SPDkim

I could see the private rooms requiring pre-authorization, but don't see why the rest would need pre-auth. And prior auth is never required for emergency room visits, per the No Surprises Act.

Not a requirement, but definitely best practice. It's likely that your plan offerings change every year--either options, covered benefits, cost sharing or premium costs--so it's important that your employees take the opportunity annually to make sure their elections still make sense for them. In addition, the enrollment process gives you as the employer an opportunity to verify dependent information, which may be needed for ACA reporting and/or spousal surcharge administration. Annual enrollment is the one time a year that almost every employer communicates about benefits (never mind that it should be a year-round exercise). Forcing an active election will also encourage more employees (and their families!) to review any and all information you can provide them about their benefits package and how to use it effectively--and these days, anything we can do to improve health literacy and health insurance literacy, the better off we all (employers and employees alike) will be.