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Open Enrollment: What It Is: How To Maximize


Most large employers and many smaller ones offer employees a chance to adjust health, life and other benefits during a set period of time each year with no questions asked about current or past health condition. This period is known as an Open Enrollment Period. For federal employees, it's called Open Season.

An open enrollment period is a good time to reexamine your benefits and adjust them to your wishes given your current state of health and prognosis.

No medical questions are asked for changes in health coverage.

Medical questions may be asked if you apply for life or disability coverage. If medical questions are asked, consider the potential consequences of answering -- particularly if you haven't yet disclosed your health condition to your employer.

The sooner you think about what changes you can and should make during an open enrollment period, the more likely you will be able to maximize your benefits to fit your needs.

How An Open Enrollment Period Works

When an Open Enrollment Period starts, employees generally receive a packet that contains information on all the potential alternatives, costs to the employee of those alternatives, and deadlines for making changes.

As soon as you receive notice of an Open Enrollment Period, set an alert in your computer or on your calendar at least three business days before the deadline so you don’t miss it. Assume that open enrollment deadlines will not be waived for any reason.

Open Enrollment Period: Health Insurance

During an open enrollment period, without any questions asked as to why you want to do what you want, or about your current or past health condition, you can usually:

  • Switch from one health plan to another.
  • Sign up for the first time for a plan.
  • Make changes in your coverage.
  • Add new dependents if you didn't take advantage of the part of your plan which lets you add children when they are born or adopted or a spouse when you get married.

Any changes during an open enrollment period are not usually accompanied by a waiting period for coverage for a pre-existing condition. Check the terms of the offer to determine whether you will be fully covered under the changed plan from the first day it becomes effective.

If you were diagnosed with a health condition since you first signed up for your plan, now may be the time to change to a plan better suited to your specific needs.

To learn how to choose a health plan that is best for you, click here. 

Open Enrollment: Life Insurance And Long Term Disability Insurance 

An open enrollment period can be an opportunity to purchase life insurance or disability insurance that you otherwise couldn't purchase -- much less at group rates which are generally lower than individual rates.

Before applying, check to see if there are health questions.

There are generally no health questions asked if you have life insurance and only want to increase it one level. For instance, if you have life insurance in amount of $30,000 and $100,000 is the maximum amount that is authorized for someone in your position, you can generally increase coverage to something like $40,000 without having to answer any health questions. Each year thereafter you can do the same, increasing it by similar increments each open enrollment period.

If there are health questions to obtain or increase coverage:

  • If it is likely you would be rejected, it may be in your interest not to apply for the coverage. The denial of coverage -- and the information you provide that causes the denial -- will probably be reported to the Medical Information Bureau (MIB) and could affect your ability to obtain this or other life insurance coverage.
  • If your employer knows about your health condition, speak with a human resource supervisor to find out if you would be able to obtain that coverage in spite of your condition.
  • If your employer doesn't know about your health condition, see if you can send the form directly to the insurer instead of through the employer. Since you can't ask Human Resources about the likelihood you'll be approved, see if you can learn about the underwriting requirements informally through a friend at work who can ask general questions. Your Advisor may also have helpful information.

Retirement Plans

Open Enrollment is a good time to adjust the amount of money being put into a tax qualified 401K or 403b savings plan, or into a tax qualified medical savings account. Put as much into those plans as you can while you are still working.

What  If I Haven't Disclosed My Health Condition At Work?

If you haven't disclosed your health condition at work, making a change in your health insurance, including switching plans, during the Open Enrollment period, doesn't provide the employer with even a hint that you're not in perfect health.

On the other hand, if medical questions are asked, disclosing them on the form may be the same as disclosing your condition to your employer. Rather than allowing that risk to prevent you from obtaining the maximum coverage for which you may qualify, perhaps this becomes the overriding reason for disclosing your condition.

For practical information about disclosing your health condition to your employer, see Disclosing Your  Health Condition To Your Employer

Timing: If You Are Considering Stopping Work

If you are considering leaving work to go on disability, and you know an Open Enrollment Period is coming up, consider waiting to find out whether you can make changes which would improve your benefits.

To learn more, see: Work – Preparing To Leave Work On Disability.

NOTE: For additional ways to obtain health insurance, click here.

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