Don’t Ignore Open Enrollment

Insurance and you — why open enrollment is not something to ignore. Consider your options carefully and keep your eye on the clock.

If you are one of the 183 million people who receive health insurance through your employer, you might be asking if open enrollment actually applies to you and, if so, if there’s anything you need to do. The answer to both questions is “yes.”

Each year, an open enrollment period takes place that allows employees to enroll in their employer-sponsored health insurance. It gives you the opportunity to either confirm your current health insurance coverage or to consider signing up for a new plan that better suits your needs.

When considering your options during the open enrollment, there are several factors to take into account. Here they are.

Changes to Your Health

First, take a moment to check in with your actual health. You’ll want to plan for any upcoming or ongoing medical needs. For example, if you know you’ll need surgery in the coming months, take the time to check your insurance plan’s network of doctors. This can help you avoid any surprises when it comes to what doctors and services are covered.

Your Budget

Next, take a moment to consider how your health insurance impacts your budget over the course of the year. If you had a high deductible plan with a lower premium, did that work well for you? Or, did you have an expensive medical event that caused you to dip into your savings?

If that’s the case, it’s possible a low deductible plan with a higher monthly premium would better spread out your health care costs over the course of the year.

If you have expensive prescriptions, be sure to review the prescription benefits your company offers. Your employer might work with a prescription discount company that can help reduce your out-of-pocket costs.

More Than Just Health Insurance

Your employer may also offer additional coverage during open enrollment such as life insurance, short-term disability, long-term disability, or even pet insurance. These benefits can be valuable, especially if your employer is willing to contribute to the premium.

To determine whether or not you should participate, consider your circumstances; for example, if you are pregnant and know that you will be away from the office on maternity leave next year, you may benefit greatly from a short-term disability plan. Or, if you recently adopted a puppy, this could be a great time to look into pet insurance.

Timing Matters

Your employer will set the timing for the open enrollment period, determining the start and finish dates.

Generally, employers hold open enrollment during the fall, and your benefits will kick in on January 1 of the following year.

You should expect to receive several email notices from Human Resources – make sure to pay attention so you don’t miss any important signup details.

If you don’t believe your employer has sent anything out, make sure to ask directly. It’s important to sign up for the coverage you want by the close of open enrollment, otherwise, you may have to wait until next year to do so.

If you have a qualifying life event that occurs during the course of the year, your employer will offer you another window of time where you can adjust your benefits. Qualifying events include birth, divorce, or a spouse’s job loss. If you need to change your benefits during the year, feel free to ask questions and find out if your life event qualifies you to make a change.

During open enrollment, your employer is offering you the chance to make potentially critical adjustments to your health insurance — make sure you take advantage! Consider your options carefully and keep your eye on the clock.

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Healthcare Premiums Drop

Healthcare Premiums Drop Slightly As 2021 Open Enrollment Period Draws Near

Even with the election and oral argument in California v. Texas looming, the 2021 open enrollment period will soon be upon us and it’s all about healthcare premiums. In all states except California (where the open enrollment period began on October 15), the 2021 open enrollment season begins on November 1, 2020, with a deadline of December 15 in the 36 states that use HealthCare.gov. States with their own marketplaces—including New Jersey and Pennsylvania, which newly opened their own marketplaces—have set their deadlines later in December 2020 or January 2021.

Ahead of open enrollment, the Centers for Medicare and Medicaid (CMS) released new data on HealthCare.gov marketplace premiums and insurer participation for 2021. CMS’s analysis includes an issue brief on premiumslandscape plan data, and a map on insurer participation. (Public use files do not appear to be posted yet but will be available here when they are.) CMS also released the scheduled maintenance windows for HealthCare.gov for the 2021 open enrollment period.

Healthcare Premiums Drop 2%

Overall, healthcare premiums are expected to drop by 2 percent for a 27-year old for a silver benchmark marketplace plan sold through HealthCare.gov. This builds on a 4 percent decline for 2020 and a 2 percent decline for 2019. The unsubsidized average benchmark plan premium for a 27-year old will be $369/month for 2021 (compared to $388/month for 2020). In four states, silver benchmark premiums will decline by double-digits: Iowa (29 percent), Maine (14 percent), New Hampshire (18 percent), and Wyoming (10 percent). Only North Dakota will see an average benchmark plan premium increase of 10 percent or more (29 percent).

Lower Healthcare Premiums Ahead

Lower premiums are expected even with the pandemic. First, Congress repealed the health insurance tax beginning with 2021, which should result in premium savings that are passed along to consumers. Second, insurers continue to owe record-high medical loss ratio rebates in the individual market. This suggests that insurers are overpricing their products and those premium reductions are warranted. Third, more states have adopted state-based reinsurance programs: currently, 14 states have received a waiver to operate a reinsurance program. Fourth, the pandemic has led to higher profits for many insurers, further incentivizing premium reductions. These factors made it unsurprising that many insurers would reduce their premiums for 2021.

Insurer participation continues to increase.

Six more insurers will offer marketplace coverage through HealthCare.gov, increasing the total number of participating insurers to 181 for 2021. (Even so, this metric continues to lag earlier years in ACA implementation, remaining well below the high of 237 participating insurers for 2016.) Of the 36 states that use HealthCare.gov, 16 states will have more insurers compared to 2020 and 27 states will have counties with more insurers relative to 2020. Only Arkansas, New Mexico, and Wyoming will have an additional insurer offer statewide coverage. Four states have counties with fewer insurers in 2021 relative to 2020 while Delaware is now the only state with just one insurer (down from two states for 2020). Only four percent of enrollees will have access to only one insurer compared to 12 percent of enrollees for 2018 and 20 percent of enrollees for 2019.

Average premium reductions and higher insurer participation are encouraging. The uninsured rate was on the rise long before the pandemic, and robust individual market coverage options will be especially important in 2021 with millions of people losing their job or health insurance. Fortunately, many low-income consumers will continue to have options in 2021. CMS estimates that 30 percent of subsidy-eligible enrollees can find a marketplace plan for $10/month or less, and 71 percent can find a plan for $75/month or less. Of those not eligible for subsidies, 27 percent can find a plan for $300/month or less.

Deductibles Continue to Rise

At the same time, deductibles continue to rise. For bronze plans, the median individual deductible increased from $6,755 for 2020 to $6,992 for 2021. For silver plans, deductibles rose from $4,630 to $4,879. And gold plan deductibles rose from $1,432 to $1,533. Consistent with prior years, nearly all enrollees will have access to a health savings account-eligible marketplace plan in 2021.

Finally, potential maintenance for HealthCare.gov has been scheduled for early morning on November 1 (to make final preparations ahead of the start of open enrollment) and each Sunday from 12 am to 12 pm ET except on November 1 and December 13. Federal officials selected the Sunday morning time period because this is when the website receives the least amount of traffic. During any website downtime, HealthCare.gov will be unavailable for consumers to select a plan and enroll in coverage. As in prior years, CMS anticipates that actual maintenance periods will be much shorter than the scheduled slots. Despite the maximum allocation of 72 hours of maintenance last year, the website was down for only 24.5 hours and HealthCare.gov was reportedly available 96.9 percent of the time.

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