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What is an open enrollment period?

What is an open enrollment period?

An open enrollment period is a window during which individuals and employees may enroll in health insurance or make changes to their coverage.

For employer-sponsored coverage, the open enrollment period is generally the only time that employees can drop their coverage, whereas, in the individual market, people can drop coverage at any time during the year. But in both cases, open enrollment is the only time that people can sign up for a plan, or switch to a different plan, unless a special enrollment period is triggered by a qualifying event.

When is open enrollment?

General open enrollment in the individual market (both on-exchange and off-exchange) runs from November 1 to December 15 in most states, although states that run their own exchanges have flexibility with this and tend to offer longer enrollment windows.

You can learn more in our comprehensive guide to individual market open enrollment.

Employers can set their own open enrollment windows, so although it’s common for them to occur in the fall, they vary from one employer to another.

Medicare also has an annual open enrollment period in the fall for Medicare Part D and Medicare Advantage, as well as an open enrollment period at the start of the year for people who are already enrolled in Medicare Advantage.

You can learn more in our comprehensive guide to Medicare open enrollment.

When will my coverage take effect if I sign up during the open enrollment period?

In the individual market, most plans will take effect on January 1. This applies to everyone who enrolls between November 1 and December 15, which is the full open enrollment period in most states. But in the states that have extended open enrollment periods, coverage can take effect on February 1 or even March 1, depending on the state and the date that you enroll.

When Medicare beneficiaries make changes to their coverage during the fall open enrollment period, the new plan will take effect January 1. But if Medicare Advantage enrollees make changes to their coverage during the Medicare Advantage open enrollment period (January – March each year), the new plan will take effect the first of the month after the change is made.

If you enroll, disenroll, or make changes to your coverage during your employer’s open enrollment period, they will take effect on the first day of your employer’s plan year. In most cases, this is set up to correspond with the calendar year, meaning that the plan year starts on January 1. But some employers have plan years that do not follow the calendar year, so you’ll want to carefully read the information that your employer gives you during the open enrollment period.

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