Open enrollment refers to the period in which employees can change, or apply for, their health insurance for the upcoming year, without a qualifying event. The 2022 open enrollment period (OEP) starts on November 1, 2021 and ends on January 15, 2022, in most locations. For coverage that begins on January 1, the deadline to enroll for health insurance is December 15th, regardless of location or when open enrollment ends.
Both individual and family plans are available during the open enrollment period and can be purchased from the “marketplace” or “exchange.” It is important for employees to enroll during the OEP because after the enrollment period is over, they may face difficulties acquiring insurance or changing plans.
Open Enrollment Periods Vary By State
Although open enrollment period starts the first of November and ends mid-January in most states, some states have slightly different dates. In 2022, the open enrollment period in New York does not begin until November 16th. Due to COVID-19 related initiatives, other states also have varying open enrollment schedules.
The OEP in Idaho and Maryland ends on December 15th. In California, the District of Columbia, New Jersey, New York and Rhode Island, the OEP ends on January 31, 2022. In Massachusetts, it ends on January 23, 2022.
When coverage begins will depend on when a person signs up for insurance. If an employee enrolls in a health insurance plan on or before December 15, 2021, coverage will start on January 1, 2022. However, if the enrollment date is between December 16, 2021 and January 15, 2022, coverage will start on February 1, 2022.
In the event that a person misses the designated deadline for open enrollment, the Department of Health and Human Services (HHS) may allow individuals to sign up for insurance or change coverage under certain qualifying conditions. Low-income individuals who earn 150 percent of the federal poverty level may qualify to sign up for coverage during the monthly special enrollment period. A person may also sign up if they have a qualifying event, such as a change in household size, recent move or loss of healthcare coverage.
All States Are Required To Provide Essential Health Benefits
The Affordable Care Act (ACA), enacted in March 2010, requires all insurers in every state to provide certain essential medical benefits. Benefits covered under basic insurance plans include preventive care, emergency services, mental health, coronavirus diagnostic tests, prescription drugs, pediatric care, maternity care and substance abuse services.
No one can be denied coverage based on a preexisting condition. In 2022, health insurance plans in the marketplace are set to have an out-of-pocket maximum of $8,700 for individuals and $17,400 for families. On the marketplace, health plans will now be separated into three main tiers: Bronze, Silver, and Gold/Platinum.
The Bronze plans have the lowest monthly costs but typically have higher deductibles. These plans may also have minimal cost-sharing advantages. Plans under the Bronze tier are best suited for young, healthy individuals who are not expected to have extensive health care needs.
Silver plans offer average coverage and are best suited for people who have normal health care needs. The Gold and Platinum plans are the costliest but have low deductibles and optimal cost-sharing advantages. These plans are best suited for people who are likely to have significant health care needs.
There Will Be Health Insurance Mandates In Some States
In 2022, there will be no health insurance mandate at a federal level. Individual health insurance is not a requirement in the U.S. as the mandate was revoked by federal policies passed in 2019 and again in 2019.
However, some state-level mandates exist, including those in Vermont, New Jersey, Rhode Island, California, Massachusetts and the District of Columbia. For residents in these states, health insurance is a requirement. Although health insurance is no longer required by federal mandate, it is still important to have coverage from costly medical bills.
Opening An FSA Or HSA Can Be Beneficial
The open enrollment period is an excellent time to start thinking about opening an FSA or HSA. Both health savings accounts (HSAs) and flexible spending accounts (FSAs) enable account holders to put away pre-tax money that can be later used to pay for health care needs including deductibles, copayments, vision and dental care and medications.
Using those pre-tax dollars to pay for qualifying medical expenses can lower the amount of taxable income. During open enrollment, participants have the opportunity to choose how much they would like to contribute to these plans.
An HSA is available to people who apply for a health insurance plan that is considered a High Deductible Health Plan (HDHP). These types of plans typically only provide coverage for preventive care before deductibles, and the funds in the account are carried from one year to the next. Individuals have the option to contribute up to $3,650 to their HSA in 2022, and families can choose to contribute up to $7,300. People over age 55 can increase their yearly maximum contribution to $4,650.
Although FSAs are not present in the marketplace, they are commonly offered as part of employer-sponsored health insurance plans. This type of account enables participants to save for future medical bills, but there are some limitations.
Any money in the account at the end of the year is not rolled over to the next year. This means that account holders must put thought into aligning the balance of their FSA account to their health care spending to avoid wasted money.
Speak With An Experienced Business Benefits Consultant
There are many things to consider during the annual open enrollment period in the U.S. In addition to applying for regular medical care, the 2022 open enrollment period is also a great time to consider other types of insurance that may also be useful, such as vision, dental or life insurance.
To learn more about the 2022 open enrollment period or to schedule a consultation with an experienced business benefits consultant, contact the experts at the Business Benefits Group (BBG) today.