ATLANTA—Insurance Commissioner John W. Oxendine urges consumers who are part of a group health plan to be prepared to make the right choices during health insurance open enrollment.
“It’s the time of year when many companies across the country hold open enrollment periods for their group health insurance plans,” Oxendine said. “Consider the options carefully to be sure you and your family are properly covered.”
Open enrollment refers to the period of time during which all members of your group health insurance plan have the opportunity to enroll in certain benefit programs. During this period, insurance carriers are required to accept all applicants of the group without underwriting or evidence of insurability. Open enrollment is generally only held once a year, so if you miss it, you likely will not be able to enroll in your employer-sponsored health insurance program until next year. Certain exceptions apply for new employees or employees with life-changing events.
Make sure to check with your human resources department to see when your company’s open enrollment period begins and ends, and when your policy goes into effect.
There are many different types of major medical plans typically offered by employers. For help understanding the fundamental differences between preferred provider organizations, health maintenance organizations, point of service plans or indemnity plans, visit www.oci.ga.gov/
publicInformation/healthInsuranceFAQ.aspx.
Before making a choice:
• Check to see if your current physicians and area hospitals are in the plan’s network. Using network providers generally will save money on your health care.
• Check to see if spouses or dependents are covered. Some plans will cover spouses and other dependents, while other plans will not.
• Read all of the plan materials thoroughly. Doing so will tell you what your rights and responsibilities are under each plan.
• Review any pre-existing condition exclusions and prior authorization requirements in the plan materials.
• If you take prescription medications, check them against the list of approved drugs in each plan booklet.
• If any part of a plan is unclear to you, ask for help from your human resources department or the insurance carrier.
• If you are not satisfied with the answers to your questions, contact Oxendine’s Consumer Services Division for help and advice at 1-800-656-2298.
In this uncertain market, it’s important to carefully evaluate your health care costs when making your annual enrollment decisions. While one option might have high monthly premiums and a low deductible, and another might have a low premium but more out-of-pocket expenses, it could be misleading which plan is best for you until you do the figures.
To pick the best coverage, first calculate your healthcare costs from recent years and try to estimate what your costs might be for the coming year. Don’t forget to include the cost of doctor’s visits, daily medications and any procedures you might be planning.
