Open Enrollment For Group Health Insurance
Open enrollment is the window or period of time each year when you can make changes to your company health insurance elections. Generally speaking, except for when you are initially hired, unless you have had a qualifying event, you cannot change your health insurance coverage outside of open enrollment.
Open enrollment is usually sometime in October or November to give employees and employers a chance to make changes in time for the upcoming calendar year. Changes do not usually take effect until the first day of the New Year. If you have a family status change outside of open enrollment, you can change your insurance choices then as well. Family status changes include the adoption, birth, or death of a dependent child or spouse; marriage or divorce; and the loss of eligibility for health insurance benefits by your spouse. At these times, you can add or drop family members to your plan.
Summary Plan Descriptions (SPDs)
An SPD, or summary plan description, is your group health insurance plan administrator's description of your legal rights under the Employee Retirement Income Security Act (ERISA). ERISA is the federal law that protects your health benefits. Your company's SPD should include information about coverage for your dependents, co-pays, as well as when and under what circumstances your employer can cancel your health insurance.
You should receive a copy of your company's SPD each year in your benefits package as part of your group health insurance quote. Save it and any memos, letters, or e-mails (print these out) that relate to the SPD. If you cannot locate your SPD, ask your human resources department for a copy.
Group Health Insurance
Group health insurance is health insurance provided to a large number of people under a single master policy. Group health insurance is most often obtained through an employer but is also available to small business owners and freelance contractors through professional associations and unions.
Since groups are able to negotiate better terms with insurers, the premiums are generally lower and the service coverage generally more comprehensive when getting group health insurance. The rates available were you to purchase an individual health insurance plan would likely be considerably higher. Individual health insurance plans are those plans that are privately purchased by consumers and include coverage for individuals, couples, and families.
The Health Insurance Portability and Accountability Act
HIPAA is a federal regulation designed to provide workers with health insurance security. HIPAA stands for Health Insurance Portability and Accountability Act. Among other things, this regulation guarantees that workers and their dependents are able to continue group health insurance coverage in the event the primary insured loses his or her job, becomes disabled, dies, or gets divorced and that if you transfer to a new health care plan you will not have to qualify again during waiting period restrictions for pre-existing conditions which was met under the old plan.
Provisions of HIPAA apply not only to traditional employees, but also to freelance contractors and others with self employed health insurance. For more information on HIPAA, please visit the United States Department of Labor's Employee Benefits Security Administration Web site.