Open Enrollment Season for 2025
Navigating health insurance can be overwhelming. Whether you are an employer, an employee, on COBRA, unemployed, shopping for health insurance for you and your family, retiring or planning for Medicare, you don’t want to miss your open enrollment opportunities. Below are important timelines, as we approach the health insurance open enrollment season. DDI is committed to help you evaluate your options and choose the coverage that best fits your company’s and/or your personal needs. Understanding your health coverage is more important than ever and DDI is here to help.
- Employer Group Plans: Open enrollment for employer groups is typically a month or two prior to the plan renewal date. Employers have the flexibility to choose their specific timeframe for allowing employees and their families to review their plan options and make elections. DDI helps to coordinate the process and is available to work directly with your employees to assist them with these important decisions. Majority of employer groups renew their benefits for a January 1st effective date. Renewals are typically available in October and November. DDI prepares all year for this busy season and our Account Managers look forward to working with you to review your options and coordinate a successful open enrollment. Click here to see a snapshot of the 2025 Oregon state rate filings for small employer plans (<50 employees) by the insurance carriers. The average overall increase for 2025 is +12.2% (+8.1% in 2024, +7.8% in 2023). The healthcare industry continues to face many challenges impacting cost including inflation, wage increases, increased hospital and provider costs, and expensive prescription drugs.
- Individual Health Insurance: Open Enrollment for 2025 is November 1, 2024, until December 15, 2024, to be effective 1/1/2025 (if that deadline is missed, a February 1, 2025, effective date is possible if enrolled by 1/15/2025). Plans and prices will be available to preview shortly before November 1. Click here to see a snapshot of the 2025 Oregon state rate filings.
- Medicare: Every year, Medicare’s open enrollment period is October 15- December 7. During this period Medicare beneficiaries can change their Medicare health plans and prescription drug coverage for the following year. Most people enrolled in Medicare don’t need to act, as their plans usually rollover. Insurance companies are required to send an Annual Notice of Change. If you are satisfied that your current plan will meet your needs for the next year, you don’t need to do anything. Not sure about Medicare? Register here for a free Medicare 101 Webinar to learn more, or watch a recent Medicare 101 webinar recording here.
It’s that time of year again!
Medicare D notice reminder
All employers, large and small, who offer prescription drug coverage are required to inform their employees and CMS if their prescription drug plan is Medicare creditable by October 15, 2024. This deadline is a result of the annual enrollment period for Medicare which is October 15 – December 7th each year. Even if you are unsure of Medicare eligibility it is recommended to provide this notice to your benefit eligible employees and their dependents. Please click here for the full explanation of the Medicare Modernization Act’s requirements as well as model notices of the required forms. Any members (including dependents) who are eligible or will be eligible within the next year for Medicare must receive the notice. Employers must also notify CMS via their online form as to whether their plans are or are not creditable.
**Please note: Due to the improved Medicare Part D coverage (in 2025 the annual out-of-pocket maximum for drug costs will reduce to $2,000 from $8,000) it is expected that more employer plans will not be creditable in 2025.
According to CMS:
This disclosure must be provided to Medicare eligible active working individuals and their dependents, Medicare eligible COBRA individuals and their dependents, Medicare eligible disabled individuals covered under your prescription drug plan and any retirees and their dependents. The MMA imposes a late enrollment penalty on individuals who do not maintain creditable coverage for a period of 63 days or longer following their initial enrollment period for the Medicare prescription drug benefit.
Click here to download the model notice letters you can customize and send to employees. If you are unsure whether your plan is creditable or not, please contact your health insurance carrier or DDI. Most carriers send notices to clients indicating if the plan was creditable. Also, you need to re-evaluate the creditability of your prescription plan if you make changes at your plan’s renewal and notify your employees accordingly.
Please Note: If you are a DDI Administration / Outsourcing client, we will send the letter to your employees on your behalf.
Please call us with any questions.
