2023 Open Enrollment Season Compliance Reminders
Open Enrollment Season for 2023
Healthcare continues to be top of mind, especially in these times. Whether you are an employer, an employee, on COBRA, between jobs, 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 looks forward to working with you to review your options and coordinate a successful open enrollment. Click here to see a snapshot of the 2023 Oregon state rate flings for small employer plans (<50 employees) by the insurance carriers. The average overall increase is +7.8%, with Providence and Kaiser leading as most competitive.
- Individual Health Insurance: Open Enrollment for 2023 is November 1, 2022, until December 15, 2022, to be effective 1/1/2023 (if that deadline is missed, a February 1, 2023 effective date is possible if enrolled by 1/15/2023). Plans and prices will be available to preview shortly before November 1. Click here to see a snapshot of the 2023 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 take action, 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.
Oregon Paid Family and Medical Leave Insurance
Payroll Deductions Begin Jan. 1, 2023 / Waiver Requests due by Nov. 30, 2022
ORS 657B was enacted in 2019, creating a Paid Family and Medical Leave Insurance (PFMLI) program housed within the Oregon Employment Department.
Funded by a shared, 1% employer/employee payroll tax (0.60% employee/0.40% employer) that begins 1/1/2023, the program will begin covering claims on 9/3/2023. All employers with 25 or more employees, including part time employees, must participate unless they offer an “equivalent” leave plan approved by the Employment Department, which will begin accepting equivalency applications from employers in October 2022. Several insurance carriers plan to offer leave products (voluntary plans) that would allow employers to waive the state program. Small employers (24 or fewer employees) may choose to opt into the program. The rules of the program are still being established, and more details will be provided in the coming months. Your DDI team is available to help you navigate the new program and review your options. For more details about the program, please read below and/or reach out to you DDI Account Manager.
The PFMLI program provides employees with compensated time off from work to care for and bond with a child during the first year of the child’s birth or arrival through adoption or foster care; to provide care for a family member who has a serious health condition; to recover from an employee’s own serious health condition; and to take leave related to domestic violence, stalking, sexual assault, or harassment (safe leave). Click HERE for an FAQ. To waive the state plan, which begins contributions 1/1/2023 and benefits 9/3/2023, an employer must submit a request for approval of an equivalent private plan by November 30th. The Employment Department will begin review in October 2022. Click HERE for more information.
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, 2022. 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.
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.
Medicare Disclaimer: We do not offer every Medicare plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.
Information provided in part by The Standard and is for informational purposes only and should not be relied upon for tax or specific legal advice. Further, this information may or may not reflect the most current legislative or regulatory PFML requirements.
