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Annual enrollment information


In the United States, annual enrollment (also known as open enrollment or open season) is a period of time, usually but not always occurring once per year, when employees of companies and organizations, including the government,[1] may make changes to their elected employee benefit options, such as health insurance. The term also applies to the annual period[2] during which individuals may buy individual health insurance plans through the online, state-based health insurance exchanges established by the Patient Protection and Affordable Care Act. Prior to January 1, 2014 insurers offering individual medical coverage typically allowed new members passing underwriting to enroll at any time throughout the year.

Annual enrollment is also prominent in Medicare, where almost 50 million enrollees can choose to stay in original Medicare, or join or change plans within the Medicare Advantage and Medicare Part D Prescription Drug programs for the coming calendar year. Individuals usually can make changes to, or sign up for, their health insurance or fringe benefits only once per year[2] during the annual enrollment period or when they have experienced a specific qualifying event.[3] Open enrollment periods are used in insurance markets to limit adverse selection risks resulting when enrollees can switch plans at will.[4]

During this time period, an employer will typically communicate to all eligible employees what options they have for their benefit program. Often the vendors or insurance providers will be present to explain the details of their products. This can be done either with group presentations, "benefit fairs" or meetings one on one with each employee. As travel expenses continue to rise many vendors and insurance providers have turned to using independent "contract enrollers" to do the communication on their behalf. Some companies and organizations distinguish between an active enrollment benefits election period, where employees must re-review or confirm their benefits selections for the coming year, and a passive enrollment benefits election period, where employees are automatically renewed with their existing benefits selections from the current year if no action is taken.[5]

Open season is a prominent feature of the Federal Employees Health Benefits Program during which some three million federal civilian employees and retirees may choose among several dozen health insurance plans[1] for the coming year. Open season is scheduled in the fall each year, and plan enrollment decisions take effect in the following calendar year.

  1. ^ a b "Open Season". U.S. Office of Personnel Management. Retrieved 2020-10-27.
  2. ^ a b "State Enrollment Deadlines". Annual Open Enrollment. 2020-09-25. Retrieved 2020-10-27.
  3. ^ "2020 Medicare Annual Enrollment Period". MedicareFAQ. Retrieved 2020-05-21.
  4. ^ Decarolis, Francesco; Guglielmo, Andrea; Luscombe, Calvin (2017). "Open Enrollment Periods and Plan Choices". National Bureau of Economic Research, No. W24156. doi:10.3386/w24156. S2CID 168942702.
  5. ^ Miller, Stephen (8 September 2017). "Open Enrollment: Active vs. Passive Benefits Election". SHRM. Retrieved 15 November 2021.

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