As group health plan open enrollment looms for most companies, communicating your offerings to your staff is key to getting as many of them as possible to sign up for coverage.

That requires a solid strategy aimed at helping your employees understand their choices and the financial implications of them. Most importantly, you want to reach those employees who didn’t sign up last year and stress the importance of health insurance.

To achieve maximum participation, your communications in the run-up to open enrollment are crucial both in terms of how and what you are messaging. A robust strategy includes: 

Simple messaging

Simplify the process of deciding which health plan to choose in a series of snappy messages that are easy to understand. One of the best ways to get the point across is by using vivid examples, preferably with graphics.

Explain the basics — Focus on your employees’ costs and coverage considerations:

• Their share of premium,
• Their deductible, copay or coinsurance,
• If their doctor is in the plan’s network,
• If there are any drugs they need for any ongoing health issues.

Help them with the math — Many people have trouble grasping the math. They may look at a low premium without considering the cost on the back end in terms of a higher deductible and/or other out-of-pocket expenses.

Break expenses down with different health care scenarios and the associated out-of-pocket costs based on the plan they have.

Explain coverage for big-ticket items— This includes costs associated with things like a knee replacement or cancer treatment. Humanize the examples by creating a persona and how their health plan covered treatment.

Use creative materials — Provide vivid documentation that includes a lot of bullet points and quick, punchy messages.

Use sidebars to cover important information they need to know, like an increase in deductibles or copays, or that a plan has overhauled its doctors’ network.

Dispensing sage advice

Help your employees by providing guidance on choosing the right plan:

• Provide clear and direct advice.
• If an employee is getting family coverage, it’s important they discuss possible choices with their spouse. You can assist by sending hard copies of the enrollment materials to their home.
• Provide tools for comparing plans to see what their costs would be under each option.
• Highlight wellness and virtual benefits, which are growing in popularity. Provide details on how to sign up and access these benefits.

Staggering your communications

Step up announcements to build interest by focusing on:

New or changing plans — Use these blasts to let them know about any new benefit programs you are offering or plans you may be discontinuing. You can point them to resources on how the benefits work and any demos. You can also announce changes to plan out-of-pocket costs or deductibles ,or if a plan has beefed up coverage.

Timely communications — These should include reminders about open enrollment and checklists on what your employees should do before it starts.

Once open enrollments starts, you’ll need to send out messaging to get stragglers to act.

Popular programs — If you are adding a plan that your staff has requested, make sure to blast out a few announcements to the troops.

The takeaway

Communication is a key component of a successful open enrollment. You can follow the above advice to generate interest and to help your staff pick plans that are right for them.

As open enrollment is right around the corner, now is the time to gear up to maximize employee enrollment, help them make the best selections for their own personal circumstances, and stay compliant with relevant laws and regulations.

It’s a lot to take in as uncertainty has been a constant during the last few years with the COVID-19 pandemic and its lingering effects on people’s health and the economy.

Still, since health coverage and other employee benefits are an important part of your compensation package — and your competitive edge for talent — it’s important that you get it right, particularly now with the intense competition for talent. 

Here are some pointers to make open enrollment fruitful for your staff and your organization.

Review what you did last year

Review the results of the previous year’s open enrollment efforts to make sure the process and the perks remain relevant and useful to workers. How effective were various approaches and communication channels, and did people give any feedback about the process itself?

Start early with notifications

You should give your employees notice at least a month before open enrollment to let them know it’s coming, as well as provide them with information on the various plans you are offering. Encourage them to read the information and come to your human resources point person with questions.

Help them sort through plans

You should be able to help them figure out which plan features fit their needs, and how much the plans will cost them out of their paycheck. Use technology to your advantage, particularly any registration portal that your plan provider offers. Provide a single landing page for all enrollment applications.

That said, you should hold meetings on the plans and also put notices in your employees’ paycheck envelopes.

Plan materials

Communicate to your staff any changes to a health plan’s benefits for the 2023 plan year through an updated summary plan description or a summary of material modifications.

Confirm that their open enrollment materials contain certain required participant notices, when applicable – such as the summary of benefits and coverage.

Check grandfathered status

A grandfathered plan is one that was in existence when the Affordable Care Act was enacted on March 23, 2010 and is thus exempt from some of the law’s requirements. If you make certain changes to your plan that go beyond permitted guidelines, the plan is no longer grandfathered.

If you have a grandfathered plan, talk to us to confirm whether it will maintain its grandfathered status for the 2023 plan year. If it is, you must notify your employees of the plan status. If it’s not, you need to confirm with us that your plan comports with the ACA in terms of benefits offered.

ACA affordability standard

Under the ACA’s employer shared responsibility rules, applicable large employers must offer “affordable” plans, based on a percentage of the employee’s household income. For plan years that begin on or after Jan. 1, 2023, the affordability percentage is 9.12% of household income. At least one of your plans must meet this threshold.

Out-of-pocket maximum

The ACA’s out-of-pocket maximum applies to all non-grandfathered group health plans. The limit for 2023 plans is $9,100 for self-only coverage and $18,200 for family coverage.

Make sure your plans are in line with these figures.

Other notices

Consider also including the following notices:

• Initial COBRA notice.
• HIPAA notice. This may be included in the plan’s summary plan description.
• Notice of HIPAA special enrollment rights.
• HIPAA privacy notice.
• Summary plan description.
• Medicare Part D notices.

Get spouses involved

Benefits enrollment is a family affair, so getting spouses involved is critical. You should encourage your employees to share the health plan information with their spouses so they can make informed decisions on their health insurance together.

Also encourage any spouses who have questions to schedule an appointment to get questions answered.

With the COVID-19 pandemic continuing to throw a wrench into the economy and the workplace, employers are gearing up for another unusual open enrollment for their group health plans for the 2022 policy year.

As a result of the pandemic, your employees’ priorities may have changed and some of them may be looking at enhanced benefits, or to change their plans’ deductibles or out-of-pocket maximums.

The coronavirus is obviously not in the rear-view mirror, so employers need to consider workers’ new priorities when choosing health insurance plans and other employee benefit offerings.

Employees’ new priorities

Here’s what’s become a priority for many workers today:

• Mental health support
• Access to telehealth
• Higher interest in health savings accounts (HSAs).

Employers should consider their staff’s new priorities when designing health and benefit programs. If you decide to make changes to your plans or if your health plans have changed, you’ll need to effectively communicate those changes to your workforce.

More health plans are rolling out more and improved access to mental health support, the demand for which has surged during the pandemic as many people struggled with the sudden changes and isolation spawned by stay-at-home orders.

Additionally, because many people were afraid or because of doctor’s office restrictions, many tried telehealth video-conferencing services for the first time in 2020 or in 2021. Insurers see telehealth as a viable option for reducing the cost of care, and they have invested heavily in the infrastructure to enable health plan enrollees to meet virtually with their doctors.

More health plans are also covering mental health video-conference sessions as well.

Many plans have expanded these services, but you’ll need to check to see if the ones you are offering include these enhancements.

Additionally, the pandemic has resulted in more employees looking for ways to set aside funds during the year to pay for health care and medications. This can be done through HSAs and flexible spending accounts (FSAs). which are funded by the employee using pre-tax dollars. The funds in those accounts can be used to reimburse for a wide variety of qualified medical expenses.

HSAs, however, can only be offered to employees who are enrolled in a high-deductible health plan (HDHP). HSAs can be kept for life and can be transferred from one employer to the next if a worker switches jobs. FSAs are easier to set up, but they are not kept for life and cannot be transferred to another employer when an individual leaves your employ.

There are some changes to these plans that you should know about.

The Coronavirus Aid, Response and Economic Security (CARES) Act, signed into law in March 2020, allowed HSA-qualified HDHPs to cover telehealth services before plan enrollees reached their deductible. This provision expires Dec. 31, 2021.

However, another change brought by the CARES Act is permanent: Employees with HSAs, health reimbursement arrangements or health FSAs are now allowed to use those accounts to reimburse for over-the-counter medications without a prescription, and for certain menstrual care products, such as tampons and pads.

Communications and planning

During your open enrollment meetings and in your communications material, you’ll want to highlight any new services that the health plans you are offering your staff will cover.

Since COVID-19 is still present and is raging in some communities, you may want to consider:

Holding a ‘virtual benefits fair’ — In these virtual fairs, employees and families can go online and check out the offerings of all the plans available to them, so they can learn more about their offerings and provider networks. These events can be done on the employees’ and families’ own time.

Conducting virtual open enrollment meetings — Consider holding teleconference open enrollment meetings to go over the employees’ health plan choices, and the deductibles, copays, premium amounts and what the maximum out-of-pocket is for each choice.

Sending out more frequent and targeted communications — Targeted communications can be sent to various cohorts of your employees, such as information on plans that would be of most interest to people in their 20s and 30s. What you send them in terms of recommended options would be different than what you send older employees, who have other priorities.

Using technology for enrollment — Some health plans offer apps through which employees can choose and sign up for the plan of their choice. Talk to us about what’s available to you.

Schedule it

The Society for Human Resources Management recommends that you do the following in the two months prior to open enrollment (September through October). This is the time to get the word out about the upcoming open enrollment. Consider:

• Distributing a pre-enrollment flier (printed and online) in September.
• Holding a virtual benefits fair in mid-to-late September.
• Distributing the enrollment packet at the end of October (printed and online).

With open enrollment right around the corner, it’s time to review the health plan options available to you for the next year and prepare your workplace for signing up for the 2021 policy year.

The big decision for employers is finding a plan that fits not only their budget but also the budgets of their employees. And this is particularly important for “applicable large employers” under the Affordable Care Act, who must also ensure that the least expensive of their plans must not cost more than 9.83% of any of their health-plan-eligible employees’ household incomes.

This year, due to the COVID-19 pandemic, benefits advisors recommend that employers get an earlier than usual start on preparing for their upcoming open enrollments. The following are just a few issues you need to consider for this year’s open enrollment:

Determine how many employees will receive coverage – It’s to your advantage to try to get as many of your employees to enroll in your health plan as possible, particularly if you are a small employer. The more lives in your plan, the more the risk is spread for the insurer, which can translate into lower policy premiums for all of your workers.

Keep things simple – Try not to make open enrollment complicated. Your employees have enough on their minds during the pandemic. Your literature and meetings should provide easy-to-follow instructions that tell your workers:

• What they need to do to enroll or re-enroll.
• How they can choose the right health plan for themselves and their family, and
• When the deadline is.

Get an early start and provide employees with health plan information prior to open enrollment, so as to give them enough time to review and compare their insurance options.

Informing your employees – If you are planning to meet with your staff in person, you’ll need to plan for social distancing as well as offering employees that cannot or do not feel safe the option to join the meeting via video conferencing.

If you plan to have your staff enroll and choose plans electronically, you need to make provisions for the ones who may not have access to a good internet connection or the technology to do so.

Periodically remind your employees to submit their applications or make changes before the end of the open enrollment period. Have a mechanism in place for identifying and approaching laggards as the deadline approaches.

The COVID factor – Your employees will want to know if testing and treatment of COVID-19 will be covered, as well as any vaccine that may eventually become available. Federal legislation enacted in March required all private insurance plans to cover costs associated with COVID-19 tests. A number of insurers announced that they would also waive all cost-sharing for in-network medical visits related to COVID-19, as well as for telehealth visits.

Since there are no laws that require private insurance plans to waive cost-sharing for COVID-19 treatment, you will have to explore your plan options to see which ones may offer treatment without cost-sharing. Also check to see if the plans you have access to will waive out-of-pocket fees for a coronavirus vaccine should one become available.

Coverage questions for your employees – Encourage your employees to ask questions during your meetings, and ask them to consider re-evaluating their coverage in light of:

• Change in dependents – Will employees be adding or removing any dependents, such as children or a spouse, from their health plans? Will you the employer contribute to qualified dependent coverage and if so, how much?  
• Health issues – Does any employee have evolving health issues that will require more medical services than they have used in the past. They should also check to make sure their plan network includes their personal physician, as well as covering the medicines they may be taking regularly.
• Affordability – How much are they willing to pay for coverage and what kind of deducible would be in their price range? What is the premium cost-sharing (how much the employee pays for their share of the premium)?

The takeaway

During the pandemic, you’ll need to get a head start on open enrollment by getting information on your offerings to your staff as early as possible. Be prepared to answer questions about coverage, particularly as it pertains to COVID-19.

You can work with us to make sure you have everything in place for a successful open enrollment.