Next Open Enrollment Period Uncorked…

Posted by Phil Dougherty
July 31, 2014

In addition to sizing up a turkey or sniffing a yam, you might add squeezing a health plan or two into your Thanksgiving shopping list. This year’s open enrollment period was moved from October 15 – December 7 to November 15 – February 15, 2015, and if you want to ring in the New Year with a “fresh” plan, you’ll have a shorter amount of time to act this year.  Let’s look a little closer to see what this enrollment period date change really means.

What is Open Enrollment: It is during the open enrollment period when consumers can research, change and enroll in a health plan for the next plan year (January 1 to December 31).  Unless there has been a life event change such as a move, drop in group insurance, or marriage, one can only enroll or make a change during the open enrollment period.  Some exceptions may apply.

This year, with the high number of dissatisfied consumers, it is expected to be a busy time. The poor performance by several key carriers will result in many consumers requesting a change or at least closely evaluating their options. Problems have included poor plan implementation, billing snafus and, perhaps the most disruptive, more restrictive provider access. It would not surprise me to see a migration to better-performing carriers with larger networks. But rates may drive the final decision and the Department of Insurance must first review and approve rate increases. Final rates aren’t expected for weeks.

Since all health plans follow a calendar year, and because a health plan’s deductible and out-of-pocket maximum correspond with a calendar year (i.e., they start over every January 1), it makes sense to start a new plan on January 1. To make the most of your plan, you’ll want medical expenses incurred in all twelve months of the year to apply to the annual deductible and out-of-pocket maximum. But, if you want a first of the month effective date, the law requires that you enroll by the 15th of the previous month. This means, as of this writing, for a January 1, 2015 effective date, you will have from November 15 to December 15, 2014 to enroll. That’s just four weeks with a major holiday crammed in there as well! When you consider the millions of consumers who may want to make a change and the horrific performance by carriers the last open enrollment, it is certain to be a chaotic time.

My recommendation: Stay informed, read your carrier mailings (and my blog), and start your research early. If all goes well, and you can enroll early, you can focus on other things at Thanksgiving time. 

Phil Dougherty