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Big Q4 FAQ: Can an employee change elections after open enrollment?

Updated: Jun 4



Understanding Employee Election Changes After Open Enrollment

During the busy open enrollment season, one of the most frequently asked questions BCS gets is whether employees are allowed to modify their benefit elections once the enrollment window has closed. Today's video, and the blog below will hopefully provide you the insight you're looking for.

Can Employees Change Their Elections After Open Enrollment?

During the open enrollment period, employers typically provide a window of two weeks to 30 days for employees to review and select or modify their benefit elections for the upcoming plan year. This process could be through either an online enrollment platform or via traditional paper forms.

The good news is, employees do have the flexibility to amend their benefit selections even after the open enrollment period has officially ended. However, there are some important caveats and limitations to keep in mind.

Setting Limits on Election Changes

While employees are generally permitted to change their elections after open enrollment, employers can still impose certain restrictions and deadlines. Here are a few common scenarios:

  • If the open enrollment period closes a few weeks before the new plan year begins, the employer may prohibit further changes beyond that cutoff date.

  • Employers may set a specific deadline, such as two weeks after open enrollment closes, for employees to make any final adjustments to their elections.

  • Some employers may only allow changes within a narrow window immediately following the close of open enrollment.

Imposing these types of limits helps ensure consistency and streamlines the benefits administration process for the employer. When working with an employer, it's important that benefits consultants clearly understand any restrictions the employer has in place.

Exceptions to the "No Changes" Rule

Once the new plan year or coverage period officially commences, employees are typically locked into their benefit elections and cannot make changes until the next open enrollment period. However, there are some exceptions to this rule in the event of a qualifying life event*:

  • Marriage or divorce

  • Birth or adoption of a child

  • Change in employment status (e.g., going from part-time to full-time)

  • Change in spouse's employment or benefit eligibility

*list is not extensive

If an employee experiences one of these qualifying life events during the plan year, they are typically allowed to adjust their benefit elections mid-year to account for the change in their circumstances.

Communication is Key

To ensure a smooth benefits administration process and avoid confusion, it is crucial for employers to clearly communicate the rules and deadlines surrounding election changes to their employees. Benefits consultants and third parties assisting in the process should also take note. This communication should include:

  • Providing detailed information during open enrollment about the window for making changes

  • Notifying employees of any cutoff dates or deadlines for final adjustments

  • Educating employees about qualifying life events that would permit mid-year changes

  • Outlining the specific procedures and documentation required for reporting a qualifying life event

Conclusion

Many of the common compliance issues BCS sees with employers arise from rushing through open enrollment and either ignoring or forgetting the rules in the process. It's a complex and busy period - but it's one in which employers and benefits consultants should exercise extra care with regards to compliance. By staying informed about the regulations surrounding election changes and maintaining clear communication with employees, organizations can ensure compliance and smooth benefits administration processes. Ultimately, this empowers employees to make informed decisions about their benefit selections and adjust as needed based on their changing life circumstances.


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