Open Enrollment (OE) is one of the most critical times of the year for HR managers. With multiple deadlines, compliance requirements, and employee communications all happening at once, preparation is key. At Clarity, we understand the challenges you face — and we are here to help. That’s why we’ve created this Simply Smarter OE Checklist: a step-by-step guide designed to provide Clarity to the process and ensure nothing falls through the cracks.

Mark Your Key Dates: Lock in Deadlines

• Create a central OE calendar with IRS filing deadlines, carrier cutoffs, COBRA election deadlines, and employee notice requirements.
• Confirm submission windows for rate changes, eligibility feeds, and enrollment file transfers with carriers & vendors.
• Note deadlines for ACA reporting (1094/1095), PCORI fees, and Form 5500 (if required).
• Build in buffer days for payroll, data validation, and employee communication review.
• Clearly outline employee deadlines for elections/changes, dependent verification, and grace periods.

Update Plan Documents

• Confirm annual limits (FSA, HSA, Transit, Parking) reflect IRS updates.
• Validate waiting periods, part-time classifications, and seasonal/temporary worker policies.
• Ensure Summary Plan Descriptions (SPDs) and Section 125 POP documents are updated and distributed on time.
• Confirm required notices (ERISA, HIPAA, WHCRA, CHIPRA, Medicare Part D) are current and distributed.
• Verify continuation coverage updates (COBRA & state) align with federal/state mandates.
• Double-check pre-tax deductions are mapped correctly into payroll and W-2 reporting.

Prep Employee Communication

• Plan multi-channel communication: emails, live meetings, webinars, portal/mobile app guides.
• Use plain language summaries for FSA rollover, HSA contributions, commuter benefits, and COBRA continuation rights.
• Prepare custom FAQs addressing common employee pain points.
• Include compliance disclosures in OE packets (SBC, HIPAA, Medicare Part D).
• Confirm communications are ADA compliant, mobile-friendly, and available in required languages.
• Provide a feedback loop for employee questions (dedicated email, HR portal, or office hours).

Run a Compliance Check

Confirm notices, filings, and ACA reporting are aligned. No surprises later.

ERISA (Employee Retirement Income Security Act)

• Provide Summary Plan Descriptions (SPDs) to all participants within 90 days of coverage (and every 5 years if amended, or every 10 years otherwise).
• Distribute Summary of Material Modifications (SMMs) within 210 days after the plan year in which a change was adopted.
• Maintain written plan documents that comply with ERISA disclosure and fiduciary requirements.
• Ensure fiduciary responsibilities are documented (plan assets must be handled prudently and solely in the interest of participants).
• Maintain required ERISA disclosures and notices (e.g., claims procedures, HIPAA notice of privacy practices, Women’s Health and Cancer Rights Act, CHIPRA notice).

Section 125 POP (Premium Only Plan)

• Have a written Section 125 Plan Document (cannot be retroactive).
• Ensure elections are made before the start of the plan year and follow irrevocability rules (unless there is a qualifying life event).
• Perform nondiscrimination testing annually (eligibility test, contributions/benefits test, key employee concentration test).
• Distribute an updated Summary Plan Description (SPD) to participants.
• Confirm pre-tax deductions are correctly reflected in payroll and W-2 reporting.

COBRA (Consolidated Omnibus Budget Reconciliation Act)

• Provide General COBRA Notice to covered employees and spouses within 90 days of plan coverage.
• Provide Qualifying Event Election Notice within 44 days of the qualifying event.
• Track and monitor maximum coverage periods (18, 29, or 36 months depending on the event).
• Ensure accurate COBRA premium calculations (including 2% admin fee).
• Maintain COBRA recordkeeping (proof of notices sent, elections made, payments received).
• Offer Open Enrollment opportunities to COBRA participants.

ACA (Affordable Care Act)

• Determine Applicable Large Employer (ALE) status (50+ full-time equivalents).
• Provide Marketplace Notice to new hires within 14 days.
• Distribute Summary of Benefits and Coverage (SBCs) at open enrollment and new hire enrollment.
• Offer affordable, minimum essential coverage to at least 95% of full-time employees (if ALE).
• File Form 1094-C and 1095-C with the IRS annually (for ALEs).
• Provide 1095-C statements to employees annually.
• Pay PCORI fees (if sponsoring a self-funded plan).
• Track waiting periods (cannot exceed 90 days).

Form 5500 & Related Filings

• File Form 5500 annually for ERISA-covered health and welfare plans with 100+ participants.
• Attach required Schedule A (insurance contracts) and Schedule C (service providers, if applicable).
• Provide participants with Summary Annual Report (SAR) within 9 months after plan year end (unless filing extension).
• Maintain compliance with DOL electronic filing requirements (EFAST2).

Final Review & Launch

• Broker/Carrier: Confirm rates, plan designs, and eligibility rules are correctly loaded into systems.
• Verify file feeds and integrations are tested (payroll → carrier, COBRA vendor, commuter/HSA custodian).
• Train HR staff on OE changes, new processes, and compliance-sensitive issues.
• Provide a quick-reference guide or escalation matrix for HR compliance issues.
• Confirm compliance notices (SBC, HIPAA, CHIPRA, Medicare Part D, WHCRA) are included in OE packets.
• Run test cycles for payroll deductions to confirm correct mapping.
• Audit elections for missing dependents, ineligible participants, or errors.
• Confirm portals, apps, and forms are live and accessible; test end-to-end enrollment.
• Document sign-off from HR, brokers, and compliance before go-live.
• Send final reminders to employees about OE deadlines and support channels.

Additional Key Points

• Dependent Eligibility Verification: Require proof before finalizing elections; document the process.
• State-Specific Requirements: Check continuation rules and commuter mandates (e.g., CA, NJ, MA, NYC, SF).
• Wage Parity / Prevailing Wage: Verify correct contributions to fringe benefit accounts.
• Payroll & Tax Readiness: Confirm payroll codes updated for IRS limits; test W-2 reporting.
• HSA Eligibility: Ensure employees understand rules (no HSA with non-HDHP coverage).
• Data Privacy & Security: Audit platform HIPAA compliance and restrict unnecessary access.
• Documentation & Audit Trail: Keep a compliance binder with all notices, filings, and sign-offs.
• Post-OE Follow-Up: Audit enrollments, correct errors, and communicate next steps to employees.

Your role in guiding employees through OE while maintaining compliance is essential — and you don’t have to do it alone. If you have any questions or need support, our Compliance Officer and Benefit Specialists are here to help. Reach out to Clarity anytime for expert guidance and partnership. Together, we’ll make this Open Enrollment season seamless, compliant, and successful.