Employee Benefits

Brokers Offer 4 Tips for Open Enrollment

Many employers offer open enrollment once or twice a year to allow employees to sign up for and/or change their benefits selections. To make the best decisions on benefits offered through your employer, review four tips from brokers featured in Forbes:

1. Check costs – Benefits costs can increase from one year to the next, such as prescriptions, physician fees, tests and insurance premiums. Protect yourself from surprises by:

  • Contacting providers for current costs.
  • Verifying deductibles, copays and insurance.
  • Reviewing insurance plan out-of-pocket costs that must be satisfied before procedures are covered.

Evaluate the costs to determine whether the coverage choices fit your budget, especially if the deductible, copay or coinsurance amount increases.

To assist with benefits expenses, ask your employer about a pretax Flexible Spending Account or Health Savings Account.

2. Verify providers accept plans – Doctors, hospitals and professional service providers may become unsatisfied with an insurance carrier’s reimbursement rate and decide not to renew their contract. Before enrolling in plans, contact your providers to confirm whether they will accept your insurance coverage.

3. Review new insurance codes – Every procedure is given a medical diagnostics code that is used when submitting insurance claims. Historically the codes have used nine digits, but in October 2015 they were updated to 10 numbers. According to the Centers for Disease Control and Prevention, the code options will increase from 17,000 to 140,000, requiring diagnostics to be more specific. When receiving medical bills, carefully review insurance payments and the explanation of benefits. If procedures listed are not covered, contact your provider to confirm that the correct diagnostics codes were submitted. If not, ask them to resubmit the claim.

4. Evaluate domestic partner coverage – After the U.S. Supreme Court legalized same-sex marriages, many businesses changed their health coverage requirements. If you are in this category, review plan options for same-sex couples to ensure expected coverage will be available.




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