Smart Benefits: 9 Tips for Health Benefits Open Enrollment Season

Monday, October 24, 2011


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Open enrollment season is coming: are you prepared to make a smart decision?

More employers renew their benefit programs in January than any other month, so open enrollment materials are typically distributed about now. And most employees won’t be surprised by what they see: yet another year of higher healthcare costs for less coverage.

Once again, employees will face some tough choices, ones they’ll need to live with for a year. So they should approach open enrollment with these tips in mind. 

Ask Questions

Employees should gather as much information as they can about their benefits package. This means  attending open enrollment meetings and actively participating. Ask questions about your different options, what they mean to your health and pocketbook, and how you can best utilize your plan to maximize benefits and savings.

Pick the Right Plan

If you’re married and you and your spouse both work, carefully review both employers’ plan offerings. Consider which plan provides more benefits for less, any deductibles required, and the amount, if any, each employer is contributing to the cost of the plan. And be sure to compare the costs of each spouse choosing individual coverage versus a family plan.

These days, it seldom makes sense to be covered by both employer plans, and many employers no longer allow what is known as “double coverage.” Instead, some employers offer bonuses for waiving coverage if you get it elsewhere, so don’t forget to ask about this possibility.

Don’t Forget Dependents to Age 26

Keeping older dependents on your plan may be a relief if you have children without jobs who need health coverage. And it may not cost you any more. If your plan is a non-grandfathered one, you may elect to add dependents up to age 26 to your coverage. The dependents do not need to be in school, do not need to be living at home, and can even be married.  If your plan is grandfathered, you should check with your human resources department for coverage details.

Lower Premiums with Higher Deductibles

Many employees are concerned when their employers switch to high deductible plans. But don’t forget, these plans typically come with an upside: premium savings. And they can add up. Savings can be as high as 10-20%, especially when employees select a high deductible plans paired with a Health Savings Account (HSA).  

Save Tax-Free for Healthcare Expenses

Tax-free contributions to HSAs can be as much as $3,100 for individuals and $6,250 for families in 2012, savings that can be used to pay current – and future –  healthcare expenses.

Flexible Spending accounts (FSAs) are another pre-tax way to pay for out-of-pocket medical, dental, vision and prescription expenses. With an FSA, employees elect an amount to put aside on a pre-tax basis from a paycheck, then use a debit card loaded with their savings to use during the year. The only catch: employees must use the entire amount of lose it. 

Be Well

Slowly, but surely, more employers are offering wellness programs and rewarding employees who participate in behavior-changing activities with premium credits, HSA rewards and even gift cards. Don’t overlook the potential savings: employees who take part will pay less for healthcare than those who don’t.

Schedule Your Annual Primary Care Visit

Thanks to healthcare reform, your annual visit to your primary care doctor and many preventive screenings are free for individuals and family members. Saving on these copays can put hundreds of dollars back in your pocket for other healthcare costs.

Get Meds by Mail

Prescription copays are on the rise. But you can save two to four weeks of prescription costs each quarter just by switching from retail to mail order for maintenance medications. Another way to save? Compare drug costs and ask your doctor if less expensive, but equally effective, alternatives are available.

Enroll in Voluntary Plans for Less

Some employers offer voluntary plans that allow employees to purchase vision, life or even disability insurance for less than they would pay if they bought the coverage directly. Consider your needs and decide if adding coverage or supplementing what’s already offered by your employer is right for you and your family.

The bottom line: while open enrollment happens every year, the benefits keep changing. So pay attention to materials and meetings to learn more about your coverage choices. The key is to get the best value for your dollar, this year and every year. 

Amy Gallagher has over 19 years of healthcare industry experience.  As Vice President at Cornerstone Group, she advises large employers on long-term cost-containment strategies, consumer-driven solutions and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, is a member of local organizations like the Rhode Island Business Group on Health, HRM-RI, SHRM, WELCOA, and the Rhode Island Business Healthcare Advisory Council, and participates in the Lieutenant Governor’s Health Benefits Exchange work group of the Health Care Reform Commission.

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