Labor and Employment

Health Care Reform Changes Open Enrollment

  • Open enrollment lets many employees make changes to their employer-provided benefit plans
  • The new health care reform laws will make some things very different in 2010's open enrollment
  • Know what you can do to get the coverage you and your family need


For many workers in the US, early Fall means open enrollment, that once-a-year opportunity to make changes to their employer-provided insurance benefits. In 2010, the process will be much different than before because several provisions of the new health care reform law go into effect this year.


Many of the major changes contained in the health care reform laws don't go into effect until 2014. For example, in that year, you'll have to buy insurance or pay a fine, most employers will have to offer their employees insurance, and insurers won't be able to deny anyone coverage because of pre-existing conditions.

Nonetheless, some parts of the new reform law go into effect on September 23, just in time for open enrollment:

  • Insurance companies can't refuse coverage to employees' children who have pre-existing conditions
  • Employees must be given the chance to cover their children who are 26 years old and younger
  • Insurance plans can't set lifetime limits on essential benefits, such as emergency services, hospitalization, maternity and newborn care, prescription drugs, and preventive and wellness services, like routine physicals and cholesterol screenings
  • Plans can't charge co-pays, or make employees pay deductibles, for essential benefits

What It Means

For one thing, the changes should make better health insurance coverage available to many workers and their families. There are costs, though. For example, in all likelihood, most employees will have to pay more for their coverage. Employers need to make a lot of new things available, and they cost money. So, the expenses will be passed on to the employees.

Also, if you enroll in a health care (or medical) savings account (HSA/MSA) or flexible savings account (FSA), or some similar plan, you won't be able to use that money for over-the-counter medications after December 31, 2010. Unlike in years past, you'll have to pay for them out-of-pocket with after-tax dollars.

For some employers there's an upside right now. If you have fewer than 25 employees and provide health care insurance, you may qualify for a small business tax credit of up to 35 percent of your premiums to help offset the cost of your insurance.

What You Can Do

If you haven't heard from them yet, contact your human resources department and ask about the details of open enrollment. You can get a lot more information about these and other changes made necessary by the health care reform law.

Here a few other things to consider:

  • If you have a pre-existing condition and don't have insurance or if your employer doesn't offer it yet, see if you can get insurance through your state's high-risk insurance pool or Pre-Existing Condition Insurance Plan (PCIP)
  • If your child has a pre-existing condition and is under 19, contact your insurance company on September 23 and get details on how to add her to your coverage and how much it will cost
  • Look carefully at the family budget and any recurring or expected medical expenses to see how changes in your employer's benefit plan will impact you

There's no question that health care coverage is important, even for healthy people. The changes to employer-provided health care plans brought about by the health care reform law may make it easier for you and your family to get insurance coverage.

Questions for Your Attorney

  • Can I take a tax deduction for health care insurance premiums I pay at work?
  • Can an insurance company "stall" when it comes to adding my child with a pre-existing condition to my insurance policy? How long should it take?
  • Can my employer suddenly decide not to offer health insurance all together?
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