a list of providers included in your plan. If your preferred providers are not included in the plans you’re considering, ask your HR representative if there’s an option to pay an additional premium to include non-network providers.


What else should I consider when I’m making my health care decision?

Although it may seem obvious, employees sometimes forget to talk to their spouses about anticipated health care needs and expenses in the coming year. Without consulting your partner, you may make a decision that isn’t the best one for your future needs. If your spouse is employed, also take a look at what his or her employer offers being careful to compare coverage, premiums, deductibles and out-of-pocket expenses. Your spouse’s employer may provide better options than the ones you’re considering.

An investment of your time can make all the difference in making the best choices for your health. Before selecting your choices during open enrollment, arm yourself with all the knowledge you can gather. Use these questions as a guide to think about what you need to know, and spend time with your HR benefits representative. You’ll be healthier for it!

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