How to Change Your Health Benefits During Open Enrollment

Open enrollment is your once-a-year chance to review, adjust, or switch your employer-sponsored health benefits. Outside of a qualifying life event such as marriage, birth, or loss of other coverage, it's the only time you can make changes. Get this right and you could save hundreds, even thousands, in premiums and out-of-pocket costs, all while making sure you and your family have the coverage you actually need.

Step 1: Know Your Dates

Your employer sets a specific window, usually in the fall (October through December) for coverage starting January 1. It's typically two to four weeks. Mark it on your calendar, set reminders, and don't wait until the last day. Systems crash, and missing the deadline means you're stuck for another year.

Step 2: Pull Your Current Plan Details

Before you can make a smart change, know what you have. Find your Summary of Benefits and Coverage (SBC). Key numbers:

• Monthly premium – what you pay each month from your paycheck.
• Deductible – the amount you pay before the plan starts covering costs.
• Co-pays and coinsurance – your share for visits, prescriptions, specialists.
• Out-of-pocket maximum – the most you'll pay in a year before the plan covers 100%.
• Network restrictions – which doctors, hospitals, pharmacies are covered.

Step 3: Think About Next Year

Your healthcare needs change. Ask yourself:

• Any major medical events coming up (surgery, pregnancy, chronic condition)?
• New prescriptions or expensive meds on the horizon?
• Income or family situation changed significantly?
• Happy with your current doctors and specialists?

If you're generally healthy and see the doctor rarely, a high-deductible health plan (HDHP) with a Health Savings Account (HSA) could save you money. If you have ongoing needs, a lower-deductible plan with richer co-pays is probably smarter.

Step 4: Compare All Plan Options

Go to your employer's benefits portal and look at every plan for the coming year. Compare side by side. Don't just look at premiums. A lower premium often means a higher deductible and higher out-of-pocket costs. Use an HSA vs. FSA comparison to see which account fits your situation. Many employers offer decision-support tools that estimate your total annual cost based on your expected usage. Take advantage of those.

Coordinate With Your Spouse's Plan

If you and your spouse both get coverage through work, open enrollment is your chance to compare both plans side by side. Run the same numbers on each: premium, deductible, out-of-pocket maximum, and whether your doctors are in network. You can cover the whole family on one plan, or split coverage so each spouse takes self-only and the kids sit on whichever plan fits them best.

Doubling up on coverage is rarely worth it. When a child is covered under both parents' plans, coordination-of-benefits rules decide which plan pays first. Most plans follow the birthday rule: the plan of the parent whose birthday falls earlier in the calendar year is primary, and the other plan pays second. The second plan only covers what the first doesn't, and you pay two premiums for that. One good plan usually beats two overlapping ones.

Confirm the details with both employers' plan documents before you lock anything in. If your own plan covers you as an employee, it is primary over any plan that covers you as a dependent.

Step 5: Don't Forget Ancillary Benefits

Open enrollment is also the time to enroll in or modify:

• Dental and vision plans – often separate, but equally important for routine care.
• HSA or FSA – pay for medical expenses with pre-tax dollars, reducing taxable income.
• Life and disability insurance – employer-sponsored options are often cheaper than individual policies.
• Wellness programs – some employers offer incentives for health screenings, biometrics, or preventive care.

If your employer offers a system like WellthCare™, which rewards verified preventive health actions with reward dollars at the WellthCare Store™ and automatic retirement contributions, jump on it. These programs work alongside your health plan and can cut out-of-pocket spending while building long-term wealth.

Step 6: Make Your Selections

Once you've decided, log into your employer's benefits system (Alight, Workday, or a dedicated portal). Follow these steps:

1. Enter personal info – confirm dependents and beneficiaries.
2. Select your medical plan – pick from the options you've reviewed.
3. Enroll in ancillary benefits – dental, vision, life, disability, HSA/FSA.
4. Review and confirm – double-check premium, deductible, contributions.
5. Submit – the system should generate a receipt. Save it.

If your employer offers a benefit system like WellthCare, you might need to complete a quick health action to activate rewards. It takes only a few minutes and can unlock reward dollars at the WellthCare Store and automatic retirement contributions that compound over time.

Step 7: Verify After Enrollment

A few weeks after your effective date, you should get new insurance cards (digital or physical). Make sure your doctors and pharmacies are still in-network. If you set up an HSA or FSA, learn how to file claims or use the debit card. If something's off, like a missing dependent or a wrong plan, contact HR immediately. Errors caught early are easier to fix.

Pro Tips

• Don't auto-renew blindly. Premiums, networks, and formularies change. Always review.
• Use comparison tools. Many portals have total cost estimators. Use them.
• Ask about preventive care. Under the ACA, many services are covered at $0 co-pay. Confirm yours.
• Maximize tax-advantaged accounts. Contribute the max to an HSA (if eligible) or FSA.
• Don't forget wellness incentives. Programs like WellthCare reward verified preventive health actions with Store dollars and automatic retirement contributions.

What If You Miss the Window?

If you miss the deadline, you typically have to wait until next year unless you experience a qualifying life event (QLE) like marriage, divorce, birth, adoption, death of a dependent, or loss of other coverage. Then you usually have 30 days to request a special enrollment period, or 60 days if the event involves Medicaid or CHIP. Contact HR immediately if a QLE happens.

Final Thought

Changing your benefits is a chance to manage healthcare costs and to make your health work for your financial future. Programs that link preventive care with retirement savings or reward dollars at the WellthCare Store turn routine health actions into real wealth. WellthCare automates verification of these actions through its patent-pending AI platform and clinician-reviewed plans of care, so rewards are earned securely. The best plan protects you when you're sick and rewards you for staying healthy. That's the future of employee benefits.