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Open Enrollment Tips and Definitions

10/27/2018

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Open Enrollment may seem confusing, but it doesn’t have to be. With all the recent volatility in the healthcare market, it’s good to know that LBMC Employment Partners' PEO has maintained single-digit increases over the past years.

Key things to know when preparing to enroll in a healthcare plan.

  1. If employees already enrolled in a healthcare plan, they must still re-enroll. Because of this, it’s good to encourage employees to review their elections and medical expenses. 
  2. Employees should also review their beneficiaries. This is the perfect time to make any changes, and if an individual is electing any new beneficiaries, they’ll need the social security number and date of birth of the new beneficiaries on hand. 
  3. Along with medical, dental, and vision plans, LBMC Employment Partners' PEO will offer a health savings account (HSA), which will be associated with medical plans. It’s advisable to encourage employees to contribute to this account, as tax-deductible contributions can be made to the account to help offset qualified medical, dental, and vision expenses.
  4. Since LBMC Employment Partners has been using the same open enrollment portal, employees’ general information will populate, except for elections from the previous year. If they are adding a dependent, they will need to have the dependent’s social security number and date of birth.
  5. Open Enrollment is the only time of the year in which changes can be made to elections unless there is a qualifying event (marriage, divorce, the birth of a child, death in the family, etc.). These elections are for the entirety of the year.
  6. There are three deductible options that LBMC Employment Partners' PEO has to offer. Each deductible will have options of Employee Only, Employee + 1 (either a spouse or a child), or Family (an employee with at least two other dependents).
  7. All of LBMC Employment Partners PEO’s enrollment plans are independent of each other. So if employees only want to enroll in dental insurance, but not medical, or if they want to enroll their family in medical, but only themselves in vision, they can. However, the employee must be enrolled in a plan if they want to apply it to any dependents. 
  8. LBMC Employment Partners' PEO also offers supplemental products, like additional life-insurance. Even though the company is going to provide standard life insurance, employees can elect to supplement it with additional coverage for themselves, their spouse, or any dependent children. 

With these tips in mind, Open Enrollment should be a piece of cake for employees, and if not, we’re here to help. We are well versed in all things Open Enrollment and related to the ACA, and we are more than willing to offer support through this process. If there are have any questions about the details of Open Enrollment, please don’t hesitate to call your local LBMC Employment Partners representative.

Healthcare Definitions: Understanding Open Enrollment Jargon

With open enrollment around the corner, people are researching new health plans. With the complexity of the Affordable Care Act (ACA) and all that comes along with it, sometimes it may be difficult for individuals to understand the jargon.

To ease understanding, here are the top 10 most commonly used open enrollment acronyms defined:

1. CDHC: Consumer-Driven Healthcare

In an effort to curb rising healthcare costs, consumer-driven healthcare is a trend in health insurance to lower premiums and raise deductibles by incentivizing individuals to become more educated about healthcare and price conscious of their healthcare plan.

2. CDHP: Consumer Driven Health Plan 

A consumer-driven health plan is an increasingly popular type of health insurance amongst individuals with lower medical expenses. A CDHP plan allows individuals to pay less in monthly premiums, instead of covering more of their medical expenses through out-of-pocket deductibles.

3. DME: Durable Medical Equipment

Durable medical equipment describes the supplies ordered by a healthcare provider for everyday or extended use. DME typically includes things like oxygen equipment, wheelchairs, crutches, slings, walkers, etc. — essentially any piece of equipment that an individual may require to function on a daily basis. 

4. EOB: Explanation of Benefits

An explanation of benefits (also called a “member health statement”) is a record of how much you owe that your health insurance provider sends you every time you use your health insurance. In addition to how much you owe, the EOB also shows the total cost of care, how much your plan paid, and the allowed amount an in-network doctor or other healthcare professional is permitted to charge a plan member.

5. FSA: Flexible Spending Account

A flexible spending account is a cost-savings tool that allows you to spend pre-tax dollars on qualified healthcare-related expenses. Money deposited in an FSA must be spent within the same year, or they are forfeited — otherwise known as the “use it or lose it” rule. 

6. HRA: Health Reimbursement Account

A health reimbursement account is an employer-funded savings plan that reimburses any out-of-pocket medical expenses you may have. However, unlike an FSA, unused balances will roll over and accumulate over time, though they may not be cashed out. 

7. HSA: Health Savings Account 

A health savings account is similar to an FSA, and it can be funded through pre-tax deductions by either the employee or the employer. However, HSAs are only available to people enrolled in a high-deductible health plan, and unlike an FSA, balances accumulate over time and you won’t lose any unused balances after the year is up.

8. MSA: Medical Savings Account

A medical savings account is a savings account, generally associated with self-employed individuals, in which tax-deferred deposits can be made for qualified medical and dental expenses, including co-payments or deductibles. 

9. PCP: Primary Care Physician

A primary care physician is a doctor who directly provides a wide range of medical services for a patient and includes medical doctors, doctors of osteopathic medicine, internists, family practitioners, general practitioners, OB/GYNs, and pediatricians — essentially any provider that’s not a specialist. 

10. QLE: Qualifying Life Event

A qualifying life event is a change in your life that allows you to make changes to your health coverage outside of the annual open enrollment period. These events can include a change in marital status, the number of eligible children or a family member’s benefits eligibility under another plan. 

Knowing these common acronyms and what they mean will make the open enrollment process easier on you. If you should have any questions, don’t hesitate to contact your local LBMC Employment Partner representative. We are well versed in all things open enrollment and relating to the ACA, and we are here to make this process as easy as possible.