For Your Employees: 5 Questions to Keep in Mind for Health Insurance Enrollment

Open enrollment is still several months away, but it’s not too early to share these tips with new hires and your other employees.


Open enrollment is more than a yawn-worthy chore to rubberstamp your health insurance coverage for another year. It’s an important opportunity – usually one or two weeks once each year – to take a good look at your options.


Spend the time to learn everything you can. Remember – once you sign on the dotted line you may not be able to change until next year.


Have you done your homework?


Be sure you know the terms you’re likely to encounter.


  • Co-payment: Set amount you pay for services, such as doctor’s office visits.
  • Deductible: What you have to pay out-of-pocket before insurance kicks in.
  • Co-insurance: Percentage of costs you’re responsible for after deductible is met.


PPOs (preferred provider organizations) and HMOs (health maintenance organizations) contract with health care providers to provide care to their members at reduced costs.


  • HMOs usually are less expensive, but they pay for care only from network providers. A primary care physician (PCP) must refer you to specialists.
  • PPOs allow you to see any doctor, but they pay more for network providers. You don’t need referrals to see specialists.


What’s going on in your life?


Take a good look in the crystal ball to see what might happen during the next year.


  • Are you planning on having a baby or getting new dependents by marriage or adoption?
  • Have you recently been diagnosed with a chronic illness?
  • Are you anticipating surgery or other procedures?


Have the coverage options changed?


A lot of companies are tweaking benefits to save money.


  • Have premiums, co-pays, deductibles or other expenses gone up?
  • Are your dependents still covered? At what cost?
  • Will your medications still be paid for? Will prices change?
  • Pay extra attention to services such as mental health care and physical therapy.


Are your providers still part of your plan?


Contracts are usually re-negotiated yearly. Be sure your physician, dentist, hospital and other providers are still covered by your plan.


Should you consider a health savings account (HSA) or flexible spending account (FSA)?


These tax-advantaged tools may save you money, but be sure to read the fine print to see if they’re for you.


Health care is expensive, and the decisions you make during open enrollment can have a huge impact on your bottom line. Choose carefully.



US Department of Labor




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Susan Peters