Open Enrollment — What Do I Need to Know?

Having health insurance is one of the most important steps you can take to protect yourself and your loved ones. We insure our cars, home and other material items, so why would you decide to put yourself last? Car or home repairs can be very costly, but have you thought about what it would cost to fix YOU if something went wrong? Did you know that in 2020, the average cost to treat a concussion in an emergency room is $18,454?

Open enrollment period happens once a year, whether you have employer-based insurance or individual plans. Open enrollment generally lasts 4 to 6 weeks (depending on your health plan). It is important to note that this is one of the few times you can:

• Enroll in benefits for the first time; or
• Make changes to your current health, dental, vision, life, or disability insurance benefits
  

 
Health insurance decisions can have a significant financial impact, so it’s important to weigh your options carefully. Even with employer provided insurance plans you usually have options.  Here are a few things to consider when making choices for your 2021 benefits package.
 
Premiums
Premiums are the amount of money you'll pay every month for coverage; they are the most obvious expense associated with health insurance. While it's important to find insurance that fits your budget, the cheapest plan may not be the best. Low premiums can mean higher deductibles or a restricted network. Instead of buying based on premiums alone, the monthly cost should be just one factor you consider when selecting the plan that is best for you.
 
Out-of-pocket expenses
Most health insurance plans come with several out-of-pockets costs. The deductible is the amount you'll pay upfront before insurance coverage begins. Health insurance policies also may charge copayments and coinsurance once a deductible is met. A copayment is a flat fee for a particular service, such as a $30 charge for doctor visits. Coinsurance is a percentage of the total cost of care. One of the most common types of coinsurance found in health insurance policies is an 80/20 split. This requires patients to pay for 20 percent of the bill while the policy covers the other 80 percent.
 
Prescription drug coverage
It's not enough to know your plan has prescription drug coverage. It's also important to know how your specific prescriptions will be covered. Many insurers use formularies, or lists of covered drugs, that categorize prescriptions into tiers. Generics may have a low copay, while brand name drugs cost more. And keep in mind, some insurers may require patients to try lower-tier drugs first or get prior authorization before the plan will pay for expensive medications.
 
Your claims history
Knowing a plan's deductibles and network details is most helpful when viewed in the context of your health history. Think about you and your dependents’ past years’ health care. Did you go to the doctor more than once? Does anyone you will be covering have routine doctor visits? For instance, do you have a small child with allergies? If the answer is yes, you will want an insurance plan that includes office visit copays. If you don’t have any medical issues, you may want to look at a high deductible plan that simply covers major illnesses or accidents.
 
The choices you make during open enrollment will be what you will live with until the next open enrollment, unless you have one of the following qualifying events:

• Marriage
• Divorce
• Birth
• Adoption
• Death of a dependent or
• Lose your job with an employer-sponsored plan

 
Open enrollment windows don’t stay open long. Make sure to give it some thought and get signed up as soon as possible. You don’t want to find yourself without coverage when you need it the most.

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Allied National

Founded in 1970, Allied is one of the nation's oldest and most experienced third-party administrators. Allied National is a 90 Degree Benefits Company, a subsidiary of Blue Cross Blue Shield Alabama. As the small group benefit experts, Allied works with small business employers to provide unique and affordable group health benefits.