What Is Open Enrollment?
Open enrollment is the annual period when you can sign up for health insurance, switch plans, or make changes to your existing coverage — without needing a qualifying life event. It applies to marketplace (ACA) plans, Medicare, and employer-sponsored benefits. Outside of open enrollment, you generally can't make changes unless you experience a qualifying life event like marriage, birth of a child, or job loss.
ICHRA changes the equation: If your employer offers an Individual Coverage HRA (ICHRA), open enrollment works differently. Your employer sets an employee health budget, and you choose your own plan on the marketplace or off-exchange.
Thatch handles the entire enrollment experience.
Open Enrollment Dates and Deadlines for 2026–2027
ACA Marketplace Open Enrollment
November 1, 2026 – January 15, 2027 (dates subject to CMS confirmation)
Coverage effective January 1 if enrolled by December 15.
Medicare Open Enrollment
October 15 – December 7, 2026 (Annual Enrollment Period).
Medicare Advantage Open Enrollment: January 1 – March 31, 2027.
Employer-Sponsored Plans
Varies by employer. Most run open enrollment in October–November for January 1 effective dates.
ICHRA employers using Thatch can run enrollment year-round with flexible effective dates.
Who Needs to Enroll During Open Enrollment?
Everyone with health insurance should review their coverage during open enrollment — even if you're keeping the same plan. Premiums, networks, and formularies change every year.
Key groups:
Individuals buying marketplace plans
Employees with employer-sponsored benefits
ICHRA participants choosing their own plans
Medicare beneficiaries
Anyone currently uninsured
ICHRA participants: If your employer uses Thatch, you'll receive a guided enrollment experience that shows you exactly which plans are available in your area, what your employer contributes, and what you'll pay out of pocket — before you enroll.
What Happens If You Miss Open Enrollment?
If you miss the open enrollment window, you generally can't enroll in or change your health insurance until the next open enrollment period — unless you qualify for a Special Enrollment Period (SEP). Qualifying life events include: marriage or divorce, birth or adoption of a child, loss of other health coverage, moving to a new state, changes in household income affecting subsidy eligibility.
One advantage of ICHRA: employers can set plan effective dates outside the standard open enrollment window, giving employees more flexibility. With Thatch, new hires can enroll at any time — no waiting for November.
Open Enrollment for Employers: What You Need to Know
If you're an employer, open enrollment is your annual opportunity to review benefits, communicate changes, and ensure employees are enrolled in the right coverage. Key employer responsibilities:
Set contribution levels
Communicate plan options and deadlines
Process enrollments and payroll deductions
Ensure compliance with ACA, ERISA, and state mandates
How ICHRA Simplifies Open Enrollment for Employers: With a traditional group plan, open enrollment means negotiating renewals, managing carrier relationships, and processing enrollment forms for every employee. With ICHRA through Thatch, you set an employee health budget — employees choose their own plans, and Thatch handles enrollment, compliance, and reimbursement automatically.
See how Thatch eliminates open enrollment headaches
How to Prepare for Open Enrollment (Step-by-Step)
Step 1
Review your current coverage. Check what's changing — premiums, deductibles, provider networks, prescription formularies.
Step 2
Assess your healthcare needs. Had any major health changes this year? Expecting a baby? Planning a surgery?
Step 3
Compare plan options. Use tools like Thatch's plan comparison to see side-by-side costs, coverage, and provider access.
Step 4
Check for financial assistance. ACA subsidies, employer contributions (ICHRA/QSEHRA), HSA/FSA options.
Step 5
Enroll before the deadline. Mark the dates. Set reminders. Don't assume last year's plan auto-renews with the same terms.
How Open Enrollment Works with ICHRA
Individual Coverage Health Reimbursement Arrangements (ICHRA) change how open enrollment works for both employers and employees. Instead of choosing from a limited set of employer-selected plans, employees pick any individual health insurance plan that works for them — and the employer reimburses them tax-free.
With Thatch:
Employers set an employee health budget by class
Employees see available plans with real-time pricing
Thatch handles enrollment, carrier payments, and compliance
No more annual renewal negotiations — employees choose new plans if they want, or stay on their current one
| Traditional Group Plan | ICHRA with Thatch | |
|---|---|---|
Employer workload | Renewal negotiations, carrier management, and enrollment forms for every employee | Set an employee health budget — Thatch handles enrollment, compliance, and reimbursement |
Employee choice | A limited set of employer-selected plans | Any individual health plan available in their area |
Plan flexibility | Changes only during the annual window or after a qualifying life event | Flexible effective dates — new hires can enroll at any time |
Renewal process | Annual rate negotiations with carriers | No renewal negotiations — employees keep their plan or choose a new one |
Compliance burden | Employer manages ACA, ERISA, and state mandates | Thatch handles compliance automatically |
Ready to simplify your next open enrollment?
Open Enrollment FAQ
When is open enrollment for 2026 health insurance?
ACA marketplace open enrollment for 2027 coverage begins November 1, 2026 and runs through January 15, 2027. Enroll by December 15 for January 1 coverage. Medicare Annual Enrollment runs October 15 – December 7, 2026.
Can I get health insurance outside of open enrollment?
Yes, if you experience a qualifying life event (marriage, baby, job loss, moving) you may qualify for a Special Enrollment Period. ICHRA employers using Thatch can also offer enrollment outside the standard OE window.
What's the difference between open enrollment and special enrollment?
Open enrollment is the annual window when anyone can enroll or change plans. Special enrollment periods are triggered by specific life events and are available year-round. Learn more in our guide to Special Enrollment Periods.
Do I have to re-enroll every year during open enrollment?
For marketplace plans, your coverage typically auto-renews, but premiums and benefits may change. It's always worth reviewing your options. For employer plans, it depends on your company's policy. With Thatch ICHRA, employees can keep their current plan or choose a new one during any enrollment window.
How does open enrollment work with ICHRA?
With ICHRA, your employer sets an employee health budget and you choose your own individual health plan. During open enrollment, you can switch plans or stay on your current one. Thatch guides employees through the process with personalized plan recommendations.
What is the penalty for not having health insurance?
There is no federal penalty for being uninsured since 2019. However, some states (California, Massachusetts, New Jersey, Rhode Island, DC) still impose state-level penalties. Having coverage through ICHRA satisfies any applicable mandate.
