BENEFITS DIGEST

Jimmy Nesbitt’s roundup argues open enrollment goes better when communication runs all year, with employee resource groups feeding input, clear explanations of plan and cost changes, and a feedback loop afterward. The timing survey it cites about when to send enrollment messages reflects one vendor’s data rather than a universal ideal. Track employee questions, understanding and subsequent use of benefits, rather than treating completed enrollment forms as proof that the communication worked.

Fisher Phillips assembles an open-enrollment checklist that runs from eligibility and the ACA offer requirement through prospective section 125 elections, required disclosures, and enrollment access for employees on FMLA leave or COBRA. The guide collects the 2027 dollar limits announced so far, including HSA figures the article sources to Rev. Proc. 2026-24, and flags the figures still awaiting announcement. The guide’s process reminder is that plan terms, cafeteria-plan rules and enrollment communications have to agree, and that the carrier does not handle compliance by default.

Open enrollment tests whether benefit documents, payroll systems, vendor arrangements and employee communications agree. Mitratech’s Angela Surra recommends starting preparations well before enrollment opens, confirming responsibilities and checking the notices and eligibility information employees will receive. The article treats the process as an opportunity to find inconsistencies that a last-minute communication campaign can miss. Employers still need to distinguish their own preparation schedule from the actual deadlines attached to particular notices and plan requirements.

Employees need help understanding their benefits before open enrollment begins. Employee Benefit News highlights employers that provide education throughout the year, giving workers more time to weigh their choices. The need is substantial. Alera Group reports that 84 percent of employers saw premium increases, while Prudential found that only 38 percent of employees feel confident navigating enrollment. Solidarity Health Network’s CEO projects per-employee premium increases above 8 percent for 2027, with increases of 15 to 22 percent in some markets.

KFF’s annual explainer lands ahead of Medicare open enrollment, which runs October 15 through December 7. Beneficiaries with employer or union retiree coverage can lose it permanently by switching between traditional Medicare and Medicare Advantage, because many employers offer retiree benefits exclusively through one or the other. Sixty-five percent of beneficiaries did not compare options during the last enrollment period. For 2027, the average beneficiary will have 35 Medicare Advantage plans to choose from. On the drug side, the Part D out-of-pocket cap reaches $2,400, and the new GLP-1 Bridge Program offers $50 monthly copays for weight-loss coverage outside Part D. The brief also notes that roughly 32,000 current beneficiaries are set to lose eligibility starting in 2027 under the reconciliation law’s immigration provisions.

The number that frames the season comes from Alera Group’s annual employer benchmark. 84 percent of employers reported premium increases, up from 81 percent last year, and 34 percent of those saw spikes of 11 to 20 percent, making this one of the steepest renewal cycles in years. Alera’s Nicole Negvesky says the notable pattern is employers absorbing the increase rather than passing it to employees, then layering on supplemental products, accident, critical illness, cancer and long-term care coverage, to blunt out-of-pocket exposure under higher-deductible designs. Her warning is that those products only earn their premium if employees know they exist and when to use them, which argues for year-round communication instead of a two-week enrollment sprint, and for communications that say plainly how each program pays off and how to reach it.

Roberts Disability breaks down Wright v. Hartford, a Kentucky federal decision with an uncomfortable fact pattern. After her divorce, an employee called her employer’s benefits line to ask what to do and was told she could not stop her dependent life election until open enrollment and that the coverage would stay in force. Premiums kept coming out of her paycheck. When her former husband died, the claim was denied because the policy defines a spouse as someone not divorced from the employee, and the employer refunded the premiums while acknowledging the bad advice. The court dismissed everything at the pleading stage. Coverage ended at divorce under the plain policy terms regardless of the continued deductions. The court also rejected the employee’s other claims for relief. Under the legal rules it applied, the employer’s incorrect advice did not override the policy’s clear terms, and the premiums had already been refunded. The employer escaped liability, but the lesson for sponsors is about the phone line. A wrong answer at a qualifying event did not create coverage here, and it did create two years of litigation.

EBN’s award-winner roundup is a working catalog of enrollment season tactics from benefits managers at LandCare, BMO, Koch, Aflac and a handful of nonprofits. The common thread is retiring the two-week crash course in favor of year-round education, so enrollment becomes, in one manager’s phrase, a confirmation of informed decisions. Koch uses data to place its on-site enrollment events and tracks selection remorse as the thing to minimize, the University of Pittsburgh targets communications by age, tenure and enrollment history instead of one-size-fits-all blasts, a Louisiana health system is building its campaign around new state pharmacy laws that change what employees pay per fill, and a nonprofit set a measurable goal of a 5 percent increase in dependent care FSA enrollment. Aflac’s benefits chief supplies the market datapoint, with supplemental insurance offered by 31 percent of employers while 95 percent of employees call it essential.

KFF’s updated tracker counts 11 carriers announcing full or partial exits from the ACA marketplaces for 2027 against six entering new states. Cigna is the headline departure, leaving the individual market in all 11 of its states after reporting more than 350,000 on-exchange members in the first quarter. KFF ties the retrenchment to the expiration of the enhanced premium tax credits at the end of 2025, which already cut sign-ups by more than a million between the 2025 and 2026 open enrollments, shrinking the market and likely worsening the risk pool as healthier enrollees drop first. Employers feel this indirectly but concretely. Fewer individual-market options can make employer-funded individual coverage less attractive, narrow the alternatives for departing employees weighing COBRA, and raise the stakes of the subsidy fight Congress has not resolved.

Seventy-three percent of companies told the Business Group on Health that use of mental health and substance-use services rose in 2025. One response profiled is the crisis receiving center, a walk-in emergency room for behavioral health whose operator says 65 percent of patients who would otherwise wait for an inpatient bed can be stabilized and discharged with a plan within 24 hours. The article also examines employees' fear of being judged (48 percent worry colleagues would), recovery apps entering benefit menus, and a recommendation to introduce new mental health benefits off-cycle, away from the noise of open enrollment.

A Q&A on why employees pick the wrong plan: they shop by per-paycheck deduction and miss the drug-tier copays, coinsurance, and employer HSA contributions that decide actual cost. The advice is simple and travels well. Compare what each plan would cost for the care you actually use, and check that your doctors and prescriptions are covered. A familiar insurer's name doesn't guarantee a familiar network, a trap the piece calls incumbent bias.

Progyny's chief human resources officer argues that employees need help understanding their benefits throughout the year. A new child, an aging parent, or a chronic condition can make a benefit relevant long after open enrollment ends. She urges employers to judge their communications by whether employees can find and use the help they need, rather than by enrollment totals or email open rates.

Federal oversight of the ACA marketplaces just escalated sharply. In late August, CMS canceled about 315,000 policies covering more than 760,000 people, roughly 4 percent of marketplace enrollment, after concluding the enrollments were unauthorized, and it plans to investigate 440,000 more. An interim final rule published September 23 then froze new agent and broker registrations for the federally facilitated marketplaces for the 2027 plan year, a moratorium expected to run to February 1, 2027. CMS expects to recover about $2.2 billion in advance premium tax credits, and enrollees who did not answer a 30-day verification request lost coverage, which Morgan Lewis notes has stakeholders asking whether legitimate enrollments were swept in. Employers are not directly regulated here, but a tightened individual market changes the fallback for COBRA-eligible workers, part-timers, and early retirees, with open enrollment starting November 1.

Two benefits deadlines are approaching. Health plans with prescription drug coverage must tell Medicare-eligible individuals before October 15 whether the coverage is creditable, meaning expected to pay, on average, at least as much as standard Medicare prescription drug coverage, so recipients can decide about Part D during Medicare open enrollment, which runs October 15 through December 7. Because employers rarely know which spouses and dependents are on Medicare, Venable recommends simply sending the notice to everyone enrolled in or eligible for the health plan, using the CMS model notices. The separate online disclosure to CMS is due within 60 days after the plan year begins. October 15 is also the extended Form 5500 deadline for calendar-year plans that filed a Form 5558 extension by July 31.

KFF's refreshed polling lands as open enrollment season starts, and the numbers explain what employees are feeling. Health care costs top the list of family financial worries, ahead of housing, food, and utilities, with 27 percent of adults very worried about affording care. About 28 percent skipped or postponed care in the past year because of cost, 22 percent had problems paying medical bills, and 43 percent did not take medication as prescribed for cost reasons, including 19 percent who cut pills in half or skipped doses. For benefits teams writing open enrollment communications, this is the context employees bring to every premium and deductible number.

CMS has paused new agent and broker registrations for the federal ACA exchanges through February 1 and canceled coverage for more than 760,000 people it says were enrolled without authorization. New brokers make up 11 percent of the field but drew 30 percent of compliance terminations for the 2026 plan year, per the agency, which has sent termination notices to more than 200 agents and brokers since January. Existing agents must re-verify their identities, and a new HHS anti-fraud group will meet regularly. A trade group for insurance professionals calls the blanket freeze "a blunt and inappropriate response" that could thin broker capacity during open enrollment. Employers that reimburse workers for individual health insurance through an ICHRA should consider whether these changes affect the brokers their employees use. Workers who buy marketplace coverage should also check their enrollment status before open enrollment.

Open enrollment is not landing with the youngest employees. An Empower study of more than 1,000 workers found only 44 percent of Gen Z and 50 percent of millennials navigate the process successfully. The practical fixes come from benefits consultant Jennifer Schaefer. Assume no baseline understanding and explain terms from scratch, with real-world cost examples. Make plans easy to compare. Test whether the enrollment technology is actually intuitive, and ask employees what they value instead of building the strategy on assumptions. Her broader point travels beyond one generation, since a process rebuilt to be easier for the newest hires gets easier for everyone.

The fourth quarter calendar for health and welfare sponsors, in one place. October 2 brings QSEHRA and ICHRA notices and Medicare Part D subsidy applications; October 15, creditable coverage notices and extended Form 5500s; December 15, summary annual reports for extension filers; December 29, the employer share of MLR rebates within 90 days of receipt; December 31, gag clause attestations plus WHCRA and Section 1557 notices. A companion checklist covers open enrollment materials—SBCs, Michelle's Law, HIPAA notices, wellness alternative standard disclosures—and the state assessments landing this quarter, from Massachusetts payor assessments to Washington's long term care tax.

An argument that menopause is a benefits design problem, not an awareness problem: $1.8 billion a year in lost productivity, roughly 6,000 U.S. women reaching menopause daily, and a Mayo Clinic finding that 13 percent experienced an adverse work outcome from symptoms. With the FDA's removal of the warning that long discouraged hormone therapy now driving demand—and a shortage of estrogen patches—direct to consumer vendors are rushing into the gap, some initiating hormone therapy without a physical exam or mammogram. The prescription is integrated primary care built into the plan rather than point solutions, with Rhode Island's first-in-the-nation menopause accommodation mandate a sign of where this is heading.

The sources converge on one design principle—keep a human in the loop and make access to a counselor a standing choice rather than an escalation. Gallagher's Robby White urges advisers to steer employers toward communications, decision support, and navigation first, inside a governance framework that is transparent about what data the tools use. Collective Health's Ali Diab says autonomous agents making healthcare decisions are not here yet, though the direction is set.

An opinion piece argues AI's best use in open enrollment is taking over the repetitive administrative work so benefits teams can spend their time actually helping people, citing research that only 69% of employees feel they understand their medical benefits. The pitch is efficiency in service of the human conversation, not a replacement for it.

MetLife's president of U.S. business makes the case that improving employees' benefits literacy leads to smarter choices for their health and financial wellness, an argument for personalized decision support as employers look for ways to get more from every premium dollar.

Collective Health's Jacque Ludwig on how employers can drive engagement and make benefits easier to navigate as open enrollment season approaches.

Employees say cost, complexity and relevance are getting in the way of benefits value, according to Prudential's latest research, which outlines what that means for employers.

As artificial intelligence continues to move into the mainstream, opportunities abound for eliminating confusion, personalizing content and improving outcomes.

Experts says plan sponsors should be transparent and should address healthcare costs head-on.

Discover practical open enrollment communication strategies that help employees understand options, make informed decisions and take action.