Setting Up Open

Open Enrolment / Open Season / Annual Enrolment, is a process with which employers provide an option to the employees to add/remove/update their benefits elections. This is usually once a year process; however there will be instances where the employer would wish to do it twice a year. The mostly used plan year is 1^st Jan of every year till the 31^st of December.

What it means for the employer:

The employer gets a chance to renew its contract with the carriers. It can renew the contracts, with discussions to bring the Premium price down. It can also work with the carriers to get more lucrative plans and implement them.

For the carrier:

This is the time when the Carriers will restructure their plans to attract employers. They will negotiate rates with the Employers and set up Premium prices.

For the Employee:

As an employee, one need not have to wait for any life event. Open is the time, where all eligible options are actually part of one’s electable options (In most cases). So the employee can go and make elections for the next plan year and plan his expenditure towards his health coverage well in advance. Apart from that, many employers launch awareness plans during this time, where the employee gets to read and answer few questionnaires and in return they get some percentage of their rates off.

For a Functional Consultant:

For a consultant, it means a lot of work. : )

To be more specific, Employers might drop a lot of plans and add new, to support new Carriers. The benefit Structure changes, and so does the eligibility and enrolment structure of Non-Schedule life events for next plan year.

The changes might also include new interfaces/ extracts to the new carriers that are added, and changes to the existing. So while configuring Open, one must plan well in advance and take ample time in hand before the enrolment windows open.