What To Do If An Employee Misses The Annual Open Enrollment Period

The benefits open enrollment period is typically the only point during the year in which your employees can make changes to their benefit elections—including adding or dropping coverage or dependents, switching plans, or even enrolling in benefits for the first time. And because there’s a limited amount of time to make these important decisions, it can be a confusing (and often overwhelming) experience for employers and employees alike.

During open enrollment, HR representatives often block off hours in their calendars to respond to employee questions about coverage, requirements, and deadlines. HR teams in larger companies may even conduct special meetings or hold benefits fairs, all designed to help employees understand their benefits options so they can make informed decisions.

Despite your own best efforts to communicate important information and deadlines, you may have employees who don’t successfully enroll on time. And missing the open enrollment deadline can have serious consequences for your employees—including loss of coverage or the inability to change coverage options. As an employer, you may be faced with administrative burdens and unhappy or unproductive employees.

To prevent these issues, it’s important to have a clear communications strategy in place, start those communications early, and clearly educate employees on the consequences of missing open enrollment.

Note: We understand that open enrollment—and employee benefits, in general—can be complicated, so we’ve put together an easy-to-use glossary of common terms related to employee benefits that can help simplify the process for you and your employees.

As an employer, what am I required to do if an employee misses open enrollment?

Legally, nothing. In fact, the terms of your benefits plans may prohibit you from making exceptions for employees who do not make benefits elections within a certain time period—such as before the new plan year begins.

The only exception to these terms is if an employee qualifies for a special enrollment period (SEP). Employees who experience qualifying life-changing events (such as getting married, divorced or legally separated, having or adopting a child, or moving to a new residence or work location that affects benefits eligibility) are eligible to enroll in or make changes to their benefits elections outside of the open enrollment period. It’s a good idea to create simple and comprehensive policies and procedures so you’re prepared in the event of an SEP.

Applicable large employers (ALEs) under the Affordable Care Act (ACA) may have additional concerns. They must offer affordable, minimum-essential coverage to their full-time employees or potentially face the employer shared responsibility penalty. If appropriate coverage is offered to employees (regardless of whether they enroll) these employers will not be subject to the penalty.

To avoid these penalties, document that coverage has been offered by requiring employees to sign either:

• An acknowledgement of benefits form–for those who opt in to coverage

• A waiver of coverage form–for those who opt out or miss the deadline to enroll in employer-based benefits packages

Although you are not legally required–or potentially even allowed–to make an exception for an employee who misses open enrollment, you can help limit the possibility of a missed open enrollment deadline.

Before open enrollment begins, it’s a good idea to reach out to your provider directly to learn how your plan handles a missed deadline, as well as what can—and cannot—be done to aid any employee who misses enrollment. It’s important that you understand deadlines as dictated by your benefits specialist or provider before open enrollment begins and before you communicate those deadlines to your team.

In addition, consider putting passive enrollment safeguards into place, which can ensure employees are automatically enrolled in the future—even if they miss important deadlines.

Tips to Help Employees During Open Enrollment

So, odds are there isn't much you can do to help an employee who has missed open enrollment. And while you can’t guarantee deadlines are met, you can help minimize the possibility of missed open enrollment deadlines through proactive communication.

To help your employees make the most out of the open enrollment period and the benefits your company provides, consider implementing the following strategies before the enrollment period begins:

Offer opportunities for education.

Offering benefits education to your employees prior to and during the open enrollment period can help minimize confusion and cut down on time spent addressing commonly asked questions. Begin preparing your communications in advance. We recommend about 4-6 weeks prior to the start of the enrollment period. Find additional communications tips in our Open Enrollment guide.

You can provide information in a wide variety of ways, including:

• Regular emails

• Flyers

• Posters

• Videos

• Personal worksite consultations

• One-on-one appointments with HR representatives

• Seminars, webinars, and/or self-paced e-learning modules

Be proactive in your communication and opportunities for employee education. For your convenience, you can find additional communications tips in our Open Enrollment guide.

Regularly ask for feedback.

Ask your employees if they like the way information is being provided, if they would prefer information be distributed in different ways, or if they have questions that have yet to be answered. Surveying your employees will help you clarify benefits options and the open enrollment process, demonstrate your willingness to set aside time to help answer their questions, and potentially reduce the number of employees that miss open enrollment.

Adjust internal deadlines.

To help employees meet open enrollment deadlines, consider implementing internal company deadlines that build in a safety net.

“If the open enrollment dates are Nov. 15 through Dec. 15, consider giving your employees a deadline of Dec. 5,” suggests Starr Harry, senior client success manager at G&A. “This will give you the ability to answer any lingering questions from employees and build in extra time for those who are apt to miss deadlines, without placing any extra burdens on your HR team.”

Employers can also gather status updates during the open enrollment period to view which employees have not completed enrollment. HR teams can send additional reminders to those employees and follow up with them individually so they don’t miss the deadline.

Learn what steps to take during and after open enrollment closes with our Open Enrollment guide.

Be proactive in helping employees during open enrollment.

Contractually, employers may not be able to accommodate employees who miss open enrollment, unless they qualify for a special enrollment period. Therefore, it’s important employers be proactive in their approach to open enrollment.

If your benefits packages haven’t changed from the previous year, consider offering a passive enrollment, which automatically enrolls employees who don’t wish to make any changes to their selections. Keep in mind, though, that employees must make changes to their flexible spending accounts or health savings accounts each year. If you’re offering new plans, however, passive enrollment isn’t an option, so allow additional time and resources to communicate and follow up with employees.

Are you offering benefits your employees want? Discover a more strategic approach to open enrollment planning in our free guide.

If employees do miss open enrollment, provide opportunities for them to meet with HR or attend informational meetings that discuss their options to obtain coverage for the next year.