ICHRA enrollments have a lot of moving pieces! Employees first elect plans, then get enrolled, and then have to set up payment for these plans. At Zorro, we believe in giving everyone as much visibility in relation to each individual’s enrollment journey. To achieve this, we’ve defined several terms that are important to understand:
Enrollment: The entire process after an employee is added to Zorro and throughout their coverage period.
Enrollment record: A record of an employee’s specific coverage decision for a specific period. For instance, an employee that starts the year by waiving and then has a QLE and decides to get coverage would have two enrollment records–the first for the first period with a status of “Waived”, and the second for after the health plan coverage began.
Election window: The dates during which employees can submit elections on Zorro. If an employee’s election window is not active, they will not be able to submit any elections (including waiving coverage).
Open enrollment: A company-wide period where all employees are eligible to enroll in benefits. All companies have an Open Enrollment in November-December in anticipation of the new plan year in January. Companies that join Zorro mid-year have an Open Enrollment mid-year. The election window during an Open Enrollment is identical for all employees.
Special enrollment: An individual employee’s mid-year enrollment record related to a specific event, such as joining the company as a new hire or experiencing a Qualifying Life Event. The election window for Special Enrollments is calculated based on the company’s waiting period, time of month, and other factors. You can read more about how election window dates are calculated here.
Application: The process of submitting a plan election to the carrier, executed by the Enrollment Team after an employee elects a plan during their election window.