OPEN ENROLLMENT BASICS
The dates Open Enrollment runs this year.
What is February 16–22?
The medical carrier for all medical plans this year.
Who is Cigna?
The amount an employee must pay before insurance starts sharing costs.
What is a deductible?
The benefit that includes annual eye exams and allowances for glasses or contacts.
What is vision insurance?
The single most important thing managers should remind employees to do before February 16.
What is make sure they can log into ADP?
The system employees must use this year to enroll in benefits.
What is ADP Workforce Now?
The plan with the lowest paycheck deductions but highest out-of-pocket risk.
What is the Bronze plan?
Doctors and facilities that cost less because they are contracted with the insurance carrier.
What is in-network?
The benefit that typically covers cleanings at 100%.
What is dental insurance?
An employee asks where they can see payroll deductions before confirming enrollment.
What is in ADP during the enrollment process?
This is the enrollment period when employees must log in and make selections or be assumed to decline coverage.
What is open enrollment?
The plan with the highest level of coverage and lowest deductible.
What is the Gold plan?
Annual checkups, screenings, and vaccines that usually cost $0 or have no copay, even before meeting your deductible
What is preventive care?
The program that offers discounted access to certain medical services such as med spa, massage, botox, weight management, and acupuncture outside of insurance.
What is the Beyond Med Discount Savings Program?
An employee wants medical coverage but forgets to log into ADP. What happens?
What is they will not be enrolled?
What happens if an employee does nothing during Open Enrollment.
What is they are assumed to be declining coverage?
The type of medical plan offered that does not require referrals.
What is a PPO plan?
The set dollar amount paid for a doctor visit, such as $30 for primary care.
What is a copay?
The program that offers discounted access to certain medical services such as med spa, massage, botox, weight management, and acupuncture outside of insurance.
What is the Beyond Med Discount Savings Program?
An employee asks if they need a referral to see a specialist. What do you say?
What is no, because it’s a PPO plan?
This is the term for the amount deducted from an employee’s paycheck to pay for insurance coverage.
What is a premium?
This document explains what a plan covers, what it costs, and key coverage examples in a standardized format.
What is a Summary of Benefits and Coverage (SBC)?
If an employee enrolls outside of Open Enrollment due to marriage, birth, or loss of coverage, this is called what?
What is a qualifying life event (QLE)?
The benefit designed to help offset out-of-pocket medical costs.
What is GAP coverage?
An employee asks, “I don’t want medical insurance, but I do want dental. Is that allowed?”
What is yes, employees may elect dental without enrolling in medical?