Open Enrollment

Open enrollment is the annual window during which employees can elect, change, or waive their employer-sponsored health benefits for the upcoming plan year. Outside of open enrollment, elections are locked unless the employee has a qualifying life event. For ACA marketplace plans, the federal open enrollment window runs from November 1 through January 15 for coverage starting January 1 (or February 1 for enrollments after December 15).

For employer plans, the timing is set by the employer and typically runs four to six weeks before the plan year begins. A July 1 plan year might have open enrollment in May; a January 1 plan year typically has enrollment in October or November. The window is the one guaranteed opportunity for employees to review their coverage, compare plan options, adjust HSA or FSA elections, add or remove dependents, and make changes they've been meaning to make all year. Benefits-savvy employees use open enrollment to model their expected medical utilization against the available plan options — running the math on whether a high-deductible plan with HSA savings beats a lower-deductible plan at higher premium. Most employees don't do this analysis and default to last year's election even when their circumstances have changed significantly. Employers who provide clear, personalized comparison tools during open enrollment consistently see better plan selection outcomes and fewer mid-year surprises. Digital decision-support tools that plug in the employee's prior-year claims and model different plan scenarios have been shown to shift 15 to 25 percent of employees to better-fit plan choices.

The takeaway: open enrollment is not a formality — it's the single annual chance to get the benefits selection right. Employees should review their prior year's medical spend, factor in any anticipated changes (pregnancy, surgery, new medications), and run the premium-plus-expected-cost math across all plan options before defaulting to their current elections.