Open enrollment has arrived. It’s once-a-year opportunity for employees to update their health benefits—and sadly, it is historically underutilized. More than 90 percent of people choose the same health plan year after year, even though their health needs and budgets regularly change. As a result, millions of Americans end up in the wrong health plan, paying more than a thousand dollars extra on health insurance every year.
These mistakes persist because choosing a health plan is too confusing. At MyHealthMath, we calculate an individual’s optimal plan based on more than 8,000 data points—expecting anyone to do that math on their own is unrealistic. It’s no wonder then that so many people would rather clean up dog poo than shop for health insurance.
Helping employees make better decisions about their health plans requires a two-tiered approach:
- Generate buy-in: Help employees understand the importance of changing plans
- Reduce barriers: Make it easy for employees to choose the right plan
Build buy-in with your employees by sharing these common reasons to consider changing health insurance this open enrollment.
You or your beneficiary’s health needs have changed or will likely change
You should reconsider your plan choice if your health needs have changed over the past year (e.g., you were diagnosed with an illness or became pregnant), or if they may change (e.g., you are trying to get pregnant). Look into what each plan covers and consider your own risk tolerance. For example, if you have a critical illness, you might want the peace of mind of a higher coverage plan.
Importantly, in most states, pregnancy is not a qualifying event (giving birth, adopting a child, or welcoming a foster child into your home is). If you are thinking about getting pregnant, factor in the costs of pregnancy, including the delivery.
Potential job loss
This year’s uncertain economic climate makes potential unemployment, and therefore potential loss of insurance, a real possibility. If your partner is on their own health plan and experiences a layoff, they’ll likely need to join your plan (and vice versa). And while they can join your plan because job loss is a qualifying event, you might not be able to change your plan until open enrollment. (*You should always check with your Human Resources department to see what plan changes are allowed during Qualifying Life Events)
This becomes even more complicated if children are covered by the old plan and need to be moved from one plan to another. Take time to consider these scenarios when reviewing your plan options, especially if you or your partner is facing job insecurity.
Your or your beneficiaries are at risk for COVID-19 or the flu
COVID-19 is a major health event that will continue to plague Americans in 2021. Everyone can be affected, but those with increased risk factors (e.g., severe obesity, cancer, sickle cell disease) have a higher likelihood of a prolonged hospital stay. If you or your beneficiaries are at an increased risk, as set forth by the CDC, it’s important to factor this extended care into your health insurance planning.
Experts also expect this year to be one of the worst flu seasons on record. If anyone on your plan has been hospitalized for pneumonia or the flu in the past, consider another potential hospital stay when choosing a health plan.
Your plan no longer covers what you need
Coverage for prescriptions can change from year to year—a prescription you usually take may no longer be covered or only partially covered, and that can lead to a major increase in your medical costs over the year.
Similarly, your doctor might not accept your health plan anymore, so be sure to check with them before choosing your plan.
You might benefit from a Health Savings Account (hint, most people fall into this category)
In a recent study, people on average overpaid for health insurance by $1,700 a year. One reason people overspend on health insurance is to avoid high deductible health plans in favor of plans with lower deductibles and higher premiums—a strategy that often costs more in the long run. If a high deductible health plan is right for you, opting in will save you money and give you access to a health savings account (HSA).
Consumers can invest pre-tax dollars into HSAs and then withdraw this money tax free to pay for eligible medical expenses. Investments also grow tax free and can be rolled over year to year, which make HSAs a powerful vehicle for saving for retirement. Additionally, HSAs have several advantages because of the recent CARES Act: HSAs can now be used to pay for a number of common use items, like menstrual products, pain relief, and allergy pills.
By sharing common reasons to change plans, employers can generate open enrollment buy-in, so employees will consider their options more carefully, and ideally, migrate to their optimal health plan.
Reducing barriers is just as important as generating buy-in. That’s where MyHealthMath’s advanced decision support comes into play. We make it easy for employees to choose an optimal plan, savings them an average of $1,300 a year. With MyHealthMath, you can easily (and affordably) increase employee savings and benefits satisfaction. Learn more.