Open Enrollment: Choosing a Health Plan for You and Your Family

What is Open Enrollment?

Open enrollment is when individuals and families can enroll in or change their health insurance plans for the upcoming year. It’s critical to review your options and select a plan that fits your health and financial needs. Outside of open enrollment, you can only enroll if you experience a qualifying life event, such as getting married, having a baby or losing your group coverage.

When is Open Enrollment?

Open enrollment for the 2025 health insurance year begins on November 1, 2024, and ends on January 15, 2025. If you want your coverage to start on January 1, 2025, you’ll need to enroll by December 15, 2024. Waiting until the last minute can lead to stress, so we encourage you to review your options early.

Why Open Enrollment Matters

Open enrollment gives you a once-a-year opportunity to enroll in or switch health plans to ensure you have coverage for the year ahead. It’s the perfect time to reassess your health insurance needs, especially if your circumstances have changed, such as a new job, marriage or the addition of a child. Choosing the right coverage ensures you’re ready for medical needs or unexpected health events.

How to Enroll in a Health Insurance Plan

Getting started with your enrollment is easy:

• Visit GHC-SCW’s website
• Compare plans based on your health needs, budget and provider preferences.
• Make sure to submit your application before the open enrollment deadline.

If you have any questions along the way, contact GHC-SCW’s Individual Sales Representative who is available to help guide you through the process at (608) 828-4831.

When You Can Enroll Outside of Open Enrollment

If you miss the open enrollment window, you may still qualify for a Special Enrollment Period (SEP) if you experience certain life events. Qualifying events include:

• Marriage
• Birth or adoption of a child
• Loss of group health coverage
• Significant changes in income

If you experience one of these events, contact your insurance provider to explore your options and ensure continuous coverage.

Choosing the Right Plan: Factors to Consider

Selecting the right health plan is essential. Keep the following factors in mind as you compare your options:

• Cost: Look at premiums, deductibles and co-pays to ensure they fit your budget. A good calculation is take the monthly premium, multiply it by 12; then add in the maximum out-of-pocket (MOOP). Keep in mind if there is more than one person on the plan, use the family MOOP.
• Coverage: Ensure your plan covers the necessary primary and specialty care services.
• Provider Network: Verify that your preferred doctors and specialists are included in the plan’s network.
  • If you live in Dane County, your primary care provider must be at a GHC-SCW-owned clinic.
• Additional Benefits: Check for coverage of behavioral health services and medications

How GHC-SCW Supports Members During Open Enrollment

GHC-SCW offers a range of health plans designed to meet the unique needs of individuals and families. Our dedicated individual sales representative is available to assist you in choosing the plan that best fits your lifestyle. Just call (608) 828-4831. Whether you need a plan with low out-of-pocket costs or access to world-class specialty care, GHC-SCW has you covered.

Take Action Today

Don’t wait—now is the time to explore your health plan options for 2025. Open Enrollment runs from November 1, 2024, through January 15, 2025. Review your options early to ensure you have health coverage for the coming year. Contact our GHC-SCW Individual Sales Representative to get the assistance you need. Your health and peace of mind are worth it!

Key Resources for Enrollment Help

Need help with your enrollment? Use these resources:

• GHC-SCW Member Services Team: Call (608) 828-4856
• GHC-SCW Individual Sales Representative: Call (608) 828-4831