Open Enrollment: 5 Things Employees Most Often Misunderstand

Open enrollment means one thing for HR pros: Your inbox and voicemail will be full of questions, and employees will be knocking on your door to get their questions answered. They’re confused before it even starts. And they need your help.

The best way to help: Know what employees most often misunderstand about open enrollment and address those with good information early in the process.

Most HR pros work with their brokers on a presentation that reflects all the work they recently did – assessing current benefits, examining costs and doing surveys to gauge the impact of the benefits. You bundle it up into a nice, neat benefits guide and/or a presentation on the details of the open enrollment process. 

But what’s often missing are simple explanations of what employees misunderstand most.

How to Explain Open Enrollment to Employees

Here are the top five things most people – sometimes even HR people – have a tough time understanding during open enrollment, plus tips on helping them make sense of it.

1. Privacy Standards

Since COVID-19, employers have been encouraged to do more for their employees’ mental health, overall well-being and work/life balance. But many employers don’t ensure that the use of these benefits is private. 

Remember, it’s illegal for employers to see who used Employee Assistance Program (EAP) services. EAP vendors have strict regulations. Employers can know how many people used an EAP site, hotline or program, but not who, where they were or what role they have in the company. 

Some employees believe employer-provided coverage allows the employer to know all about their medical usage. Define the privacy standard in plain English, not using the blanket HIPAA statement, which can be confusing and off-putting.

2. HRA, HSA, FSA Differences

While Health Reimbursement Arrangements (HRA), Health Savings Accounts (HSA) and Flexible Spending Account (FSA) provide ways for reimbursement of medical costs, they all have differences, which employees often can’t distinguish.

Some roll over from year to year. Others need employees to enroll in them every year. Some can’t be combined. And others have usage restrictions. 

During open enrollment, plainly define the essential parameters of each account, the overlap and how being in each plan can benefit the employee. 

3. In-Network Providers vs. Out-of-Network Providers

Whether you’re fully insured or self-insured, people often have issues finding in-network providers. 

For instance, if a benefits survey uncovers a disconnect where some people rate the dental coverage the best and others rate it the worst, it could be that the people who gave it poor ratings are using out-of-network providers and aren’t aware of it. 

Help employees recognize that the best way for a member to verify an in-network provider is to register online with your provider directly. Show them exactly how, once they’re logged in via an app or the Internet, they can see coverage, claims and providers, and print ID cards. 

This is important because many companies that have plans administered by another party may use a separate provider network which may cause confusion with provider verification. Many providers have also moved away from mailing IDs for dental, vision and other benefits. 

4. How to Get Help With Claims

During open enrollment, employees make elections weeks or months before the new coverage takes effect — but it’s often much longer until they use those newly elected benefits. 

One way to fix the disconnect is to ensure your self-service platform displays the current elections each employee has. Another low-tech option is to create a wallet card with names of providers, phone numbers and websites. 

Send out quarterly reminders of the plans you offer and how to obtain help with claims or log in to the carrier websites as a member to reduce confusion and increase employee satisfaction.

5. Differences in Disability Benefits

I once discovered during an open enrollment prep that five people were signed up for long-term disability (LTD) when they would’ve been better signed up for short-term disability (STD). 

Why? No one had made it clear that STD covered the first few months of a qualifying leave and LTD started after the STD ended, roughly after three months of being unpaid.

Be Ready to Answer Unasked Questions

Benefits misconceptions exist in every organization, and not every employee will ask enough questions. All plans differ in terms and change even during renewal periods. Even if you’ve explained things previously and haven’t had turnover or plan changes, repetition helps.

It’s the responsibility of the HR benefits administration team to successfully communicate the value of employee benefits. Make sure to explain your benefits clearly and simply each year. Concise but detailed summaries are an important part of a benefits guide. The more your employees understand and value your benefits, the greater the employee satisfaction rating will be.