What Happens if Your Employee Misses Open Enrollment?

There are strict deadlines for open enrollment each year. It opens nationally on November 1st, and closes on January 15th. Some states, such as New York and California, have extended deadlines through January 31st. Click here to see your state’s open enrollment period. 

During this period, people have the opportunity to enroll in healthcare coverage, or change their plans. Failing to take action during this time can pose serious consequences because open enrollment is the time employers can take advantage of having health, dental, vision, life and other voluntary benefit insurance plans. 

Enrolling after the deadline means that there is no way to make changes to your plan or enroll again until it opens back up a year later. 

What happens if your employee misses open enrollment?

Employees who miss the deadline to sign up for health insurance during open enrollment could face a year without health insurance. In turn, those without coverage may have to pay an individual mandate penalty on their next tax return. However, there are a few options available to employees depending on their circumstances.  

What other options can you provide to your employees?

Depending on the employee’s circumstances, they may be eligible to register for alternative coverage options. 

Medicaid 

Enrollment for Medicaid is open year-round to those seeing to apply. Eligibility is based on federal requirements that differ depending on the state. It extends coverage for:

• Low-income adults 
• Children 
• Pregnant women 
• Elderly adults 

Short-term Health Insurance 

Private insurance companies offer short-term health insurance policies. Most do not cover pre-existing conditions nor do they guarantee coverage because they are not required to fit ACA minimum essential coverage (MEC) benefits. 

Young Adult Benefit Plan 

Those under 26 years old are eligible to join their parent’s plan if that plan offers dependent coverage. This plan does not require the child to be employed, a student, or have a child. A caveat may include that registration for the child may need to occur during open registration. Rules and regulations for this may vary depending on plan type and state location.