Life Prerequisites: Your Guide to Open Enrollment Season

For the majority of U.S. companies, November is when open enrollment occurs. Open enrollment encompasses a selection of workplace benefits, typically a variety of health, vision, dental, life, disability, and even pet insurance. 

To help prepare you to select your workplace benefits for the upcoming calendar year, we’ve highlighted five FAQs that come up when considering which benefits are right for you and your family.

What is a deductible? 

A deductible is the fixed dollar amount that an employee must pay before the healthcare plan starts reimbursement. For example, if you have a $500 deductible, you would be responsible for paying that amount before your insurance kicks in. A high-deductible plan offers lower monthly payments, but can also be riskier if unexpected health issues pop up. 

How much life insurance do I need?

While no one likes to think about death, life insurance can give you peace of mind, knowing that those who depend on you will be financially taken care of. To get an idea of the amount of life insurance you should carry, use NerdWallet’s life insurance calculator.

What is the difference between an FSA and an HSA? 

A Flexible Spending Account (FSA) and a Health Savings Account (HSA) can help you set aside money for healthcare-related expenses. If you elect to start an FSA during open enrollment, you’ll determine the amount you’d like to set aside from your pay to use on IRS-qualified healthcare expenses. These contributions must be spent by the end of the year. An HSA is available to those with an IRS-qualified high deductible plan and allows you to contribute incrementally throughout the year, up to an annual maximum. FSAs are employer-sponsored, so if you switch employers, those funds won’t follow you. HSAs are investable and stay with you through retirement. 

What is in-network vs. out-of-network? 

According to Cigna, most health plans provide access to a network of doctors, facilities, and pharmacies. These doctors and facilities must meet certain credentialing requirements and agree to accept a discounted rate for covered services under the health plan in order to be considered in-network. If a medical care provider doesn’t have a contract in place with your benefits provider, they are out-of-network and can charge full price. Before going to an appointment, ask them to review your coverage to determine if they are in- or out-of-network.

What classifies as a Qualifying Life Event (QLE)? 

A change in situation can make you eligible for a special enrollment period, allowing you to elect benefits outside of the annual open enrollment period. QLEs include:

• Loss of health coverage, including turning 26 and losing coverage through your parent’s plan 
• Changes in household (for example, a change in marital status, adopting or having a baby, or death in the family) 
• Changes in residence 
• Becoming a U.S. citizen 

Want to dive deeper into all things healthcare? Check out healthcare.gov for tips on finding coverage, selecting plans, and more!