It never fails. Following the close of open enrollment, some participants start to think they should have elected more or less coverage. Sill others who ignored enrollment altogether may wish they had chosen something. The good news is that whether you need more or missed open enrollment, all may still have some options!
Health Plans
Active enrollees in an existing health plan may find that it was automatically renewed. Even if the plan is no longer the best fit for the employee’s needs, it is likely better than having no coverage at all. Unfortunately, employees eligible to enroll for the first time are usually completely out of luck if they do not choose a plan during enrollment.
Benefit Accounts
Most, but not all, tax-advantaged benefit accounts are tied to open enrollment. Here are the basics of when employees can enroll in the four most common types of tax-advantaged benefit accounts.
Health Savings Accounts (HSAs)
Health Savings Accounts require owners to be enrolled at the same time in an HSA-eligible high-deductible health plan (HDHP). As long as that status is in place, regulations permit enrollment in an HSA at any time, during or outside open enrollment. Eligible participants can enroll in an HSA either through their employer or independently through another provider. You may enroll at institutions such as a bank, trade association, TPA, or similar company offering individual HSA accounts.
Health Reimbursement Arrangements (HRAs)
Health Reimbursement Arrangements come in several different versions. Standard group HRAs are tied to health insurance coverage and normally accompany open enrollment. Qualified small employers can offer also QSEHRAs, while any employers can offer Individual Coverage HRAs (ICHRAs). Since these two options reimburse premiums for individual insurance policies obtained other than through the employer, enrollment in QSEHRAs and ICHRAs can take place outside of open enrollment. Additionally, when offered outside of open enrollment, a Special Enrollment Period is triggered for eligible employees.
Lifestyle Spending Accounts (LSAs)
LSAs can cover health and wellness-related expenses but not the medical expenses covered by Section 213(d). For example, an employee going through a lot of personal stress who doesn’t have access to health insurance for mental health care could use LSA funds to attend meditation and yoga classes or access marital counseling. LSAs can start anytime during the year without open enrollment restrictions.
Flexible Spending Accounts (FSAs)
Although employees make the contributions, employers are the regulatory owners of Flexible Spending Accounts and define the plan year deadlines. Employees who miss the enrollment deadline or want to change their contributions mid-plan-year must wait until the next enrollment period. The exception is that those who experience a qualifying life event. These include having or adopting a child, getting married or divorced, etc. Those who experienced one of these events may be able to adjust their contribution level accordingly without waiting until the next regular enrollment period.
What’s the bottom line?
If you missed the open enrollment period, there may still be some coverage options available. Check with your HR or benefits administrator for more information on the specific options available through your employer.
DataPath, Inc. has been a full-service TPA business solutions provider for nearly four decades. Our cloud-based Summit platform is the industry’s first all-in-one solution for CDH, HSA, Well-Being, COBRA, and Billing administration; plus, we offer comprehensive Operations BPO and award-winning Marketing Services for users of all administrative platforms. Please enter your email (above right) to be notified when new blog articles are published.