What is Open Enrollment?

Workplace Benefits

What is Open Enrollment?

3 min read Sep 13, 2022

What is Open Enrollment?

Open enrollment refers to the period of time each year during which you can enroll in or make changes to health insurance, life insurance, dental insurance, and other employee benefits offered through your workplace. 

While the term “open enrollment” most often refers to the health insurance sign-up period, it encompasses the full breadth of employer-provided insurance solutions, as well as insurance available through the government health insurance marketplace

When is open enrollment?

The open enrollment period occurs annually in the fall. It typically runs from November 1 through January 15 each year, but may vary state-to-state, so be sure to check your state’s dates ahead of time. 

Additionally, because the open enrollment period generally applies to employer-sponsored insurance plans, human resources (HR) departments usually remind employees when the open enrollment period starts and ends.

Special enrollment period

In some special cases, you can enroll in or change your health insurance outside of the open enrollment period. If you experience qualifying life events, you can take advantage of this “special enrollment period.” 

Qualifying life events can include:

  • Marriage, adoption/giving birth, providing foster care, or making other additions to your household
  • Moving, as long as it is to a different zip code, state, or country
  • A change in eligibility, like new citizenship, release from incarceration, income changes, or becoming recognized as a Native tribe member
  • Sudden loss of health insurance due to aging out of parents’ coverage, job loss, or change in income

Qualifying events typically give buyers a limited period to enroll — usually around 60 days both before and after the event. For employer-provided special enrollment periods, the window shrinks to a minimum of 30 days before and after the event.

How does open enrollment work?

During the open enrollment period, you’ll have the chance to change, update, or enroll in benefits through your employer or the government marketplace. 

Regardless of where you enroll in your insurance policies, the process remains essentially the same and is generally straightforward. Typically, the paperwork and communication with insurance companies is done through your employer’s HR department or a government representative.

What types of insurance use open enrollment?

Nearly all insurance providers use an open enrollment period. If you’re enrolling in insurance through your employer, you may have both sponsored and employee-paid benefits available to you during open enrollment. 

Employer-sponsored insurance is purchased by your employer and available to all eligible employees (and their dependents). When you enroll, your employer typically pays for some or all of the monthly premiums, and the remainder of the cost is deducted from your pay. Traditional health insurance that you enroll in through your workplace is the prime example of employer-sponsored insurance. 

Employee-paid insurance is offered through your employer, but chosen and paid for entirely by the employee. Because of the opt-in nature of this system, these supplemental benefits are also known as voluntary benefits. They tend to include life insurance policies as well as plans for different scenarios and illnesses, ranging from accidents to specific diseases.

What types of insurance don’t use open enrollment?

There are a few cases in which sign-ups aren’t limited to a specific period of time. For example:

  • Medicaid allows buyers to enroll in health insurance at any time of year. The only catch is that you’ll have to qualify first.
  • CHIP (Children’s Health Insurance Program) doesn’t limit enrollment to a specific time, so parents can ensure their children have coverage no matter what time of year it is.
  • Short-Term Health Insurance doesn’t typically use enrollment periods, as the need for this type of insurance isn’t easy to predict. However, some states don’t participate in short-term coverage.
  • Supplemental Health Insurance that is not provided by your employer usually does not restrict applicants to a certain enrollment period.

Active vs. passive enrollment

There are two types of enrollments: active enrollment and passive enrollment. Each type follows different rules or procedures. It’s important to know which you’re working with so that you can enroll in the best plan for your needs.

  • Active enrollment requires re-enrollment each year, regardless of whether or not you make changes.
  • Passive enrollment does not require re-enrollment each year, as the policy renews on its own with nothing needed from the policyholder unless changes are being made.
Close up of a senior woman and her daughter at a doctors appointment

How to prepare for the open enrollment period

In the weeks leading up to the open enrollment period, you’ll want to prepare for the process of enrolling in a new plan or making changes to your old plan(s). Use the checklist below to ensure you have everything you need. 

  • Know the open enrollment dates.
  • Confirm the plan options available through your employer or the marketplace.
  • Research the insurance company and ensure available providers match your needs.
  • Understand the open enrollment terms and jargon ahead of time.
  • Analyze the associated costs, including premiums, copays, and deductibles.
  • Hypothesize possible events or scenarios to ensure your potential coverage will meet your needs.
  • Confirm the details of your plan meet the Affordable Care Act (ACA) guidelines (this is often vetted by your employer, but it’s good to do your own research as well).
  • Ask questions — if you’re unsure about any aspect of the open enrollment period, ask your employer for clarity.

What happens if you miss open enrollment?

If you miss the open enrollment period, there’s no need to worry. There are still options available to you:

  • Check to see if you qualify for the special enrollment period
  • Consider a short-term health insurance plan that will last you until the next open enrollment period
  • Find out if you can qualify for Medicaid or CHIP

Ready for Open Enrollment?

Explore Our Content

This article is intended to provide general information about insurance. It does not describe any Metropolitan Life Insurance company product or feature.