Yes, you can change your healthcare benefits plan during open enrollment. That's the short answer. What matters more is how and when to make those changes, and what options might exist beyond the standard plan menu your employer shows you.
Open enrollment is a limited window, typically once a year and often lasting two to four weeks, during which you can:
- Enroll in a new health plan
- Switch from one plan to another (for example, from a PPO to an HMO or a high-deductible health plan)
- Add or drop dependents
- Change contribution levels to FSAs, HSAs, or other pre-tax accounts
- Elect supplemental benefits like dental, vision, or life insurance
Outside of this window, you generally cannot make changes unless you experience a qualifying life event, such as marriage, birth of a child, loss of other coverage, or a move, that triggers a special enrollment period. What counts depends on the plan. Employer plans follow Section 125 rules and the plan document, and a move usually qualifies only if it changes your eligibility, such as leaving the plan's service area. If you buy coverage through the Marketplace, moving into a new area opens its own special enrollment window.
What Most People Miss: The Preventive-First Add-On
You can switch between your employer's standard plans during open enrollment. The bigger question is whether you are limited to those plans. In the traditional model, yes. Some employers now add a separate layer that sits in front of the health plan and gets used first.
That's where a Health-to-Wealth™ benefit system, WellthCare™ for example, comes in. With WellthCare, healthcare pays you back: every verified preventive action earns Store dollars and automatically builds retirement wealth. It works alongside your major medical insurance and gets used first. It is a no-disruption add-on, and it does not replace your existing coverage. Employees who have access to it can:
- Use $0-co-pay preventive care before touching their deductible
- Earn real, spendable dollars at the WellthCare Store™ for completing health actions
- Automatically build retirement wealth through retirement account contributions tied to healthy behavior
How This Changes Your Open Enrollment Strategy
If your employer offers a system like WellthCare alongside your traditional plans, do these three things during open enrollment:
- Review your core medical plan choices: premiums, deductibles, out-of-pocket maximums, network adequacy.
- Check whether your employer has added a preventive-first benefit that works alongside your plan. WellthCare converts verified preventive actions into direct financial rewards and retirement contributions.
- Understand the flywheel effect: free care first → earned Store dollars → growing retirement contributions → fewer claims for your employer. Over time, fewer claims help your employer hold down costs, and that is a structural win, not a perk.
What About Switching From a Traditional Plan to a Self-Funded Model?
Open enrollment is also when some employers switch from fully insured plans, such as Blue Cross, United, Cigna, or Aetna, to self-funded alternatives. If your employer is considering a move to a fully aligned, transparent system like WellthCare Complete™, they will typically use open enrollment to:
- Share the Readiness Index™, a data-driven report showing how much the company could save by expanding, based on its own usage data
- Move Medicare-eligible employees to WellthCare Medicare™ to reduce claim costs
- Replace the pharmacy benefit manager with WellthCare Pharmacy™ for typical drug savings of 20 to 40 percent
This is a structural redesign of the entire benefits experience rather than a simple swap of plans. Employees keep their Store dollars, their retirement growth, and their preventive care access, while the employer cuts waste and lowers overall spend.
Who This Add-On Doesn't Apply To
Participation in a benefit like WellthCare is limited to W-2 employees in the employer's Section 125 plan. Business owners are not eligible, including self-employed individuals, partners, members of an LLC taxed as a partnership, and owners of more than 2 percent of an S corporation. Their family members can join only if they are eligible W-2 employees themselves.
You also need ACA-compliant employer-sponsored group health coverage to use the add-on, whether through your own employer or a spouse's employer. The system is designed to sit in front of that coverage, not replace it. If you are unsure whether you qualify, ask your HR team before open enrollment closes.
Key Takeaways for Open Enrollment
- Don't default to last year's plan, especially if new options have been added.
- Ask your HR department whether they offer a benefit that pays you back for preventive care.
- Look at total value beyond raw premiums: immediate rewards, long-term wealth building, and out-of-pocket savings from $0-co-pay care can sometimes beat a lower monthly premium.
- If an add-on like WellthCare is available, enroll in it even if you are happy with your current insurance. It works alongside your plan and does not replace your existing coverage.
This annual window is your chance to optimize rather than repeat. The best choices balance your health needs with your financial goals, and systems that do both are the ones worth looking at.