Health Insurance Open Enrollment

[Guest Karin]

I have a group that have a Flex Plan including the pre-tax Premium portion. They have 2 open enrollments a year for their health insurance. Their consultant want the specific regs that state an employer can have two open enrollments for their employees who are under the premium portion of the Flex Plan. Does anyone know where I can find the specific regs?

[Sandra Pearce]

There are no regulations requiring any open enrollments. Also, no regulations restricting the number of open enrollments. The Section 125 Plan Document should state clearly when changes can be made to elections and the underlying health plan rules (see that Plan Document) would dictate when the health plan allows open enrollments.

[GBurns]

Karin,

I think someone has this situation backwards. If any consultant or anyone looks at the plan or procedures etc that any client currently has in place, there are only two relevant conclusions that can or should be drawn, the client has a reason why the plan or procedure is in place or the client does not.

If the consultant etc thinks that the plan or procedure that the client has in place is not proper, then the onus is on that consultant etc to point out why they think that the plan or procedure is not proper. If he/she thinks that there cannot be 2 OEs per year let them state why.

[mroberts]

Just out of curiosity, why would the company have 2 open enrollments per year? Rates are standardly guaranteed for 12 months. If you're allowing employees to enter the plan mid-renewal, you will probably be experiencing adverse selection. Was the insurance carrier on board with the 2 open enrollment periods?