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Open Enrollment Made Simple

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Some parts of open enrollment are confusing. Can you give some information about details and dates to watch out for?

There are very few of us who don’t know what open enrollment means. However, more than 74 percent of employees say there are at least some things they do not understand about their overall policies, including deductibles and copayments. These include an employee whose employer provides benefits; Medicare beneficiaries; individuals and families enrolled in healthcare directly or through New York State Individual Marketplace or NY State of Health.

Today, most of us have many things on our plates; deadlines and distractions are commonplace. There is one event most of us must participate in, and that’s our health insurance open enrollment.

For Medicare beneficiaries enrolled in Part A and Part B, the period for choosing from various Medicare options is from October 15 to December 7 every year, with the effective date of coverage of January 1, 2019. This is called the Annual Enrollment Period. The choices and various rules associated with this segment of the population are tremendous.

For many employees, the Open Enrollment time for their employer’s employee benefits, including health insurance, occurs during the fourth quarter each year.

For individuals and families enrolled in health insurance directly from an insurance carrier or through New York’s marketplace, the open enrollment period is November 1, 2018, through January 31, 2019.

Regardless of the type of health plan available to you, most of us, a whopping 92 percent, select the same coverage each year even though the benefits within the plan have changed!

How do I navigate this year’s open enrollment efficiently and make the best choice for myself and my family?

Utilize a broker/advisor; they are licensed and well versed in the complexities of the differences among plan options. Take time to compare plans against your life stage and look at your previous year’s choices to determine what worked and what didn’t. Take the information you receive and break it down into small, bite-sized pieces, and use tools available to compare plans.

Be aware of any changes to your prescription copays, doctor visit copays and front-end deductibles. Look at whether your options include wellness benefits or incentives to complete health assessments. Be aware of the time you have to make a decision for the next year. 

The reality is that 58 percent of us spend less than 30 minutes reviewing our options, and more than 67 percent say reading these benefit options is too complicated or stressful. However, take this year’s open enrollment task as an opportunity to feel confident with the choice you made.

Written by: Lori Anne Harris

Lori Anne Harris had almost 35 years of experience in the employee benefits field with a top-tier health insurer before opening her own insurance agency, HMS Agency, Inc., a NYS Certified Women-Owned Business Enterprise, over 21 years ago. Lori Anne is a licensed life, accident/health agent and property/casualty broker. She is a graduate of St. Bonaventure University and has served as the chairman of the Capital Region Chamber’s Business Referral Group #1. She is an active member of the National Association of Healthcare Underwriters Women’s President Organization, and serves on the board of the Ellis Hospital Foundation.