How Does Open Enrollment Work?

Health

Oct 20

The Gist

Open Enrollment is a specific time frame where you can make certain modifications to your existing health coverage or get covered if you lack health insurance.
For employer-provided or private insurance, Open Enrollment will be determined by your company or carrier, but for Affordable Care Act (ACA) plans, the Open Enrollment Period typically runs from Nov. 1 to Jan. 16 (though some states have extended enrollment deadlines).
While you can enroll in a new policy during Open Enrollment, you can also use it to modify your existing coverage. Depending on your carrier and the options available, you may be able to change coverage levels, update your Health Savings Account contributions, and more.
What happens if you miss Open Enrollment at work? You may qualify for a Special Enrollment Period (SEP). To apply for an SEP, you must experience a qualifying life event, like losing your job, getting married, or having a baby.
How does Open Enrollment work? Keep reading for our five essential tips to get ready for the OEP and make the most of your health care options.
If you’re looking to sign up for a new health insurance plan, including ACA plans, Stride can help you find the best plans for your unique needs.

In Short

We all know how important it is to have a comprehensive health insurance plan. From regular checkups to specialist visits to emergency room trips, a health policy can help offset a lot of your out-of-pocket expenses — which could save you thousands if the unexpected happens! If you lack coverage or need to make changes to your existing plan, it’s important to be prepared for Open Enrollment Period (OEP).

For private or employer-provided insurance, your OEP will be decided by your provider or company, so it’s important to reach out to your benefits coordinator for details. If you miss your OEP, it could be another year before you can sign up or make changes. For 2024 ACA plans, the OEP is from Nov. 1, 2023 to Jan. 16, 2024 for most states.

In this article, we’ll be answering some of our most frequently asked questions about Open Enrollment Periods. We’ll explain what happens when you miss an OEP and tell you everything you need to know about Special Enrollment Periods, qualifying life events, and more. Keep reading for essential info about health insurance, your rights under the ACA, and tips to help get ready for the OEP and find the best insurance available to you!

Question 1: How Does Open Enrollment Work?

Put simply, the Open Enrollment Period is a pre-set window of time where you can make certain modifications to existing plans or sign up for new health insurance.

If you have employer-provided health insurance, your benefits department will reach out about a month before the OEP to let you know your options. During the OEP, you can make certain modifications to your existing plan (we’ll cover this more in Question 3). For example, you can change your coverage levels and contribution amounts, add beneficiaries, and more. You can also enroll in an entirely new policy.

Every company handles their Open Enrollment Period differently, so be sure to read all the information they provide. If you’re wondering what happens if you miss your company's Open Enrollment, you might qualify for a Special Enrollment Period — we’ll cover that in Question 4.

If you don’t currently have health insurance through an employer, Open Enrollment Period is the perfect time to enroll in an ACA plan. For most states, Open Enrollment runs from Nov. 1 to Jan. 16 (although some states have extended deadlines).

Question 2: When Is ACA Open Enrollment for 2024?

If you’d like to make modifications to your existing ACA plan or enroll in a new policy, you’ll need to know when your state’s Open Enrollment Period is. For most Americans, the OEP runs from Nov. 1 through Jan. 16, although in Idaho, it begins on Oct. 15 and ends on Dec. 15.

The reason some states have a slightly different Open Enrollment Period involves the exchanges (or marketplaces) that are available. States that operate their own exchanges (rather than using the federal marketplace) have the option to modify their Open Enrollment Period, with some extending it by as much as two weeks.

Check out this Open Enrollment Period 101 article to learn when you can enroll for health insurance in your state. If you miss your state’s Open Enrollment Period, you may need to apply for a Special Enrollment Period, which we’ll cover in Question 4.

Question 3: What Do You Need to Know Before the OEP?

If you get insurance through your employer, reach out to your benefits officer to see if there are any new offerings for this year. They will let you know about new plan levels, contribution guidelines, and more that could impact your health care.

During the Open Enrollment Period, in addition to enrolling in a new health care policy, you can make certain modifications to your existing policy, including:

Select new coverage levels — for instance, stepping up from a Bronze to a Silver plan.
Enroll in new benefits offered by your carrier, like an updated prescription benefit.
Choose a different type of plan, like an HMO, PPO, or HDHP.
Adjust or make new contributions to a Health Savings Account or Flexible Spending Account.
Add beneficiaries or make other changes to your coverage.

To add beneficiaries, you may need to provide certain documentation (like a birth or adoption certificate), so make sure you have that on hand before you try to modify your plan.

Before the Open Enrollment Period, you should also check with your preferred doctors to make sure that they will continue to accept your insurance in the coming year. You want your regular doctors to be in-network so your co-pays and other out-of-pocket expenses remain affordable. If your doctor is out-of-network and you’d like to continue seeing them, you may need to shop for a plan they accept.

If you’re shopping for an ACA plan, Stride is the simplest way to find the right coverage for your unique needs (more on that in a moment).

Question 4: What Happens If You Miss Open Enrollment at Work?

If you miss your company’s Open Enrollment, you might qualify for a Special Enrollment Period. To apply for a Speical Enrollment Period, you must first experience a qualifying life event.

The most common qualifying life events are:

Loss of employer-provided coverage
Loss of coverage on parents’ plan when you turn 26
Birth or adoption of a child
Marriage or divorce
A death among the family members who are covered by your plan
Moving to a new ZIP code or county
Gaining U.S. citizenship
Leaving incarceration

When you apply for your Speical Enrollment Period, you may need to provide certain documentation (like a birth or death certificate), so make sure you have that handy. During the Speical Enrollment Period, you have all of the same privileges as during the Open Enrollment Period, so if you want to add beneficiaries, update your coverage level, or change your HSA contributions, this is your chance to do so.

Once you’ve been granted a Speical Enrollment Period, you only have 60 days to enroll in a new health policy or make changes to your existing plan, so don’t delay! If you miss your Speical Enrollment Period, you will have to wait until the following Open Enrollment Period, so you’ll want to enroll as soon as possible.

Which brings us to our final question:

Question 5: What’s the Best Way to Enroll in a New Health Insurance Plan?

So, what should you do if you don’t have insurance? Well, first of all, you should definitely have coverage. It’s always best to be prepared for health emergencies (and the pricey bills that come with them), and health insurance can save you a lot of money if something catastrophic happens.

But we’re not going to dwell on that — bad vibes. On a happier topic, we here at Stride can help you find the right plan. All you have to do is enter your ZIP code, provide some basic information about your health needs, and we’ll do the rest. Within minutes, you’ll get recommendations for the best plans for you, and you can narrow down your options with our comparison tool. You can even apply directly from our site — that’s right, you could be mere minutes away from finding a shiny new health plan.

Now that you know more about Open Enrollment Periods and Special Enrollment Periods, we hope you’re a little less overwhelmed by the options! Close your eyes, take a deep breath, and get started below: We’ll handle the hard stuff.

Shauna Gleason