2025 Open Enrollment Compliance Checklist
To get ready for open enrollment, employers who sponsor group health plans should be aware of compliance changes affecting the design and administration of their health plans for plan years beginning on or after Jan. 1, 2025. These changes include limits that are adjusted for inflation each year, such as the Affordable Care Act’s (ACA) affordability percentage and cost-sharing limits for high deductible health plans (HDHPs). Employers should review their health plan’s design to confirm that it has been updated, as necessary, for these changes.
In addition, any changes to a health plan’s benefits for the 2025 plan year should be communicated to plan participants through an updated summary plan description (SPD) or a summary of material modifications (SMM).
Health plan sponsors should also confirm that their open enrollment materials contain certain required participant notices, such as the summary of benefits and coverage (SBC), when applicable. Some participant notices must also be provided annually or upon initial enrollment. To minimize costs and streamline administration, employers should consider including these notices in their open enrollment materials.
View this 2025 Open Enrollment Compliance Checklist which contains important information regarding:
- ACA Affordability Standard
- Out-of-Pocket Maximum Limits
- Preventive Care Benefits
- Health FSA Contributions
- HDHP and HSA Limits for 2024
- HDHPs: Expiration of Design Options
- EBHRA Limit
- Mental Health Parity – Required Comparative Analysis for NQTLs
- Prescription Drug Benefits – Creditable Coverage Determination
- Open Enrollment Notices
Contact us for more information.
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