Open enrollment is the annual season in which employees can enroll or make changes to benefits that are otherwise restricted, or "locked", without a qualifying life event. Planning for open enrollment should start well before the end of the current plan year. In addition to providing employees an opportunity to change their elections, the open enrollment process also changes enrollment data in the Employee Navigator system; upon the closeout of open enrollment, ending plans move to an inactive prior status, and renewal plans are made current.
Adding an Open Enrollment
- Navigate to Benefits > Basic, and select “Open Enrollment”; this will bring you to the Open Enrollment Dashboard
- Click "Add+"
Note: Only one Open Enrollment can be active simultaneously. If there are different plan effective dates for plans, set up separate OE sessions for each effective date. Each new session can only be activated once the first session has been closed out.
Click the "pencil" icon to edit an Open Enrollment.
Dates are perhaps the most important things to understand about an Open Enrollment. Dates control when an Open Enrollment starts for employees in the system; when they can no longer change their elections; when HR / Admin users should be finished editing enrollments; and, if the Carrier is integrated, when data are transmitted. Five key dates in Setup control Open Enrollment Behavior (only four dates need to be set in the “Edit” tab; Open Enrollment closeout is detailed in "Closing Out" below):
- Effective Date: The date that new plans become effective. This is typically the first day of the new year. The Effective Date will automatically schedule your Closeout on the same date*.
- Enrollment Starts: The date and time that employees can begin to make their elections in Employee Navigator.
- Enrollment End: The date and time that employees can no longer make changes to their elections in Employee Navigator.
- Administration End: The date that HR / Admin users can no longer make changes to elections. This date is important for integrated Carriers. Integrated Carriers, in many cases, need files before the new plan start date. Once this date has passed, these Carriers can elect to see Open Enrollments in their data. This can be manually turned off under “Manage Tools” . "Transmission" page, with the “Send open enrollments on Carrier schedule” toggle (but don't forget to turn it on again once changes are complete.)
For companies not currently integrated with Carriers, the Admin End Date can be used as a "cut-off" date for Admin users. It helps build in a period of time for review and finalization of all enrollment changes before submission to the carrier (on the Admin End Date). The assumed administration period will run from the enrollment ends date to the administration end date.
All four dates are required in order to continue through the setup process. Once dates have been set, click "Save & Continue".
*Important Note! Closeout is automatically set to the latter of the effective date or the administration end date.
In the case where enrollment is being set up after the plan effective date is past, then Closeout will be scheduled for the latter of the above value or tomorrow.
At least one plan is required. Select all plans that should be included, then click "Save & Continue".
Note: When the open enrollment effective date is changed, the system recalculates available plans; a modal displays the changes made in the Plans tab, if any. If new plans are added after setup, remember to make adjustments in the "Plans" tab (new plans are not added automatically.)
This page sets behavior for any ending plans. If there are no ending plans (plans that end on the day before the open enrollment Effective Date), no action is required. See the below section “Active vs. Passive Enrollment: What Do I Need to Know?” for more on this topic.
- Passive Enroll: Employees that take no action during OE can be passively enrolled into a new plan. This passive enrollment is superseded by an active open enrollment election.
- Passive Decline: If employees take no action during OE, the currently enrolled plan is ended and replaced with a declination of the benefit.
- End All Elections: Ends the plan regardless of the action. It is also recommended that this option be used in order to host an active open enrollment experience.
Example: If a dental plan was offered in 2017, but will not be offered in 2018, End All Elections should be used.
Note: Passive enroll option will NOT move an EE into an ineligible plan.
For example, if the EE is not eligible for the designated replacement plan based on eligibility rules, the system will enter the ending plan end date as coverage end date for the EE, and he/she will not be enrolled once OE is closed out in the system. Another example is if the plan is enforcing ACA eligibility rules and the EE is not ACA eligible (ACA classification = Eligible or Variable Hour with enough hours in the system to be eligible for the renewal plan year), the system will enter the ending plan end date as coverage end date for the EE, and he/she will not be enrolled once OE is closed out in the system.
The Payroll page is required for users who are actively integrated with one of our Payroll Partners. Simply set the Send Deductions Date, and complete any missing plan Deduction codes for active Payroll groups. If a company is not integrated, but deduction codes are used for reporting purposes, this page is not required, but gives users the opportunity to finalize any Payroll deduction codes.
Enrollment Ready and Closeout Ready Status
Checklists for open enrollment Setup and Closeout (discussed in more detail below) have been created to help users understand which steps of the setup flow are required to complete open enrollment. The indicators can be viewed from the company Home page, Open Enrollment Dashboard, and within the selected Open Enrollment period.
Enrollment Ready: if the session is missing information, or required setup items remain for employees to start enrollment, the indicator will reflect as "Incomplete". Once all required fields are completed, the indicator will switch to "Complete" (a check mark.) Click the "Incomplete" indicator any time to find out what's missing. Requirements for "Enrollment Ready" include:
- Effective dates have been entered and saved
- At least one plan has been included in the session
- An Open Enrollment session has been Activated from the "Effective Dates" page
Closeout Ready: Open Enrollment does not have to be Closeout-Ready in order for Enrollment to start! Like the "Enrollment Ready" checklist, the indicator for a Closeout-Ready open enrollment session will be "Incomplete" until all information required for a Closeout has been entered. Requirements for "Closeout Ready" include:
- Closeout date has been scheduled. This happens automatically when the "Effective Dates" page is saved. Closeout will be scheduled on the latter of (1) the open enrollment Effective Date, or, (2) the Administration Ends date.
- Ending Plans have been mapped
- If the group is actively integrated with one of our Payroll partners, deduction codes and Send Deductions must be set
Settings under "Manage Tools" (below Setup) are not required for the session to be Enrollment- or Closeout-Ready. "Manage Tools" is used to modify Closeout settings that have been preconfigured, or to run a changes Report for the specific open enrollment period.
If any ending plan was set to Passive Enroll, this page allows users to optionally create Open Enrollment records early. Passive Enrollment occurs automatically upon open enrollment Closeout, so this is not required. To manually create open enrollment records early, select the "Enroll" button for each ending plan listed.
- This can be done prior to employees starting open enrollment, after they have elected benefits, or never.
- If the process on the 'Ending Plans" tab has not been completed for all plans, passive enrollments will not be able to be processed.
The "Restrictions" page is used in the rare cases when it may be necessary to restrict the open enrollment session to a specific class of employees.
Important! If the session should be open to all benefit eligible employees, DO NOT set up open enrollment restrictions. Email notifications are not supported when the open enrollment session is restricted.
The Open Enrollment Changes Report shows a concise summary of enrollment and demographic changes made during Open Enrollment. For more information, check out our article on Open Enrollment Reporting.
By default, the close-out process is scheduled when the Effective Dates page is saved. Closeout is scheduled for either (1) the open enrollment Effective Date, or, (2) the Admin Ends date, whichever is later.
In cases where the closeout date needs to be manually changed, use the the "Update Closeout" page to schedule a different close date, or "Close Now" to close OE immediately*. Additional email addresses of users who wish to receive open enrollment closeout update notifications can also be added. Email notifications include closeout successes and failures.
Upon closeout, all current plans and associated enrollments are made prior, and all open enrollment plans are made current. If Ending Plans are set to Passive Enroll, the closeout will also passively enroll any incomplete open enrollment elections.
Generally, closeout should be scheduled no earlier than the open enrollment effective date, to keep open and current records in sync with their "true state."
*Important Note! The "Close Now" option is not available unless all open enrollment Closeout Ready requirements have been met and the Administration Ends date has passed (Admin Ends date is < today's date).
For more information on the importance of taking the proper close-out steps, check out our article on the Open Enrollment Closeout Process.
Use the library to store open enrollment notification templates. Select "Add+" to add a new template. You can Send a Preview of the notification to yourself while drafting. Open enrollment notifications can be sent to multiple populations; templates can be created to address each of these populations. A document with sample OE email text is attached to this article.
Note: All email templates, including Open Enrollment templates, can be found at Settings > Communications > Email Templates.
Use this tool to send notifications and updates about the open enrollment session.
- From: First and last name that will display as the email's "From" field.
- Recipients: select the Recipients who you wish to notify by e-mail. Recipients include:
- All Employees
- Not Started
- Not Completed
- -Preview- (this notification will go to yourself)
- -Specific Employee- (this option allows you to search for a specific employee)
- Library Selection: Select an active e-mail template from the drop down, or draft a new one.
- Subject: Enter the e-mail subject line.
- Message: The email body; view and edit a notification template or draft. Tokens can be inserted in emails to customize the emails with employee name, username, broker name, and other fields.
- Use the "Send" button to send the notification to the selected Recipients.
Active vs. Passive Enrollment: What Do I Need to Know?
During Open Enrollment, a company may choose to communicate that they are having an “active enrollment”. In an Active Enrollment, if an employee does NOT take any action to review or modify their current benefits, existing enrollments will cease at the end of the current plan year, and will not automatically roll over into the new plan year. In other words, if the employee does NOT take action to actively elect benefits, neither they nor their dependents will be enrolled in any non-core benefits once the new plan year has begun.
Alternatively, a company may choose to communicate that they are holding a “Passive Enrollment”. In a Passive Enrollment, if an employee does NOT take any action to review or modify their current benefits, those benefits will carry over into the new plan year. In a passive enrollment, HR or the Broker is essentially guessing at what the employee will want in the new year, on a plan-by-plan basis.
Note: For cafeteria plan models, annual elections (not per-pay) are rolled over into the new plan. Understand that while we Employee Navigator supports passive enrollment functionality for this model, there may be limitations that require new elections each year, and thus the results may differ from your expectations. It always recommended that passive enrollments are thoroughly audited.
Why Employee Navigator Recommends Active Enrollment
EN recommends Active Enrollment, in short, because it takes the guess work out of the equation. Active Open Enrollment allows individual employees the opportunity to review and compare plan benefits so that they can choose what is best for their needs. The Employee Navigator software was NOT designed to guess at the benefits employees want in an upcoming plan year.
Initial enrollment requires the employee to enter the system, acknowledge their understanding of their enrollment rights, and confirm their benefit elections. Open Enrollment should not be treated any differently. When the system is set to passively enroll, someone is guessing that the employee elections are as the employee intended. On the other hand, active enrollment holds employees accountable for both their own enrollments and the veracity of their demographic information.
In addition, Carriers may want Open Enrollments before the Open Enrollment closes out. In this case, passive enrollment will not be transmitted to any integrated Carriers until the Open Enrollment closes out.
Common Problems with Passive Enrollment
Common problems to watch for with passive enrollment include:
- Dependents remain enrolled in plans for which they are no longer eligible. The EN system is not designed to automatically drop enrollment for a child who has reached the maximum age.
- Plan defaults are incorrectly assumed. In the case where one plan that is being replaced by another, it is impossible to know if the replacement plan will sufficiently cover the needs of the individual, or that the cost will be acceptable.
- Current plan elections are improperly carried over. Some plan elections have legal constraints, or financial constraints by the employee. For example, in the case of HSA elections, the correct per-pay deduction shouldn’t be assumed to remain static—up or down.
- No employee verification. When employees don’t verify elections, there is the potential for liability for the employer and/or the broker. When employees actively elect their benefits, the active election is tracked for compliance.
- First of the month eligibility makes administration much easier
- Self-bill ancillary coverage whenever possible
- Try to keep your cafeteria plan and open season in sync
- Audit your termination rules (end of the month or date of event)
Select your first clients carefully & remember that sophisticated contributions schedules are costly to manage.
Q: Why aren't my plans showing up as options to include in my OE setup?
A: Plan start dates must be on or before the OE effective date in order to be included in Open Enrollment.
Q: Why aren't my plans showing up in the Ending Plans in my OE setup?
A: Plan end dates must be on the date immediately before the OE effective date in order to be subject to Ending Plan mapping.
Q: Why don't I see the "Close Now" option in Update Closeout?
A: You have not met your Closeout Ready requirements OR your Admin period is still active. OE cannot be closed out on or before the Administrative Ends date. Check to see if you have set the Admin End date and if it has expired.