Open Enrollment Hub

Eligibility generally falls into two main groups: 

Employees: 
Anyone who meets your internal eligibility rules: usually full-time employees working a minimum number of hours can enroll, change plans, or drop coverage during open enrollment. 

Dependents:  
Most plans allow employees to add or update coverage for: 

• Spouses or domestic partners 
• Children (biological, adopted, or stepchildren) up to age 26, regardless of whether they live at home, are married, or depend on the employee financially 

Open enrollment is the one time each year when employees can make benefit changes without a qualifying event. If someone misses the window: 

• Their current benefits usually roll over into the next plan year, if they’re already enrolled. 
• They may go without coverage if they weren’t previously enrolled and don’t qualify for a Special Enrollment Period (SEP). 

Medicaid works differently as it’s open year-round, and eligibility varies by state, focusing on low-income adults, children, pregnant individuals, and older adults. 

A smoother enrollment experience leads to higher participation and fewer employee questions. A few practical ways to simplify the process include: 

• Communicating early—and in plain language 
• Using visuals, comparison charts, and short videos 
• Offering multiple touchpoints such as live Q&A sessions, virtual office hours, or one-on-one support 
• Sharing real stories or examples to help employees understand how benefits work in real life 
• Adding fun or motivational elements like raffles, challenges, or milestone badges to spark engagement 

The goal: make benefits feel less overwhelming and more relevant to everyday needs. 

 Today’s employees expect a well-rounded benefits package that supports financial security, wellness, and work-life balance. In addition to medical, FSA, and HSA options, many employers consider offering: 

Core Benefits: 

• Dental and vision 
• Life and AD&D insurance 
• Short- and long-term disability 
• Retirement savings plans 
• Voluntary or supplemental benefits 

Optional Add-Ons Employees Often Value: 

• Critical illness, accident, or hospital indemnity 
• Legal services plans 
• Identity theft protection 
• Pet insurance 
• Enhanced mental health or wellness programs 
• Financial wellness and coaching 
• Caregiving support 
• Tuition assistance or education benefits 
• Lifestyle stipends or wellness reimbursements 

Offering a broad mix allows employees to personalize their coverage based on life stage and budget. 

ecause open enrollment includes multiple moving parts, compliance needs to be intentional. To stay on track: 

• Use an open enrollment checklist to plan communications and required notices 
• Clearly outline all deadlines and eligibility rules 
• Document when and how materials were distributed 
• Maintain accurate enrollment records and confirmations 
• Partner with trusted advisors who can help you navigate regulatory changes 

Staying organized reduces risk, and helps employees make confident, informed choices. 

A qualifying life event is a major change that allows someone to update their benefits outside the annual open enrollment window. Common QLEs include: 

• Marriage or divorce 
• Having or adopting a child 
• Losing existing health coverage 
• Significant changes in income or household status 

A QLE triggers a Special Enrollment Period, usually lasting 30–60 days, during which employees can make new elections or adjust existing coverage. 

Employers are increasingly using AI tools to make open enrollment smoother, faster, and more personalized. AI can: 

• Recommend benefits that match an employee’s needs or life stage 
• Answer common enrollment questions instantly through virtual assistants or chatbots 
• Simplify plan comparison tools with clear cost-breakdowns 
• Automate reminders so no one misses deadlines 
• Spot knowledge gaps and offer targeted education materials 
• Support HR teams by reducing the volume of repetitive benefits questions 

AI is not here to replace human support but rather enhance it. The result is a more confident, well-informed employee experience with fewer administrative headaches. 

Whether to offer active or passive open enrollment depends on your goals. An active open enrollment requires employees to re-select their benefits each year and it is a good option if you're introducing new plans, changing costs, or encouraging employees to rethink their coverage. A passive open enrollment automatically rolls over existing elections and works well when your plans remain stable, and you want to reduce admin work. 

Many employers choose a hybrid approach, requiring active elections for certain benefits, while allowing others to renew automatically.  

Most organizations start planning three to six months before their open enrollment period begins. Starting early allows time to review plan changes, finalize rates, coordinate vendors, prepare communications, and train managers or benefits champions.  

A longer runway also helps you build a clear communication plan so employees understand what’s changing and what actions they need to take and so your team can get ahead of key compliance requirements and deadlines. Preparing early leads to fewer surprises, smoother execution, and higher employee engagement.