Melissa Davies
The holiday season is a time of joy, laughter, and fun … unless you work in the insurance industry.
The fourth quarter is one of the busiest times of the year in so many ways. Not only is it open enrollment for the individual market and Medicare, but it is also open enrollment for many employers and their own company benefit offerings.
Open enrollment can be a confusing and sometimes overwhelming time for health insurance consumers deciding what coverage they should choose for the following year. Let’s break it down for both individuals navigating the individual or Medicare market as well as employees choosing coverage offered by their employer.
Tips if you are enrolling in the individual market or Medicare:
• Be sure to work with a reputable insurance broker or navigator to help you compare plans & coverages so you can choose the best plan for your needs
• Understand the enrollment deadlines — you do not want to miss the cutoff date to enroll!
• Find out what information you should bring to the meeting or call with your broker or navigator to ensure you are prepared (i.e., current plan info, financial statements, list of current doctors, etc.)
• Check the plan’s provider network to make sure current doctors, hospitals & facilities you need are contracted & look up current prescriptions on the plan/carrier’s formulary list. This will help you to make sure there are no surprises when you go to the doctor’s office or pharmacy!
• Check out the carrier’s member section on their website or mobile app once your new policy is set up. These tools are the best way to stay on top of your coverage, claims, network, and ID cards
Tips if you are enrolling in a group health plan through your employer:
• Attend open enrollment education opportunities such as meetings, webinars, etc. These events will provide highlights of plan or rate changes as well as useful tips and tools you have access to through your coverage.
• Examine how you allocated benefits last year, what worked well and what coverages might need to be added, removed, or changed.
• When reviewing the plan choices with your HR or benefits broker team, check the network to make sure current doctors, hospitals, & facilities you need are contracted.
Check the plan’s formulary prescription list to make sure current medications are covered and understand how they are covered
If you have life insurance, be sure to check and make sure your beneficiary info is up to date
Once your benefits are effective, check the member website or mobile app tools as these are great resources to help you year-round and access ID cards
Open enrollment is your opportunity to consider your medical needs and prepare for the upcoming year. There’s a lot to think about when selecting health care benefits. While it may seem daunting, spending time reviewing your options can ensure you choose the best options for you and your family. Proper planning and enlisting the help of a licensed insurance broker not only allows you to be prepared, but also gives you peace of mind for the new year. Be sure to consider the above planning tips this holiday season!
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Melissa Davies is a licensed Benefit Solutions Consultant at Clark and Associates. She has 15 years of experience assisting employers and HR professionals with comprehensive employee benefit solutions. The development of creative insurance solutions for employer groups of all sizes is Melissa’s specialty.
Melissa holds a Bachelor’s Degree in Health Sciences from the University of Nevada, Reno and is licensed in both Health & Life insurance as well as Property & Casualty insurance. She also received her Registered Health Underwriter (RHU) designation in 2013, is a past president of the Northern NV Human Resources Association, and is the current Board Chair for the Reno Sparks Chamber of Commerce.
