How to Navigate Open Enrollment Like a Pro

How to Navigate Open Enrollment Like a Pro

Open Enrollment is a critical period for individual and families to review, choose, or make changes to their health insurance policies. Whether you’re a first-time enrollee or a seasoned participant, understanding the Open Enrollment period is essential for getting the right plan at the right time.

What’s Open Enrollment?

Open Enrollment is the period where individuals and families can enroll and make changes to their health insurance plan. Open Enrollment is an annual window that allows you to do things such as: switch plans, add dependents, make plan changes, and adjust coverage levels.

When Does Open Enrollment Occur?

There are a couple different Open Enrollment periods to note depending on which plans you’re enrolled in. For individuals and families, Open Enrollment period starts on November 1st and ends on December 15th. Any plan you select during this time is effective the following January 1st.

There’s also a separate Open Enrollment period, called the Annual Enrollment Period (AEP) for people specifically on Medicare. This Medicare annual period starts on October 15th and ends on December 7th. Again, any plan you select during this time is effective the following January 1st.

Review your Current Policy

During Open Enrollment, you now can review your current policy. You need to make sure to look at what your current policy’s benefits are going to be for the next plan year. Normally, an insurance company will send you a document known as an Annual Notice of Change (ANOC), where they give you a side-by-side comparison of your policy’s benefits for the current year and then the benefits for next year. It’s important when reviewing the ANOC document to look at the benefits that are changing. Changes to your policy could be minor changes to copays or major changes to plan benefits. If your policy has major plan changes for the worse, then it would be time to look at other policies to see if you could get better benefits. It’s important to note that plans change their benefits each year and so being able to review these options year after year is crucial to making sure your policy benefits fit your needs.

In addition to copays and coinsurances that could be changing from year to year, your prescription drug costs can also change. All insurance companies have formularies, which are lists are medications in which the insurance company assigns a certain “Tier” to each medication. Depending on which Tier a medication is, your cost-sharing for filling this prescription will change. Medications can change Tiers from year to year, so you must make sure to review your prescription costs as well as your medical benefits.

Change Plans if Necessary

Depending on how your benefits are changing, it may be time for you to switch policies for January 1st. If the benefit changes are minor, you might consider staying with your current policy. However, insurance companies, to keep up with their competitors, launch new products each year and it’s possible that these new policies might have better benefits than what you currently have.

When switching policies, you need to pay close attention to make sure your providers remain in the network of the insurance company you’re switching to and be aware of any negative changes to your prescription costs or copays. You should be able to find the information you need in a plan’s Summary of Benefits document, which explains the plan’s premium, deductible, out-of-pocket maximum, copays, coinsurances, etc.

 Seek Professional Guidance

If you’re unsure about which plan to pick during Open Enrollment, it would be a good time to contact a professional. Licensed insurance brokers stay up to date on the latest products on the market and can make sure you’re enrolled in the plan that most aligns with your needs and budget. Here at Vontell Insurance, we’re happy to help you look up your providers to make sure they’re in-network, estimate your prescription costs, review plans of varying benefit levels, and assist you in choosing the best plan for you. As always, all our advice is complimentary to you! Feel free to contact us this Open Enrollment either by calling (203) 375-7511 or emailing us at


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