Open enrollment season is coming to a close. Hopefully everyone in your organization has had ample opportunity to review their options and either sign up for coverage or change their existing elections. But what happens if someone forgot? If one of your employees, either intentionally or accidentally, failed to sign up for–particularly health benefits–what are you required to do?
Well, the short answer is–legally–not much.
Open enrollment is often the only time during the year when employees can make changes to their benefit elections, such as dropping or adding coverage, dropping or adding dependents, or even signing up for benefits for the first time. It can be overwhelming or stressful for all involved. And missing this important deadline could leave employees without the option of changing their benefits, or even without coverage at all.
But, while either of these situations could result in a significant impact on the employee’s finances and wellbeing, there’s little you can do as an employer. In fact, your benefit plan may prohibit you from making exceptions for an employee who misses the open enrollment deadline.
The one exception to these terms is if an employee qualifies for a special enrollment period (SEP). In the even that an employee experiences a qualifying life-changing event (e.g. marriage, divorce or separation, having or adopting a child, moving to a new residence or work location), he or she could be eligible to make changes to their benefits outside of the open enrollment period.
It’s important to have a plan in place to deal with an employee who qualifies for a SEP. If you have questions or are concerned about whether or not your situation applies, give us a call. We can help you sort it out.
Don’t freak out!
If the size of your business requires you to offer coverage under the Affordable Care Act (ACA), they you may be concerned about having a non-covered employee. Don’t worry. While the ACA does impost penalties for employers who fail to offer affordable, minimum-essential coverage to their employees, it doesn’t affect you if they choose not to enroll. You won’t be subject to a penalty as long as the coverage was offered.
A good precaution, though, is to document that you did in fact offer it. You can require employees to sign an acknowledgement of benefits form for those who do opt in, as well as a waiver of coverage form for those who opt out or miss the deadline. Doing so creates a uniform policy, without singling out only those who chose not to sign up. We have both of those forms available.
An ounce of prevention…
Although you can’t do anything to help someone who missed the open enrollment deadline, there are a number of things you can do to make sure that scenario never happens in your workforce (or, if it’s too late, to make sure it never happens again).
- Take an active role during open enrollment. Communicate often with your employees in a variety of formats.
- Educate employees about their benefits prior to and during open enrollment to alleviate any confusion they might have.
- Offer seminars, e-learning, and even one-on-one meetings to give employees as many opportunities as possible to receive their benefit communications.
- Encourage employees to take open enrollment seriously and reiterate that the deadline is final.
- Ask for feedback after open enrollment ends to find ways to improve employees’ experience for the next year.
- Give extra attention to anyone who missed the deadline and find out how you can better get them the tools they need to sign up for coverage next year.
Again, although you aren’t legally required to do anything in the case of an employee missing the deadline for open enrollment, it’s in your best interest to take these steps to protect your business and productivity. Showing your employees that their needs are important to you will help to improve morale. And making sure you’ve done all that’s required of you will help you stay out of trouble with the ACA. Call us today if we can help.