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6 Common Open Enrollment Questions (and How to Answer Them)

By Heather Kerrigan | Jul 15, 2019

Getting your members' attention during open enrollment can be a challenge. But if you proactively address open enrollment questions and make it easy to find answers, your members will feel prepared and heard. Members who understand the open enrollment process and are educated on their options will likely make better coverage choices, something essential for maintaining a productive and healthy membership.

Here are some common questions from members and how to answer them.

1. What Is Open Enrollment?

Open enrollment is the period of time when members can select or change their medical, dental and vision benefits (and any other voluntary benefits offered, like pet or life insurance). Although there is no set date for open enrollment, for health insurance benefits that begin on January 1, open enrollment typically takes place in November, and members will have a few weeks to make their selections.

2. Can I Make Changes to My Health Insurance Outside of Open Enrollment?

Changes to health insurance benefits can only be made outside the open enrollment period if a member experiences a qualifying life event. These include birth, adoption, death of a spouse or dependent, loss of health insurance coverage, divorce, separation and other major occurrences.

3. What If I Don't Want to Change My Benefits?

Members aren't required to change their plan during open enrollment. But it's important to encourage members to review their coverage options each year. Prices and plan coverage, along with lifestyle and individual health, are constantly changing. Members should make sure their existing plan is still the best for them in terms of both coverage and cost.

4. What If I Miss Open Enrollment?

In most cases, if a member misses the open enrollment period, they'll need to wait until the next one to change or enroll in a health insurance plan. As noted above, however, if the member has a qualifying life event, they can make a change within a certain time period after that event occurs. If the member's health plan offers automatic renewal, the member is reenrolled in the existing plan.

However, if the member does not have automatic renewal, they may be removed from the health insurance rolls if they take no action during open enrollment. Union leaders should make sure members know whether they must reenroll and should communicate this information frequently to ensure members do not inadvertently lose coverage.

5. How Should I Prepare for Open Enrollment?

Before the start of the open enrollment period, members should spend time determining what coverage they'll need in the coming year. Some questions to ask include:

  •  What do you like or dislike about your current plan?
  •  Did you take full advantage of your plan in the prior year?
  •  Are your prescriptions and preferred providers covered under your current plan?
  •  Do you have any upcoming health needs (surgery, medication change, etc.) or changes to your medical history or family situation that require more or less coverage?
  •  Which benefits are most important to you?

Members also need to consider how much they want to spend. It's important for members to consider the full cost of coverage, including premiums, co-payments, co-insurance, deductibles and possible out-of-pocket expenses.

When creating a health insurance budget, members should develop a best and worst case estimate for the coming year based on current health, medications and any other expected needs. Members should be encouraged to talk with a primary care physician, who may recommend tests or procedures that will increase health care costs. Fair Health Consumer provides medical and dental cost estimates to help build a budget, and if members are unsure about insurance terms, the Centers for Medicare and Medicaid Services provides a glossary.

6. What Information Should I Have Readily Available When Changing My Benefits?

If a member has decided to choose a different insurance plan, they should have available their health insurance budget for the coming year, monthly or annual health costs from the prior year, and a list of medications and preferred providers. This information will help them determine the best new coverage option.

To deliver the answers to these open enrollment questions to members, communicate regularly on a variety of channels. Keep your website updated with current information and reminders about open enrollment, and use the union's social media page or any other regular points of contact (meetings, emails, etc.) to provide reminders and tips for preparing for and enrolling in health insurance coverage.

Clearly communicate when open enrollment takes place, what your members must do during open enrollment and the consequences of failing to act. Finally, give members a union or employer contact who can assist with any open enrollment questions.

Heather Kerrigan started her career in journalism at Governing magazine, reporting on state and local politics and policy, with a specific focus on public workforce, environment, health care, education and technology issues. Prior to co-founding River Horse Communications, Heather offered freelance editorial services to a variety of outlets, including serving as volume editor and lead author for SAGE Publications' Historic Documents series and editor-in-chief of The Kanter Journal. Heather also blogs for two government-focused publications, GovLoop and NEOGOV, covering issues of importance to federal employees. Heather is the author of the book Retire Rich With Your 401(k) Plan. She holds a bachelor's degree in journalism from The George Washington University.