Ask a Broker: What Happens if an Employee Misses Open Enrollment?



​Hi,
Many thanks for your question. No matter how hard you try to ensure all your employees take advantage of the open enrollment period, there may be some who fail to either change their existing employee benefits or sign up to start receiving benefits. Unfortunately, there’s not much that can be done for employees who miss the deadline, not unless those employees meet the requirements for a special enrollment period. 

Exceptions to the Rule

Qualifying life events are the only way an employee will be eligible for the special enrollment period. Examples of such events include the following:

• Legal separation
• Getting married
• Getting divorced
• Death of a spouse or dependent
• Adopting/Having a child

 
If your employee’s reason for missing the deadline falls outside any of the above reasons, there’s not much that can be done, unfortunately. S/he will have to wait until next year.
 
What if your employee did have a qualifying life event that kept her/him from signing up for benefits? That employee will still need to act quickly to make changes to her or his benefits package or sign up to start receiving benefits. Employees only have 30 days from the date of the life-changing event to enroll in your group health insurance plan. After that 30 days, the individual will miss the enrollment window entirely until the next year.
 
The 30-day window also applies to employees who unexpectedly lose their health benefits coverage. For instance, court orders related to separation or divorce, going from part-time to full-time or working fewer hours are examples of events that can cause an employee to suddenly lose coverage.

Take Action in the Meantime

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Just because the deadline was missed doesn’t mean you and your employees should lounge around twiddling your thumbs. It’s better to sit the employee down with someone from HR and go over your existing benefits options so she or he can personalize a benefits package for next year’s open enrollment. The employee is likely to be upset about missing the enrollment period, but by taking the proactive approach for the next enrollment window, you can (hopefully) keep the employee happy and productive. 

Don’t Take the Blame for Those Who Miss the Employee Benefits Enrollment Window

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No matter if your employees make or miss the enrollment period for employee benefits, know that it is up to them to add or drop coverage. As long as you provide your staff with plenty of notice regarding enrollment and its deadline, you’re in the clear. Any losses incurred are solely the employee’s fault and no one else’s.
 
The right benefits can be key to bringing on viable candidates and keeping your current team happy and healthy. While there’s only so much you can do about employees who miss the open enrollment deadline, you can both work together to prepare for the upcoming enrollment period. For more information on benefits for your employees, you’re more than welcome to submit a contact form here on our site. Like us on Facebook, find us on LinkedIn and be sure to subscribe to our blog.
 
Best of luck,
          Emma Fitzpatrick
           Health Insurance Specialist
           Sackett & Associates Insurance Services