WHY THIS MATTERS
This is one of the most costly and stressful post-OE cleanup issues. It impacts everything from payroll deductions to employee trust.
WHAT GOES WRONG
- Incorrect payroll deductions (too high or too low)
- Employees think they’re enrolled in one plan but are enrolled in a different plan or not enrolled at all
- Can cause employee lack of confidence in the org as a whole
- Legal and compliance risks in case of claims without proper coverage
ROOT CAUSE
A lack of proactive checks between what the enrollment system thinks or wants to happen and what the carrier actually recorded. This gets worse with:
- Grandfathered plans
- Passive enrollments
- Carrier changes
- Systems that don’t talk to each other in real time
HOW TO FIX IT
- Run monthly audits comparing enrollment system volumes to carrier records
- Flag and correct mismatches in coverage tiers and volumes before OE starts
- Track and document grandfathered coverage levels outside the system (especially if not supported by the system)
- Implement a structured OE QA checklist
Want to avoid costly surprises during Open Enrollment? We can help. Let’s connect.
