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Open Enrollment: Your sound, all-encompassing insurance coverage check-up awaits

Updated: Nov 20, 2023

It’s the time of year when the leaves are colorful, the costumes are loud and the holidays stare us down like a frightful beast. It’s also the season of open enrollment. Depending on the type of coverage that you have (private employer-sponsored, Medicare, Marketplace/self-purchased plans), this annual process may already be underway. Regardless, it should not be overlooked.


Likewise, open enrollment presents an opportunity to also review the status of other insurance premiums and coverages and additional benefits that you may have or be eligible for from your employer – not “just” the health of your health insurance. Yes, everything flows from protecting your health, but this is not the only facet of life that needs protecting. Furthermore, the investments that represent other coverages can have an outsized effect on your overall wellbeing and quality of life, too.


But first: The health insurance “check-up”


Resist the biggest error that most people make, which is not doing anything at all. In a poll conducted by independent health policy researcher, KFF, 58% of those surveyed experienced problems using the insurance that they pay for and reaping the benefits that are due to them over the past year alone.


These problems included:

  • Denied claims

  • Issues with provider networks

  • Pre-authorization challenges

Of those respondents who confirmed problems with their insurance, half of them said that their issues were never resolved in a satisfactory manner. In fact, this lack of a successful conclusion led to one in six individuals not getting the care that they needed as a direct result – with 15% noting a decline in their health status and almost three in 10 (28%) saying that they had to pay more than anticipated for care as a direct result of languishing insurance issues.


Fortunately, open enrollment presents a time to make sure that the coverage fits you, your needs, situation, and financial circumstances like a glove. You do not want to be “stuck” for another 12 months with coverage whose benefits really aren’t beneficial to you. A plan may no longer serve you well due to, for instance, changes in your health over the past year – additional comorbidities that require services and medication that may not be covered or properly covered by your current plan.


When putting your finger on the pulse of the current state of your health insurance coverage, your friends at O’Donnell, Ficenec, Wills & Ferdig urge you to:


  • Take stock of any communications that you may receive related to your plan and potential changes in the coming year.

  • Be sure to review these communications right away. Don’t let them sit on a shelf. Time will not be on your side, as there are deadlines to make changes. Hasty, last-minute planning rarely results in smart decision-making.

  • Notably, take a look at that plan notice. Any letters regarding annual notices of changes should be scrutinized. Will the drugs that you need still be covered? Are the doctors and medical providers that you visit no longer in your network? How have co-pays changed? Or deductibles? These are all questions that must be considered and answered now rather than later to avoid encountering costly and stressful surprises.

  • Be an active consumer. As a consumer, you can “shop around” for coverage that is money-saving and better suits you and the needs of your family. Increasingly, there are transparent tools online to compare different plans.

  • Resources are also available at respective sites, such as Medicare.gov and Healthcare.gov. Use the information and “chat” that may be available at your fingertips. When in doubt, enlist the help of a professional! You do not want to be so overwhelmed by choice that there is paralysis in your action. Here again, there is only so much time to finalize and make changes “official.”

  • Also, you may be eligible for savings on premiums or even other money-saving programs and not even realize it! Here is a good starting point and, depending on your personal situation, a SHIP (State Health Insurance Assistance Program) counselor may be able to aid you in securing support with premiums, hospital insurance, medical insurance, coinsurance, copayments, prescriptions, and so on.

  • Make the most of Health Savings and Flexible Spending Accounts (HSAs and FSAs). These accounts can be used to cushion the costs associated with the likes of plans that have high deductibles. HDHPs have become increasingly common, and reportedly account for nearly 56% of plans that American private-sector workers are enrolled in – a record-shattering figure. More information on HSAs and FSAs and their tax benefits can be found here.

The insurance “big picture”


Due to the comprehensive services and expansive expertise available at OFWF, our team is constantly observing and pinpointing patterns, and making linkages between different “buckets” or areas of our clients’ lives. For instance, we can clearly link how a client’s estate planning must be accounted for when also embarking on business succession and transition plans.


Similarly, let this open enrollment season be an opportunity to gauge the relevancy and appropriateness of certain plans that transcend the health insurance space. You may want to consider changes to property and casualty insurance coverage, a particularly volatile corner of the market that has seen unprecedented spikes in the cost of premiums in recent years and months.


Changes in your life and circumstances, notably, can drive the need for greater coverage or new plans, and may also lead to your being eligible for savings such as special discounts. Just a few of the changes that underscore the need your current auto, home, renters, fire, flood, and other policies include:

  • Marriage

  • New dependents/children

  • New drivers in the household

  • Retirement

  • “Major” purchases

  • Buying, selling properties

  • The addition of pets to the household

  • Job changes

Everything from installing an anti-theft device and owning a hybrid care, to paying off a loan and remaining “accident-free,” can affect your premiums and any savings related to the cost of owning a car and other vehicles. Likewise, everything from recent remodels and additions to installation of security services and the introduction of a “home office” can affect premiums and potential savings associated with the cost of home ownership.


Of course, insurance coverage is an important employee benefit. But it is also just one part of your employee benefits package. Seize this open enrollment season to conduct a personal “audit” of one’s 401 (k) contributions (are you properly taking advantage of contribution limits and catch-up contributions as applicable?). Or, take a hard look at any “old” 401 (k) accounts that may be due for a roll-over from your old employer’s to your current employer’s plan. As partners in your financial health, our team is also here for you to take a deeper dive at elements like beneficiary considerations and updates, asset allocation and portfolio “rebalancing,” and your overall budget and time horizon.


Savings in the current environment can seem daunting. But it’s not impossible, especially with a little foresight, built-in cushion to address upcoming deadlines smartly, and trusted help and guidance from the professionals at O’Donnell, Ficenec, Wills, & Ferdig.

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