A Guide to Open Enrollment for 2025

Open enrollment can be intimidating without the right preparation. Questions about the process are already inevitable, but as more employees prioritize their well-being, nothing should be left to interpretation.

After all, most people rely on their employer for coverage. Employer-provided insurance covered 53.7% of the U.S. population in 2023, according to the U.S. Census Bureau. High participation, of course, creates the need for preparation. Employees want to ensure they secure the right benefits for themselves and their families. An exceptional open enrollment process helps participants:

• understand their selections
• easily and confidently make choices
• trust their employer

A frustrating open enrollment, however, fractures an employee’s experience, especially for newer generations entering the workforce. A staggering 7 in 10 full-time employees said they would be willing to switch jobs for better benefits, according to the Economist Group Economist Impact study. In other words, benefits — and, by extension, open enrollment — are crucial for retention.

So how do you ensure your company’s open enrollment process provides employees exactly what they need? Let’s explore each facet of open enrollment in 2025: what it is, how to prepare for it, important dates to know and the steps you can take to ensure a successful enrollment experience for every employee every time.

What is open enrollment?

Open enrollment refers to the period when employees can choose from the benefits their employers offer for the upcoming year. They are generally categorized into “open” and “locked” benefits.

Open benefits

Open benefits allow employees to enroll in or change them outside the open enrollment period. Some examples of open benefits may include:

• short-and long-term disability insurance
• pensions and retirement plans
• health savings accounts

Locked benefits

Locked benefits are those that an employee can’t change outside the enrollment period once they’re selected; they can only amend them during the next year’s open enrollment period.

Here are a few examples of locked benefits:

• health insurance
• dental and vision insurance
• flexible spending accounts

Key aspects to consider for open enrollment benefits

There is no one-size-fits-all approach for a perfect open enrollment, but there are things you can do to make the experience smoother for everyone. Let’s take a closer look at what to consider before rolling out your benefits.

Important dates and deadlines

The open enrollment period differs for every employer. Most companies schedule it in the fall so calendar-year benefits can take effect on Jan. 1. They usually allow two to four weeks for employees to choose their coverage. However, employees who select a plan after Dec. 15 of the current year, but before Jan. 15 of the next, may have their coverage start by Feb. 15.

For example, if an employee’s plan year runs from Jan. 1 to Dec. 31, open enrollment could take place Nov. 1 through Nov. 29 for an effective date of Jan. 1. Keep in mind that certain qualifying life events, such as the birth of a child or adoption, may allow an employee to enroll in or otherwise modify a locked benefit. New hire enrollment is another exception.

Plan options

For benefits administration to be seamless and effective, it’s important to know what your people really want. Employers should always gather feedback from employees using surveys and questionnaires before making a final selection. It’s just as helpful to conduct anonymous surveys after enrollment to gauge your workforce’s experience and improve the process for next year.

Network

Businesses must consider their health plan’s network size and structure to avoid excessive out-of-pocket fees for employees. Some plans cover a small network of “preferred” providers, meaning employees receive care at reduced rates from contracted medical professionals and facilities. These plans encourage participants to name a primary care physician and don’t require a referral to visit a specialist.

Open access plans, on the other hand, give employees more freedom to choose their provider, whether they’re “in” or “out” of network. These plans typically cover some out-of-network services and require a referral to see a specialist.

Pricing and price increases

Once you have a solid understanding of the types of benefits you want to offer, you should request proposals from multiple carriers and compare the cost and value of each option. Some vendors may have extra fees associated with administering plans, plan assets or per-employee enrollment. Remember to keep in the mind the cost of copays, coinsurance and deductibles for your plan participants.

Contributions

Under the Affordable Care Act (ACA), employers with at least 50 or more full-time employees in the prior calendar year must provide affordable and adequate insurance coverage to full-time employees and their dependents or face possible penalties. Still, employers must consider what percentage of health insurance premiums they’ll cover and how much employees will contribute. Companies can help control costs by changing the contribution amounts or adjusting their benefit offerings.

Special enrollment periods

Employees who miss the Jan. 15 deadline to enroll could still qualify for a special enrollment period if:

• their income is within a certain range
• they had a qualifying life change, such as losing their current health coverage, getting married, having a child or moving
• they are a member of a federally recognized tribe or Alaska Native Claims Settlement Act

Individuals who qualify for a special enrollment period could enroll between Jan. 16 and Oct. 31. Keep in mind that most situations let employees enroll in coverage within 60 days of when the qualifying event occurred.

When is open enrollment for health insurance in 2025?

Keep these important dates in mind for open enrollment in 2025.

Individual and family marketplace plans

Individuals and families without access to employer-sponsored health insurance can purchase coverage through the Health Insurance Marketplace, a service created by the federal government following the passage of the ACA.

Open enrollment is Nov. 1 to Jan. 15.

• Enroll by Dec. 15 for coverage that starts Jan. 1.
• Enroll by Jan. 15 for coverage that starts Feb. 1.

ACA marketplace

Established in 2010, the ACA Health Insurance Marketplace offers a single source for individuals and their families to browse for coverage from private insurers. Employees of companies who aren’t legally required to offer health insurance can also use this resource to find coverage.

The ACA marketplace also provides four tiers for plans — bronze, silver, gold and platinum — to help buyers easily evaluate plans by what they cover and the cost of their premiums. Like an employer-sponsored plan, individuals must enroll in coverage by:

• Dec. 15 for insurance that starts Jan. 1
• Jan. 15 for insurance that starts Feb. 1

Similarly, individuals can enroll in coverage outside of these deadlines if they qualify for a special enrollment period.

State marketplaces

Certain states also maintain their own health care marketplaces. Including Washington, D.C., there are currently 20 jurisdictions that include state-sponsored marketplaces.

California: Covered California is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 31, 2026. Coverage starts on Jan. 1 for those who enroll in the current year and Feb. 1 for those who enroll by Jan. 31, 2026. California residents whose household income is at or below 150% of the federal poverty level may use this marketplace.

Colorado: Connect for Health Colorado is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026. If a buyer completes enrollment by the 15th of the month during open enrollment, coverage starts by the first day of the following month.

Connecticut: Access Health CT is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026.

Georgia: Georgia Access is the state’s health care marketplace. Open enrollment begins on Nov. 1 and ends Jan. 15, 2026.

Idaho: Your Health Idaho is the state’s health care marketplace. Employees in the state can qualify for these plans even if they’re offered employer-sponsored coverage. Open enrollment begins Oct. 15 and ends Dec. 15.

Kentucky: Kynect Health Coverage is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026.

Maine: CoverMe is the state’s health care marketplace. Open enrollment begins on Nov. 1. The deadline for coverage that begins Jan. 1, 2026, is Dec. 15. For coverage that starts Feb. 1, 2026, buyers must enroll by Jan. 15, 2026.

Maryland: Maryland Health Connection is the state’s health care marketplace. Open enrollment begins on Nov. 1 and ends Jan. 15, 2026. The deadline for coverage that begins Jan. 1, 2026, is Dec. 31. For coverage that starts Feb. 1, 2026, buyers must enroll by Jan. 15, 2026.

Massachusetts: Massachusetts Health Connector is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 23, 2026.

Minnesota: MNsure is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026.

Nevada: Nevada Health Link is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026.

New Jersey: Get Covered NJ is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 31, 2026.

New Mexico: BeWell is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026. New Mexico residents may not enroll for coverage through BeWell if they have insurance through their employer or their parent’s employer.

New York: NY State of Health is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 31, 2026. Plans become available to view and compare on Oct. 1.

Pennsylvania: Pennie is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026. For coverage that starts on Jan. 1, 2026, individuals must enroll by Dec. 15.

Rhode Island: Rhode Island Health Insurance Marketplace is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 31, 2026.

Vermont: Vermont Health Connect is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026. For coverage that starts on Jan. 1, 2026, individuals must enroll by Dec. 15.

Virginia: Virginia’s Insurance Marketplace (aka Virginia Health Benefit Exchange) is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026.

Washington: Washington Healthplanfinder is the state’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 15, 2026.

Washington, D.C.: DC Health Link is the district’s health care marketplace. Open enrollment begins Nov. 1 and ends Jan. 31, 2026.

Rising premiums

Since 2023, the average marketplace health care premiums have steadily risen. Keep in mind the exact costs of premiums vary, especially across individual state marketplaces. Data from the Centers for Medicare and Medicaid Services (CMS) reveals the average increase for multiple demographics and families:

In general, premiums rise due to:

• higher supply and demand
• increased health care and prescription drug costs
• employee shortages in the pharmaceutical industry

Despite these rising costs, however, individuals may still have an opportunity for coverage through financial aid like federal and state subsidies.

Spending limit decreased

Despite rising premiums, the average maximum out-of-pocket spending limits have dropped. In 2025, the spending limit decreased to $9,200 for individuals and $18,400 for families. In contrast, 2024’s spending limits were $9,450 for individuals and $18,900 for families.

Yet this recent dip doesn’t suggest spending limits are strictly on the decline. A decade ago, for example, the spending limit was $6,600 for individuals and $13,200 for families.

Medicare

Medicare is a federal health insurance option for people 65 and older. The initial enrollment period (IEP), which runs for a total of seven months, allows individuals to enroll in Medicare around when they turn 65. If your birthday falls in January, you’ll have from Oct. 1 until April 30 to enroll without fear of facing a late penalty.

The open enrollment period runs Oct. 15 to Dec. 7 each year.

Medicaid

Medicaid is a federal program that provides wellness support to families below a certain income threshold. There is no open enrollment period for Medicaid, and each state has its own eligibility requirements. You can see what your state’s qualifications are at Medicaid.gov.

Dual eligible special needs plan

Dual Eligible Special Needs Plans (D-SNPs) enroll individuals who are entitled to Medicare and medical assistance from a state plan under Medicaid. Most people enroll in a D-SNP when they turn 65 and become eligible for Medicare. However, you can enroll in a D-SNP every year from Oct. 15 to Dec. 7.

Health insurance through work

Most insured individuals receive their coverage through their employer, which means the employer also sets the open enrollment period. Even so, health care providers generally require employee elections by a certain date to ensure coverage throughout the following year. As a result, most organizations hold open enrollment in the fall and potentially to the end of the year. How and when a company conducts it is influenced by the needs of their health care provider, as well as federal and state regulations.

What’s new for open enrollment in 2025?

Every year brings updates and considerations for open enrollment. To help ensure the smoothest process possible, keep these updates in mind.

Legislative and regulatory updates

While the open enrollment process hasn’t changed significantly since last year, CMS recently proposed standardizing the open enrollment period for all individual market coverage. Their proposal would shorten most open enrollment windows to Nov. 1 through Dec. 15. Currently, certain states keep enrollment open until the end of January, allowing coverage to start the following month.

While this proposal is still pending and may not immediately impact employers, it could inspire federal rules that impact enrollment nationwide. It’s important to regularly consult a licensed legal professional about updates that could affect your organization’s open enrollment.

Health Savings Account (HSA) and Flexible Spending Account (FSA) considerations

This year, the FSA contribution limit changed to $3,300. HSA contribution limits, on the other hand, rose to $4,300 for individuals and $8,550 for families. Based on the date of previous announcements, the IRS will likely release 2026’s contribution limits for both accounts in November.

HSA and FSA accounts can be extremely useful for covering expected health care expenses, such as:

• eye exams
• dental visits
• checkups
• regular and seasonal medication
• certain over-the-counter products

Employers are not required to offer FSAs, but employees of those that do should consider their regular medical expenses to determine if an account is right for them.

Changes in employer-sponsored plans

Specific changes to plans organizations offer will vary across employers. However, changing premium prices could affect the cost of coverage for employers and potentially their employees. Businesses should maintain an open line of communication with their health care providers to stay on top of any changes in costs, policies and other important factors.

How does open enrollment work?

With the right processes in place, you and your team can navigate your organization’s next open enrollment with confidence.

Preparation

For employers

Whenever you’re thinking of starting, chances are it’s not too early. The need for companywide communication starts before the open-enrollment period begins. Emails are a highly effective means of informing employees of an upcoming open enrollment, but when it comes to getting into the finer details of next year’s benefit offerings, there’s no substitute for meetings. It’s best practice to share your policy details electronically, too, so employees can easily find and reference them. Of course, organizational needs may differ. But every employer should prepare answers to commonly asked questions and communicate frequently to allow ample time for employees to review their choices and prepare to make changes.

For employees

Employees should start considering their health care coverage as soon as possible, or at least whenever their organization makes new updates available. Even if an employee doesn’t intend to switch their coverage, it’s still a good idea for them to review new changes and evaluate their individual and family’s needs.

Benefits review

Then there are the stickier subjects, especially changes in insurance providers and/or price increases. Be ready to address the reasons behind the structure and pricing of health plans. Some employees might be enrolling in benefits for the first time, either at your organization or in the workforce generally. Try to review the options with employees so they understand the impact on their coverage and paychecks, and remember to emphasize that benefits are just one part of their total compensation.

Process management

If your organization still relies on paper forms to facilitate open enrollment, consider the advantages of HR tech. Self-service software enables employees to log in, view and research their benefit options and make their selections, often with just a few clicks of a mouse — or even a smartphone — from anywhere at any time. Paycom’s Benefits Administration tool helps streamline the process for HR and employees.

Benefits of open enrollment

An organization’s approach to open enrollment directly impacts the employee experience. Keep these benefits in mind to give your company a positive start to the open enrollment process.

Personalized benefits selection

The ability to easily select benefits, understand them up front and access information about them later is a more-than-reasonable expectation for any employee. Personalized benefits selection helps foster a culture in which workers both know and understand their choices — choices that are likely to stick with them for the next 12 months.

Cost management and control

Open enrollment is a constant process of setting goals, measuring success and adapting for the future. It presents a unique opportunity to control costs and maximize your ROI by monitoring how frequently employees use their plans. Employers should stay in touch with their brokers throughout the year to help track inefficiencies and prepare changes for the next enrollment period.

Improved employee engagement

Employers should leverage open enrollment to show employees they truly care. It’s a chance to showcase your benefits, roll out new perks and improve engagement with a smooth and streamlined enrollment process. When employees come away with a clear understanding of their options and how their selections will impact them, everyone wins.

Compliance and risk management

Open enrollment helps companies meet their legal requirements and ensure compliance. Keeping employees informed of deadlines and providing the required notices and closures is an essential part of risk management. And when done correctly, it boosts employee engagement and your reputation as an employer people trust.

Open enrollment best practices

Employees don’t make benefit decisions lightly. With that in mind, here are four actionable ways to help them — and, in the process, help yourself and your team.

Clear communication

Communicate with your workforce frequently! The more time employees have to prepare for open enrollment, the better. Doing so could help your organization get the jump on more complicated questions. Keep in mind the likelihood of differing demographics within your organization.

If your workforce includes employees for whom English is not a first language, you might want to provide translations. Then there are age differences. Information about retirement accounts or life insurance plans, for example, might need to be conveyed or packaged differently for Generation Z employees than for baby boomers.

Timely announcements

You’ve put in the work; now don’t let it flop. Consider using multiple channels of communication to ensure the best possible delivery of your message. And don’t worry about too much repetition. It’s the key to education!

While organizational needs differ, useful platforms might include:

• companywide meetings, either in-person or virtual
• webinars
• company intranet
• social media
• texting

Consider investing in easy-to-use, self-service software that simplifies sending communication about open enrollment your employees.

Frequent reminders

Clear communication builds a great foundation, but it needs to be constant to be effective. Ensure employees receive weekly communication about open enrollment before and during the period. Even if it’s a simple message reminding them to ask questions, regular contact will help keep employees from missing a crucial deadline.

For employers who extend their open enrollment into 2026, you should consider sending reminders ahead of any deadline required for coverage that starts on Jan. 1. For example, if your organization has a Dec. 15 cutoff, you may want to send biweekly — or even daily — reminders about the deadline. Employees should be aware they could still enroll later for coverage that starts on Feb. 1, 2026, but have ample opportunity to initiate their coverage sooner if they prefer it.

Educational resources

When communication involves multiple resources that can be linked, it’s a good idea to gather them in a single document to simplify accessibility for employees. This can be done in the form of a fillable PDF. For example, Paycom offers benefits administration software so employees can review plan documents and test how deductions will affect their take-home pay before choosing. Once they enroll, payroll automatically updates so no one has to rekey a thing. Plus, our learning management system makes it easy for you to educate employees about open enrollment — even before it starts.

Utilizing technology

Open enrollment may seem like a lot, but a smooth, thorough process makes up for it in employee well-being and confidence. While a business isn’t legally required to use benefits administration software, it simplifies:

• setting up deduction amounts, enrollment dates and more
• enrolling in and informing workers about plans
• auditing benefits and avoiding overpayment
• notifying employees about benefits and open enrollment

Progress tracking

Even a seemingly smooth open enrollment has room to improve. You should continue to monitor your process through the period and continually consider:

• how quickly and easily employees enroll
• how many questions employees ask
• what obstacles make open enrollment difficult
• what benefits do employees seem to favor
• how responsive employees are to your communication
• and more

Tracking and reporting on the open enrollment process with Paycom helps create a smoother and more convenient experience later. Remember, while open enrollment has an end date, you should think about how to make it better all year long.

Open Enrollment: FAQ

How far before the benefits’ effective date should open enrollment take place?

The open enrollment period differs by employer. Most companies schedule it in the fall so calendar-year benefits can take effect on Jan. 1. They usually allow two to four weeks for employees to choose their coverage.

What benefits can be changed outside open enrollment?

Open benefits allow employees to enroll in or change them outside the open enrollment period. Some examples may include short- and long-term disability insurance, pensions, retirement plans and health savings accounts.

How does Paycom support an employer’s open enrollment?

Paycom’s Benefits Administration tool streamlines enrollment by placing employees first and automating the flow of data into payroll. We help you:

• automate enrollment for qualifying events
• generate insightful reports
• streamline carrier communication with our Benefits to Carrier tool
• empower employees with an experience that allows them to make informed decisions

When does open enrollment start?

Employers can set their open enrollment period. Most companies schedule it in the fall so calendar-year benefits can take effect on Jan. 1.

When do open enrollment changes take effect?

Changes made during open enrollment usually take effect on Jan. 1 of the following year, depending on when an employer implements their health plan and schedules open enrollment.

What is a qualifying life event?

Qualifying life events, such as the birth of a child or adoption, may allow an employee to enroll in or otherwise modify a locked benefit.

What to do if you miss the deadline for open enrollment?

Qualifying for a special enrollment period lets an employee who missed open enrollment secure coverage.

How much can I contribute to HSA or FSA?

According to the IRS, individuals can contribute up to $4,300 and families can contribute up to $8,550 to their HSA for 2025. The maximum FSA contribution is $3,300 for 2025.

How is an HSA different from an FSA?

HSAs are owned by the employee and only available to those already enrolled in a High-Deductible Health Plan (HDHP). FSAs are employer-owned and employees are considered participants.

Can I opt for insurance after open enrollment?

Yes, if you qualify for a special enrollment period. This usually involves a qualifying life event — such as childbirth or the involuntary loss of previous insurance — and allows individuals to enroll in coverage within a short, typically 60-day window.

Can you unenroll during open enrollment?

Yes, you can unenroll in health care coverage anytime. During open enrollment, this could allow you to select a new plan or decline coverage outright. If you unenroll outside of open enrollment, you may need to wait until the next open enrollment period to secure coverage for the following year.

How long is open enrollment for health insurance?

Open enrollment periods vary between employers, but most conduct theirs in the fall around November to the end of the year. (You should verify with your employer the exact dates.)

For state-sponsored health care marketplaces, open enrollment commonly starts on Nov. 1 and ends Jan. 15 of the following year, but again, these dates change between states. Ideally, you should start asking about open enrollment periods by no later than October.

Can open enrollment help me with reducing my tax liability?

In some cases, yes. Certain individuals and their families may qualify for a tax credit to help them afford health insurance. If you intend on enrolling in state- or federally sponsored coverage, consider reviewing the financial aid section of the relevant marketplace’s website.

How does Paycom’s Benefits Administration tool integrate with payroll?

Our Benefits Administration tool automatically populates employees’ deductions into payroll to prevent data reentry and inaccurate or missed selections. Plus, our tech even allows them to easily test the impact their selections will have on their net pay.

How does Paycom’s Benefits to Carrier tool communicate with carriers?

Our Benefits to Carrier tool automates secure communication with plan providers to ensure a seamless, more efficient enrollment process. It instantly notifies providers of employees’ final selections, further eliminating the potential for errors that could lead to missing coverage.

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