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What Happens if an Employee Misses Open Enrollment?

Despite your HR department and management's best efforts - an employee may not successfully enroll during open enrollment period on time. While consequences for the employee is loss of coverage or inability to change coverage - the employer is not legally responsible.

Exception: Do Your Employees Qualify for a Special Enrollment Period?

Affected employees may qualify for what’s called Special Enrollment Period (SEP).Employees who experience a qualifying life-changing events (QLEs) are eligible to enroll in or make changes to their elections outside of the annual enrollment period. Most common events include (but aren’t limited to):

  • Having or adopting a child
  • Getting married, divorced, or legally seperated
  • Moving to a new residence or changed work location

Another Exception: Applicable Large Employers

If your organization is an applicable large employer (ALEs) under the Affordable Care Act (ACA) you are required to offer full-time employees with affordable, minimal-essential health coverage – or face stiff fines and penalties. However, ALEs are not subject to penalties, if they have offered coverage, regardless of whether they enrolled in coverage on time.

How Can You Prepare Employees for Open Enrollment?

  • Engage employees around their benefits – the more personalized and customized the communication is, the more impact it has.
  • Communicate employees across all channels, including the company website, newsletters, flyers, emails, and so on.
  • Plan early.

To learn more, contact us today and schedule your free, live guided tour of our solution.


Topics: Employee Benefits