Every year, employees have the option to change their medical coverage during the annual “open enrollment” period. Open enrollment for small employers usually is the month prior to renewal date of the policy and lasts about one or two weeks. During this time employees receive plan materials, have a chance to ask questions about plan choices and enroll in a plan. They may add or drop dependents, choose a different medical plan or sign up for new plan offerings, such as an optional chiropractic plan or dental plan. For individuals interested in purchasing insurance through the individual marketplace, open enrollment is generally from November 1 through December 15 for coverage in the subsequent calendar year.
Your out-of-pocket maximum is a limit on the total amount you pay for healthcare in a given year. Once you have spent this amount on all coverage, including deductible, copayments and coinsurance but excluding your monthly premium, your health insurer will pay 100% of your remaining healthcare costs for the coverage year. For plans purchased through Healthcare.gov exchanges in 2019, the out-of-pocket maximum must be lower than $7,900 for an individual plan or $15,800 for a family plan, but could be lower based on the coverage you choose.