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Frequently Asked Questions
- Renew my plans
- Which benefits programs?
- Miss the open enrollment
- After the enrollment
- New ID cards?
- New job
- Maternity or paternity leave
- Qualifying life event?
- Find the best Insurance
- Rates Change
- Co-pay and deductible?
- What is COBRA?
Can you do it for me?
We recommend that employers take their annual open enrollment period to make necessary adjustments to their
employee benefits. Benefit information changes from year to year, and may require a change to your company’s
benefit strategy. If your company admin has decided to "plan map" they you will automatically be enrolled in the
same (or most similar) health plan as the one you originally selected. If they do not have this automated process
set up, you must re-select your health plan or you will be denied coverage.
This depends on how the administrator sets up other benefits packages. Sometimes the employers include other benefits, such as commuter benefits or wellness programs, in the same period as health insurance open enrollment. However, the main selection employees will be making is regarding health, dental, and vision
insurance plans and carriers.
What happens if I miss the open enrollment window?
This actually depends on how your specific company has chosen to set up its open enrollment process. If you
have selected an option that's referred to as "plan mapping," then the company will make automatic selections for
employees who fail to alter their health plans during the open enrollment period. Without alteration on the part of
the employee, the company will keep the individual in the same health plan or in the most similar health plan to
the individual's original selection. If that employee had previously declined coverage, the company will
automatically decline coverage once again.
However, if administrators at your company have not selected to "plan map," then any employee who does not
actively make a selection during the open enrollment period will be
declined coverage. This is even true for employees who had previously been enrolled in a health plan. These
employees would need to re-select their health plan to continue using it. If the employee fails to do so during the
open enrollment period, they can only enroll in health insurance if they experience a qualifying life event. It's
possible that the employer could submit an "exception request" for an employee who missed open enrollment;
this would be done through the employer's broker.
Are there any benefits I can enroll in after the open enrollment period?
All benefit changes should be made during open enrollment. Changes outside of this period can only be
processed if you've experienced a sufficient qualifying life event.
When will I receive my new ID cards?
Carriers send ID cards about 7-14 days after the application has been approved. When a group is going through open enrollment, it is common to receive ID cards around 30 days after the effective date.
I was hired recently and just enrolled. Do I still need to go through the open enrollment selection?
Yes, if the effective date of the company's open enrollment is after the effective date of the new hire enrollment, you will be required to enroll in coverage again.
If I'm on maternity or paternity leave, do I still need to make selections during open enrollment?
Yes, it is recommended that all employees make their plan selection during open enrollment, even if you're on paid time off, vacation, or any kind of parental leave. If an employee is unable to make the selection at this time, the administrator should work with their broker or carrier to determine their options for enrollment.
What is a qualifying life event?
A qualifying life event (QLE) is a significant lifestyle change that is either unexpected or unavoidable. In the case of a QLE, employees are able to make changes to their insurance plans outside of the open enrollment cycle. Examples of QLEs are having a baby or divorcing a spouse.
How can I find the best Health Insurance Company?
Right now, there are hundreds of different health insurance companies participating in the Exchange offering thousands of different plans. These companies are rated on a letter grading scale (A, B, C, etc.) based on their performance.
Their grade is calculated by attributes such as financial stability, claim payments, and customer service. You might also want to ask around among friends, family members, and colleagues. If their plans are working for them, they could work for you too. Here is a list of some companies that our partners work with: Aetna, UnitedHealthCare, Humana, Cigna, Anthem, and many others.
Why would my insurance rates change?
There are many factors that contribute to rate changes, such as plan designs, legally mandated benefits, ACA taxes, and more. The normal trend for medical insurance rates is an increase between 10-12% while dental and vision rates trend around a 2-4% increase.
What's the difference between a co-pay and deductible?
A copay is the amount paid out-of-pocket at a doctor's appointment or when purchasing a prescription.
A deductible is the collective amount of money that is paid out-of-pocket before health insurance carriers begin to cover medical expenses. The deductible is typically calculated on an annual basis, either according to the calendar year or the plan year. It's important to verify which time frame your deductible adheres to before making selections.
Your group health plan must be covered by COBRA
A qualifying event must occur (for example, voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, or divorce)
You must be a qualified beneficiary for that event
If you are entitled to elect COBRA continuation coverage, you must be given an election period of at least 60 days to choose whether or not to elect continuation coverage.
How do I get COBRA coverage?
Under COBRA, group health plans must provide covered employees and their families with a notice explaining their COBRA rights. Plans must also have rules for how COBRA continuation coverage is offered, how qualified beneficiaries may elect continuation coverage, and when it can be terminated. COBRA is usually more expensive and the consumer could take on additional fees associated with this type of coverage.
Disclaimer: This website is not the Health Insurance Marketplace website.
Medicare Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-Medicare to get information on all your options.