Open Enrollment: Decide Whether You’re Keeping Your Plan, Making Changes, or Making a Move

October 20, 2023by mycalchoice

It’s hard to believe we’re closing in on the end of 2023. If you’re like most employers, you’re already planning for the year ahead. You’re also likely reviewing your employee benefits program. Perhaps you’re asking yourself if you should stick with what you have or make changes. Maybe you’re even considering switching things up entirely and making a move.

So let’s take a look at your options.

Keep What You Have

There’s a good chance you and your employees (and their dependents) like the plan you have now. If so, that’s great.

Before committing to a renewal “as is,” you should still ask yourself a few questions:

  • Are you getting the best value from your current plan? Is there a premium increase planned for your next plan year? If so, is it across all plans or a select metal tier?
  • If you have an HMO, does it fit the needs of all of your employees? Would some prefer the freedom a PPO plan offers?
  • How large is the plan’s provider network? Does the plan’s network include your preferred doctors? Have there been provider network changes that will affect you, your employees, and their dependents? If the plan has a tiered provider network, are any of the tiers changing?
  • Does the plan offer you the ability to control your costs? Or, does the insurance company determine your premium?
  • Are there any “value adds” that come with your plan that your employees would appreciate?

These are all important questions to consider before you lock in your existing plan for another 12 months.

Make Changes

If you want or need to make changes to your plan and/or coverage, there are questions to consider in this scenario, too. For example:

  • Will you have to change carriers to get what you want?
  • Do you want to change carriers?
  • Do you need to find a new broker? Not every insurance sales professional is licensed and appointed to sell health products from multiple plans. That means if you have, for example, Health Net, you may need to go elsewhere.
  • If you want to add ancillary or supplemental insurance for employees, does your current agent have those product connections? Are products available as employer-sponsored, voluntary, or both?

The Affordable Care Act mandates your ability to make changes during your plan year if you have a big life change or what is referred to as a “life event.” These include:

  • Marriage or domestic partnership: A change in your or an employee’s marital status (e.g., marriage, divorce, or separation) or domestic partnership.
  • New family member: Adding a dependent child through adoption or birth.
  • Late enrollment or involuntary loss of coverage: If an employee waived coverage before, he/she/they can enroll late and/or change benefits. This can occur when that other coverage ends due to death of the spouse (who maintained it). Or if there is a loss of benefits eligibility due to reduced work hours or job loss.
  • Remove coverage or dependents: A covered employee can remove existing insurance or dependents from enrolled coverage. For example, when a dependent child reaches age 26.
  • Moving: If an employee moves to a new place of residence (and out of his/her/their existing health plan’s service area).

Ask your sales or customer service rep about the timing of any requested changes. In most cases, employees have 60 days from a qualifying event to make coverage changes.

Changes requested will be effective on the first day of the month following receipt by your carrier or administrator. For example, if an employee submits a request on May 10, the change would be effective June 1. (If an employee submits a request through you, it’s important you forward it as soon as possible, so as not to delay the effective date of the change.)

Make a Move to CaliforniaChoice

If you’re looking to expand your employee options — and still control costs for your business — you might want to consider making a move to CaliforniaChoice. It offers you and your employees more choices than other single carrier solution in California. In today’s workplace, with more employee diversity than ever, choice is a must — and employees expect it. 

With CaliforniaChoice, you can offer your employees a program that includes HMOs, PPOs, EPOs (Exclusive Provider Organization plans), and Health Savings Account-qualified High Deductible Health Plans (HDHPs).

CaliforniaChoice has something for everyone:

  • Eight health plans and 20+ networks – through a single health program
  • A choice of 130+ options across all four ACA tiers: Bronze, Silver, Gold, and Platinum
  • Cost control with Defined Contribution – you choose how much you put toward employees’ insurance; then they apply that contribution to the cost of the plan they like best (If they choose a plan that costs more than you’re contributing, employees pay the difference.)
  • Greater access to providers – including 80,000+ doctors and nearly 400 hospitals
  • Options for Dental, Vision, Acupuncture + Chiropractic, and Life Insurance
  • Consolidated billing: one bill for all employees’ coverage – even if employees enroll in different carrier plans

You might choose a PPO from Anthem Blue Cross because you want access to a particular doctor in the Anthem network. One employee might prefer a local or regional HMO like Sutter Health Plus, Western Health Advantage, or Sharp Health Plan.

Another employee might want an HMO plan from Health Net, Kaiser Permanente, or UnitedHealthcare. Others might choose an EPO from Anthem or Cigna + Oscar. With CaliforniaChoice, it’s your – and their – choice.

At your renewal in 12 months, you can adjust your premium contribution, up or down. That gives you complete control over what you’re spending for another 12 months. Your employees can change plans and still stay in the CaliforniaChoice program.

Get Help from a Broker

Whether you’re considering keeping your current plan, making coverage changes, or switching your plan entirely. A good place to start your search is by talking with a broker. Using a broker won’t cost you anything. In fact, it could save your time and money.

If you don’t have a broker, we make it easy to search for one.

Shopping for group health insurance?

This guide compiles a list of common questions you may have before you start offering health insurance coverage.