Open enrollment is a busy time with a high risk for mistakes that can lead to employee confusion, missed benefit opportunities, and legal risk for employers. Here are five common compliance mistakes employers should avoid making at open enrollment time:
- Mistake: Not Communicating Benefit Changes Clearly
Employers routinely update benefit offerings before open enrollment to stay competitive and enhance satisfaction. These changes, ranging from new options to adjustments in cost sharing and coverage, can result from business decisions, insurer requirements, or federal and state mandates, including annual updates to high-deductible plan limits and compliance with evolving insurance laws.
Ahead of open enrollment, clearly identify and communicate all benefit changes so employees can make informed choices. Start early, leverage multiple channels, keep messages simple, and use practical examples to drive understanding.
For ERISA benefits, communicate changes with an updated Summary Plan Description or Summary of Material Modifications. Maintain and periodically review your written plan document to ensure compliance.
- Mistake: Failing to Provide Required Health Plan Notices
Employers should include key benefit notices in connection with their plans’ open enrollment period. Some notices must be provided at enrollment time and other notices must be distributed annually. Many employers elect to include the annual notices in their open enrollment materials too for administrative convenience.
The following health plan notices are often provided in connection with annual open enrollment:
- Summary of Benefits and Coverage (SBC)
- Summary Plan Description (SPD)
- Children’s Health Insurance Program (CHIP) Notice
- Initial COBRA Notice
- WHCRA Notice
- Medical Part D Notice
- Grandfathered Plan Notice
- Notice of Patient Protections
- Health Insurance Portability and Accountability Act (HIPAA) Privacy Notice
- HIPAA Special Enrollment
Most health plan notices can be sent electronically if they comply with certain rules and delivery ensures recipients actually receive the information.
- Mistake: Not Distributing Open Enrollment Materials to All Eligible Employees
Employers should ensure that all eligible individuals, including newly eligible employees, those on leave or furlough, and COBRA beneficiaries, receive open enrollment materials with clear benefit details and deadlines. They should share details on benefits, costs, election procedures, and deadlines through multiple channels. It’s also important to keep distribution records to help prevent disputes.
- Mistake: Underestimating the Importance of Election Deadlines
Open enrollment typically occurs in the months before the plan year and should end early enough to confirm elections and process enrollments. Employees’ benefit elections, made pre-tax through a Section 125 plan, are generally effective for the upcoming year and cannot be changed unless a qualifying life event occurs. To reduce errors, employers should communicate deadlines clearly and encourage early enrollment.
- Mistake: Not Describing the Availability of a Reasonable Alternative Standard for Health-contingent Wellness Programs
Health-contingent wellness programs must offer a reasonable alternative standard to comply with HIPAA nondiscrimination requirements. Employers should clearly disclose this option, including contact information and a statement that physician recommendations will be accommodated, in all plan materials describing surcharges or rewards.
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Resources
Revenue Procedures 2025-19, which includes the inflation-adjusted limits for Health Savings Accounts (HSAs) for 2026
Model notices for group health plans
Model COBRA notices for group health plans