Open Enrollment Guide

It's Open Enrollment Season. Time to look at your 2019 health coverage.

Quick Facts and Tips 

  • Enrollment dates may vary state, check the dates in your state to ensure you opt into coverage for 2019.
  • If you miss the Open Enrollment Period, you will not be able to change your coverage for 2019, unless you qualify for a Special Enrollment.
  • Check how much you could save with an FSA. It's easy to sign up for any health care coverage and be done with the enrollment process. But you could save hundreds of dollars by electing to use a Flexible Spending Account.
  • Take your time and weigh all the options. Spend some time with your HR representative and walk through each of your options. There is no one size fits all when it comes to health care coverage.
  • Be Prepared. Gather all the essential information before you start the enrollment process, like your social security number, current health coverage, and information about your dependents. 
  • The penalty for lack of coverage is no longer in effect for 2019. But it's still important to cover yourself and your family for unexpected medical expenses.

Your Benefits and Cost may Change in 2019

It's important to take note that most plans will see a price hike from the previous plan year, averaging around 18%. So if your plan is to let your current plan rollover into 2019, double check your finances and see if that makes sense for you.

Due to the individual mandate, all insurers were required to cover 10 essential health benefits. For the 2019 plan year, states can now choose between 50 health benefits for more flexible plans. Double check all the plans and see if your current plan coverage has changed, or if there is something new for you to choose from.

Without the individual mandate, the coverage in your state may change. But that means you won't be fined for declining health insurance in this year's Open Enrollment. If you decide to take the risk and forego insurance entirely, you won't be slapped with a fine on your tax bill.

There are a few states that have continued to uphold the individual mandate. If you live in Massachusetts, New Jersey, or Washington D.C., you are still required to have health insurance.

If you decide to get coverage through your state's marketplace, the Open Enrollment window was reduced to just 45 days. So if you forget that December 15th deadline to purchase through your state marketplace, you'll be unable to enroll until next Open Enrollment at the end of 2019, unless you have a qualifying life event. The following states have extended their Open Enrollment windows:

  • California: October 15, 2018 to January 15, 2019
  • Colorado: November 1, 2018 to January 15, 2019
  • Massachusetts: November 1, 2018 to January 23, 2019
  • Minnesota: November 1, 2018 to January 13, 2019
  • Rhode Island: November 1 to December 31, 2018
  • Washington D.C.: November 1, 2018 to January 31, 2019

What is the Special Enrollment Period?

If you've experienced a qualifying life event, you'll be given between 30 and 60 days to enroll in private or statewide health insurance. The qualifying life events are:

  • Loss of coverage: Loss of a job, losing qualification for Medicare or Medicaid services, or aging out of your parents' plan.
  • Changes in household: A birth, adoption, death, marriage, or divorce in the family.
  • Changes in residence: Moving to an area outside of your current insurer's coverage.

Should you Open an FSA?

Here are the benefits of FSAs:

  • Anyone can open an FSA as long as your company sponsors the plan.
  • You can contribute up to $2,700 of pre-tax dollars toward your FSA, amounting to hundreds of dollars in tax savings.
  • You also get access to those funds right away!

Some things to keep in mind:

  • FSAs adhere to a "use it or lose it" rule. That means you lose the funds you don't spend within the year.
  • Unlike health insurance plans, your FSA does not automatically continue into the next plan year. You must sign up and designate how much you want to contribute every year.

The "use it or lose it" rule used to be something scaring individuals from opting into this great tax savings. However, the rules have changed, and most companies offer 1 of 2 rollover options. You can rollover up to $500 from the previous year, or you can have a 2 and a half month deadline extension. You can only choose one or the other, and not every employer will offer both options. Check with your HR representative to find out which options are available to you.

The best way to maximize your FSA is to calculate your medical expenses from the year, and plug it into an FSA calculator. Seeing how much tax you save can take away that fear of losing your funds at the end of the year. If you save $600 in taxes, but you've left $400 in your FSA at the end of the year, you still saved $200 in taxes. Take that into account when you're thinking about this option.

What is an HSA?

HSA stands for Health Savings Account. While a lot of the benefits between FSA and HSA are really similar, there are some differences you need to know.

  • You can only sign up for an HSA if you have a qualifying high-deductible health plan. That means your deductible is more than $1,350 for an individual, and $2,700 for a family.
  • You may contribute up to $3,500 per year for yourself, and $7,000 for a family.
  • Health Savings Accounts do not expire at the end of the year, so you can keep it and continue to contribute to it.

There are also some similarities between the two accounts.

  • HSA and FSA have the same eligibility list. All the products listed on our FSA Eligibility List are also covered under your HSA! 
  • Anywhere FSA debit cards are accepted, HSA debit cards will also be accepted.
  • It is also funded by tax free income of your choice. During Open Enrollment, you select the amount you want to contribute each year. 

What about Optional Insurance?

Dental, Vision, Supplemental A&D, Critical, Hospital, and more. These are all possible "optional" plans your company may allow you to enroll in. The bottom line is that these are all optional, so they are not required by law. Dental and Vision coverage are nice options if you need anything above regular exams and routine care. However, you can also use your FSA or HSA funds to pay for these services. Speak with your HR representative to discuss the options you have, and whether they make sense for you.

*Please note that all advice provided is for general information. Contact your benefits administrator or HR representative for more information.