Changing Health Plans Mid-Year — Why You Need Another Open Enrollment

Many employers are surprised to learn that changing health plans during the year isn't as simple as signing a new contract.

Whether you're moving to a new carrier, an Association Health Plan, a Union Health Plan, a level-funded plan, or a self-funded plan, you'll typically conduct a brand-new Open Enrollment for your employees.

This is your opportunity to educate employees, collect new elections, and ensure everyone is properly enrolled before the new plan becomes effective.

A New Plan Means New Elections

Even if every employee intends to keep health insurance, they should complete new enrollment forms.

Why?

Because the new plan may include:

• Different provider networks
• Different deductibles
• Different copays
• Different prescription drug formularies
• Different employer contributions
• Different eligibility rules
• Different dependent information requirements

Never assume elections from your previous carrier automatically transfer.

Common Mid-Year Open Enrollment Mistakes

Assuming Employees Automatically Transfer

One of the biggest mistakes employers make is assuming everyone enrolled in the old plan will automatically appear in the new plan.

Most carriers, TPAs, and Association Health Plans require new enrollment forms or electronic elections.

Without completed enrollments, employees may experience delays in coverage.

Forgetting New Waivers

Employees declining the new plan should complete new waiver forms.

A waiver signed for your previous health plan generally does not satisfy the enrollment requirements of the new carrier or administrator.

Not Explaining Network Changes

Employees immediately want to know:

• Can I keep my doctor?
• Is my hospital still covered?
• Are my prescriptions covered?
• Do I need a new ID card?

Providing provider search tools and answering these questions before enrollment creates a much smoother transition.

Waiting Until the Last Minute

Changing health plans requires planning.

Employers should allow enough time for:

• Employee meetings
• Provider searches
• Enrollment completion
• Payroll updates
• ID card production

A rushed enrollment increases the likelihood of errors.

Forgetting Payroll Changes

New plans often have different employee contributions.

Payroll deductions should always be updated and verified before the new plan becomes effective.

Mid-Year Open Enrollment Checklist

• Schedule employee meetings.
• Explain why the plan is changing.
• Review provider networks.
• Discuss benefit changes.
• Complete new enrollment forms.
• Collect new waivers.
• Verify dependent information.
• Update payroll deductions.
• Confirm effective dates.

The Bottom Line

Changing health plans isn't simply about selecting a better carrier or funding arrangement—it's about successfully transitioning your employees.

A well-organized Open Enrollment ensures employees understand their new benefits, complete the proper paperwork, and begin coverage without delays.

Employers who treat a mid-year plan change as a new Open Enrollment experience far fewer administrative problems and create a much smoother transition for everyone involved.