Choosing a benefits package can feel overwhelming.
And, you’ll likely face a variety of options during Open Enrollment (OE), with each available carrier having their own coverage. With so many choices, you probably have just as many questions about which benefits package is right for you.
Before you submit your elections, here are 5 important questions you should ask when choosing benefits.
1. Is my provider in network and are my prescriptions covered?
Probably one of the most common questions employees have when choosing benefits is whether or not their provider is in network. This question is especially important if your employer moves from one carrier to another.
Simply put, being “in network” means that your provider has contracted with your health insurance plan to provide services. This usually means that you have lower co-pays or out-of-pocket expenses whenever you see your medical provider.
So how do you know if your provider is in network? You can find out in 2 easy ways!
- Check with your medical carrier. Many carriers’ websites or apps have a ‘Find a provider’ search option, where you can type in your provider’s name or office to see if they’re in network. You can also call the number on the back of your member ID card.
- Ask your provider. You can either call their primary office or, for some providers, check their main website.
Of course, when asking about network provider coverage, the next question is whether or not your current prescriptions are also covered. Use your medical carrier site or their mobile app to check if certain medications are on their formulary list.
2. How well do I know my associated plan costs?
Another common and important question employees have is how much their benefits plan will cost. Your premiums are usually deducted from your paycheck each pay period, depending on your enrollment selections. While this is important, there are other healthcare costs that you should consider, like:
- Your deductible, which is the possible amount you could owe for any healthcare costs before your carrier begins to pay.
- Coinsurance, which is the percentage of costs you pay once your deductible is met.
- Out-of-pocket maximum, which is the most you could pay for your share of the costs within a Plan Year. This usually includes costs like your deductible, your coinsurance, and your copay.
These costs should also be considered in addition to your monthly benefits premium costs.
3. Will my benefits choices fit my monthly budget?
As you consider the monthly costs of your benefits coverage, another question you might have is whether or not your plan choice addresses both coverage and affordability. You’re not alone – 39% of employees told us they weren’t prepared for an unexpected medical emergency when we asked during our yearly Employee Benefits Survey.
If affordability is top of mind for you, there are options you can consider that may help – Health Savings Account (HSA) and Flexible Savings Account (FSA). For full details on both of these and much more, visit our Summary Plan Description (SPD).
- HSAs allow you to set aside money on a pre-tax basis and can be used to cover eligible medical expenses (such as copays). To be eligible to open an HSA, you’ll need to be enrolled in a qualified High-Deductible Health Plan (HDHP).
- FSAs – which include Health Care FSA, Limited Health Care FSA and the Dependent Care FSA – allow you to pay for certain medical or dependent care expenses with pre-tax dollars. Forfeitures of FSA balances may apply.
4. Am I prepared for any upcoming life changes?
Life changes can be a broad topic, as they mean different things to different people. Life changes can include things like:
- Upcoming medical procedures or ongoing medical conditions.
- A change in your number of dependents.
OE is the perfect time to think about these changes. Keep in mind, your benefits elections cannot be changed during the Plan Year unless you experience a qualifying life event. A qualifying life event (QLE), is a change that affects your health insurance needs and qualifies you to make certain plan changes outside of Open Enrollment periods. These include events like a marriage, a death or having a baby.
Think about what may be ahead for you during the upcoming ADP TotalSource Plan Year so you can identify the right coverage to fit your life today, and throughout the year.
5. Are voluntary benefits right for you?
When you think about your benefits coverage, most likely you’re thinking about medical, dental, or vision coverage. However, there are other benefits called voluntary benefits that may be available during your enrollment.
Voluntary benefits are additional coverage that can provide a financial safety net in a wide range of scenarios, like unexpected illnesses, legal matters, accidents, etc. We go into deeper explanations about voluntary benefits (and if they’re worth it) in this article.
What You Can Expect During ADP TotalSource Open Enrollment
Now that you know which questions should be top of mind during Open Enrollment, you’re probably asking “what happens when OE starts?”
- You’ll receive a series of emails starting a few weeks before your enrollment begins.
- Email includes helpful resource links, and some contain personalized videos.
- Reminder emails are standing by to ensure you make your elections before your window closes.
Keep an eye out for these emails. We recommend you sign up sooner rather than later.
And that’s it!
Remember that once you’ve successfully enrolled in benefits, you can only adjust or change your benefits during the next enrollment period or if you experience a QLE. ADP TotalSource wants to make your OE experience as easy as possible, so if you have any questions or need to make a change, please contact our award-winning MyLife Advisor team at 800-554-1802.
