Open Enrollment Education Opportunities

Open enrollment is a period of time each year when employers permit new employees to enroll in a health plan and allow current employees to make changes to their existing medical coverage. During open enrollment, employees may decide to change plans, add or drop a dependent or add an optional benefit, such as a dental plan. Employers can assist employees during open enrollment by distributing materials that explain new health options and changes to existing benefits.

Open Enrollment Education Strategies

To help employees select the plan option that best meets their needs, employers should provide information about the following:

• A general summary of what benefits are covered by the plan
• Limits on coverage, as well as limits on coverage for certain conditions
• Coverage for preventive services, procedures, and medications
• Prescription drug coverage details
• Cost-sharing (e.g., premium contribution, deductible, copayment or coinsurance requirements)
• Consumer-directed and high deductible health plans or other non-traditional plan types

The following are ways for employers to improve their open enrollment communication strategies:

• Communicate frequently with employees regarding their health coverage options, but avoid overwhelming employees with information.
• Be honest and direct when discussing health benefits, especially if employees are facing cost increases for their coverage.
• Discuss the “Five Cs” of enrollment with employees: Cost, coverage information, changes to plans, comparisons to last year’s plans and current options.
• Provide information to employees about the health care providers or networks that will be available to them in new or revised plan options.
• Use a variety of communication methods, such as the Internet, printed materials and face-to-face discussions.
• Some groups of employees may need additional assistance, particularly those with mental or physical disabilities, low or fixed incomes, parents of children with special needs and non-English speakers. Without special assistance, these groups may miss open enrollment periods or have large gaps in their coverage.

Article adapted with permission from the National Business Group on Health article “Primary Care and the Medical Home: Promoting Health, Preventing Disease, and Reducing Cost.”