Open enrollment is the best time for Pennsylvania employers to review benefits, confirm compliance, and correct issues before the new plan year begins. The checklist below covers the most important items to review, including plan documents, employee notices, eligibility rules, contribution changes, deadlines, ACA tracking, and employee communication. By addressing these essentials early, employers can reduce risk, prevent delays, and keep their teams informed and prepared.

At 1 Benefit Solutions in State College, PA, we support employers statewide with hands‑on guidance, benefits administration, and year‑round compliance assistance—helping you stay organized, audit‑ready, and confident going into open enrollment.

Review and Update Your Plan Documents

Before open enrollment begins, confirm that all plan documents match your upcoming plan year elections and employer policies. Pennsylvania benefits compliance rules require employers to maintain accurate, up‑to‑date documentation for every group benefit offered.

• Summary Plan Descriptions (SPDs): Ensure they reflect the current year’s plan terms, eligibility, waiting periods, and benefits.
• Summary of Benefits and Coverage (SBCs): Provide updated SBCs to all eligible employees and new hires.
• Plan Amendments: Document any plan design changes such as deductibles, copays, or networks.
• ERISA Wrap Documents: Confirm that all employer-sponsored plans are included and current.

For additional guidance, review the Benefits Compliance resources available from 1 Benefit Solutions.

Verify Required Employee Notices

Pennsylvania employers must issue several annual notices during or before open enrollment. Confirm that all required documents are prepared and distributed on time.

• CHIP Notice: Required for all employers offering group medical coverage.
• Women’s Health and Cancer Rights Act (WHCRA): Must be provided annually.
• Medicare Part D Creditable Coverage Notice: Must be given to eligible employees and filed with CMS by the annual deadline.
• HIPAA Notices: Special enrollment and privacy notices must be updated and available upon request.

Open enrollment is the ideal moment to distribute these notices so they are not missed during the year.

Confirm Employee Eligibility and Classification

One of the most common compliance issues arises when employer eligibility rules do not match actual enrollment practices. To avoid penalties or coverage disputes, review the following:

• Full-time and part-time definitions: Ensure they align with ACA, ERISA, and carrier requirements.
• Waiting periods: Must not exceed 90 days under federal law.
• Variable-hour tracking: Confirm look-back measurement periods for ACA compliance.
• Seasonal employee classifications: Verify correct placement under plan rules.

Proper eligibility documentation protects both the employer and employees, especially during audits or claims reviews.

Review Employer Contributions and Cost-Sharing Changes

If you anticipate changes to premium contributions, cost-sharing amounts, or employer-sponsored allowances, these must be documented and communicated before open enrollment. Consider reviewing:

• Employer medical, dental, and vision contributions to ensure they meet affordability tests.
• HSA and FSA contribution limits for the upcoming plan year.
• Life and disability insurance premiums for proper taxable/non-taxable treatment.
• Any new plan additions or alternative plan options you plan to offer.

Employers searching for updated market options can also review Group Medical plans through 1 Benefit Solutions to compare benefits and pricing for Central Pennsylvania organizations.

Track Key Open Enrollment and Compliance Deadlines

Missing deadlines is one of the most preventable compliance challenges for employers. To keep your organization on track, map out all important dates ahead of time:

• Carrier renewal deadlines for plan confirmation or changes.
• Employee Navigator or enrollment platform deadlines for data updates.
• ACA reporting deadlines for Forms 1094/1095.
• Medicare Part D disclosure deadlines to employees and CMS.
• FSA rollover or grace period deadlines to confirm employee eligibility.

A clear calendar helps employers avoid rushed decisions and ensures compliance with both federal and Pennsylvania requirements.

Confirm ACA Tracking and Reporting Processes

For Applicable Large Employers (ALEs), open enrollment is the right moment to confirm ACA compliance systems for the year ahead. Review these items carefully:

• Monthly ACA hours tracking for variable-hour and part-time employees.
• Affordability determinations based on the new IRS safe harbor percentage.
• Categorization of full-time, part-time, and seasonal employees under ACA rules.
• Data accuracy within your enrollment platform for year-end 1094/1095 reporting.

1 Benefit Solutions provides Pennsylvania employers with ACA compliance support to ensure accurate reporting and reduce the chance of IRS penalties.

Prepare Employee Communication and Enrollment Materials

Clear communication helps employees understand their benefits and reduces the volume of questions HR receives during open enrollment. Incorporate the following into your communication strategy:

• Open enrollment announcement emails with key dates and instructions.
• Updated benefits guides explaining plan changes in plain language.
• Eligibility reminders to ensure employees understand who can enroll.
• How-to guides for using Employee Navigator or other enrollment tools.
• Q&A sessions or virtual meetings for employees who need extra support.

Effective communication is an essential part of employer benefits support, especially for small and mid-sized organizations without large HR teams.

Document Everything for Compliance and Audit Readiness

Documentation is your best defense during a carrier audit, DOL audit, or IRS inquiry. Before open enrollment begins, confirm you have:

• Copies of all employee notices and distribution records
• Current SPDs, SBCs, and wrap documents
• Enrollment records and evidence of elections
• Historical plan documents for prior plan years
• A secure system for retaining employee communications

Pennsylvania employers can also review the Pennsylvania Benefits Compliance Guide for additional state-specific requirements.

Need Help Preparing for Open Enrollment?

1 Benefit Solutions supports employers throughout State College, Central PA, and across Pennsylvania with personalized open enrollment support, benefits administration, and year-round compliance guidance. If you need help reviewing documents, tracking deadlines, preparing employee communication, or comparing plan options, our local benefits team is here to help.

Request compliance support today and make this your smoothest open enrollment season yet.