2025 Open Enrollment Checklist
August 2, 2024
2025 Open Enrollment Checklist

To get ready for open enrollment, employers who sponsor group health plans should be aware of compliance changes affecting the design and administration of their health plans for plan years beginning on or after Jan. 1, 2025. These changes include limits that are adjusted for inflation each year, such as the Affordable Care Act’s (ACA) affordability percentage and cost-sharing limits for high deductible health plans (HDHPs). Employers should review their health plan’s design to confirm that it has been updated, as necessary, for these changes.


In addition, any changes to a health plan’s benefits for the 2025 plan year should be communicated to plan participants through an updated summary plan description (SPD) or a summary of material modifications (SMM).


Health plan sponsors should also confirm that their open enrollment materials contain certain required participant notices, such as the summary of benefits and coverage (SBC), when applicable. Some participant notices must also be provided annually or upon initial enrollment. To minimize costs and streamline administration, employers should consider including these notices in their open enrollment materials.


Plan Design Changes

ACA Affordability Standard

The ACA requires ALEs to offer affordable, minimum-value health coverage to their full-time employees (and dependents) or risk paying a penalty to the IRS. This employer mandate is also known as the “pay-or-play” rules. An ALE is an employer with at least 50 full-time employees, including full-time equivalent employees, during the preceding calendar year.


An ALE’s health coverage is considered affordable if the employee’s required contribution for the lowest cost self-only coverage that provides minimum value does not exceed 9.5% (as adjusted) of the employee’s household income for the taxable year. For plan years beginning in 2024, the adjusted affordability percentage is 8.39%.


The affordability percentage for plan years beginning on or after Jan. 1, 2025, has not been released yet. Going forward, ALEs should take the following steps:


  • Monitor future developments for the IRS’ release of the affordability percentage for 2025; and
  • Once the affordability percentage is released, confirm that at least one of the health plans offered to full-time employees satisfies the ACA’s affordability standard. Because an employer generally will not know an employee’s household income, the IRS has provided three optional safe harbors that ALEs may use to determine affordability based on information that is available to them: the Form W-2 safe harbor, the rate-of-pay safe harbor and the federal poverty line safe harbor.


Out-of-Pocket Maximum Limits

Non-grandfathered health plans and health insurance issuers are subject to limits on cost sharing for essential health benefits (EHB). EHBs reflect the scope of benefits covered by a typical employer plan and must include items and services in 10 general categories, including emergency services, hospitalization, ambulatory patient services, prescription drugs, pregnancy, maternity and newborn care, mental health and substance use disorder services, rehabilitative and habilitative services, laboratory services, preventive and wellness services and chronic disease management, and pediatric services.


The annual limits on total enrollee cost sharing for EHB for plan years beginning on or after Jan. 1, 2025, are $9,200 for self-only coverage and $18,400 for family coverage. With this in mind, employers should take the following steps:


  • Review the out-of-pocket maximum limits for the health plan to ensure they comply with the ACA’s limits for the 2025 plan year; and
  • Keep in mind that the out-of-pocket maximum limits for HDHPs compatible with HSAs must be lower than the ACA’s limits. For the 2025 plan year, the out-of-pocket maximum limits for HDHPs are $8,300 for self-only coverage and $16,600 for family coverage.


Preventive Care Benefits

The ACA requires non-grandfathered health plans and issuers to cover a set of recommended preventive services without imposing cost-sharing requirements, such as deductibles, copayments or coinsurance, when the services are provided by in-network providers. The recommended preventive care services covered by these requirements are:


  • Evidence-based items or services with an A or B rating in recommendations of the U.S. Preventive Services Task Force;
  • Immunizations recommended by the Advisory Committee on Immunization Practices for routine use in children, adolescents and adults;
  • Evidence-informed preventive care and screenings in guidelines supported by the Health Resources and Services Administration (HRSA) for infants, children and adolescents; and
  • Other evidence-informed preventive care and screenings in HRSA-supported guidelines for women.


Health plans and issuers are required to adjust their first-dollar coverage of preventive care services based on the latest preventive care recommendations. In general, coverage must be provided for a newly recommended preventive health service or item for plan years beginning on or after the one-year anniversary of when the recommendation was issued. For example, health plans and issuers must cover screenings for anxiety disorders in adults, including pregnant and postpartum patients, effective for plan years beginning on or after June 30, 2024 (e.g., the plan year beginning Jan. 1, 2025, for calendar-year plans). More information on the recommended preventive care services is available at www.HealthCare.gov.


Before the beginning of the 2025 plan year, employers should take the following step:


  • Confirm the health plan covers the latest recommended preventive care services without imposing any cost sharing when the care is provided by in-network providers.


Health FSA Contributions

The ACA imposes a dollar limit on employees’ pre-tax contributions to a health FSA. This limit is indexed each year for cost-of-living adjustments. An employer may set their own dollar limit on employees’ contributions to a health FSA as long as the employer’s limit does not exceed the ACA’s maximum limit in effect for the plan year. For plan years beginning in 2024, the health FSA limit is $3,200. The IRS has not yet released the health FSA limit for plan years beginning in 2025. Moving forward, employers with health FSAs should take these steps:


  • Monitor future developments for the release of the health FSA limit for 2025;
  • Once the IRS releases the health FSA limit, confirm that employees will not be allowed to make pre-tax contributions in excess of the limit for the 2025 plan year; and
  • Communicate the health FSA limit to employees as part of the open enrollment process.


HDHP and HSA Limits

The IRS limits for HSA contributions, HDHP minimum deductibles and HDHP maximum out-of-pocket expenses all increase for 2025. The HSA contribution limits will increase effective Jan. 1, 2025, while the HDHP cost-sharing limits will increase effective for plan years beginning on or after Jan. 1, 2025. Looking ahead, employers should take these steps:



  • Check whether HDHP cost-sharing limits need to be adjusted for the 2025 limits; and
  • Communicate HSA contribution limits for 2025 to employees as part of the enrollment process.


The following table contains the HDHP and HSA limits for 2025 compared to 2024. It also includes the catch-up contribution limit that applies to HSA-eligible individuals age 55 and older, which is not adjusted for inflation and stays the same from year to year.

HDHPs: Expiration of Design Options

To be eligible for HSA contributions for a month, an individual must be covered under an HDHP as of the first day of the month and have no other impermissible coverage. In general, except for preventive care benefits, no benefits can be paid by an HDHP until the minimum annual deductible has been satisfied. However, there are a few narrow exceptions to the minimum deductible requirement, including the following exceptions that are expiring:


  • For plan years ending after Dec. 31, 2024, an HDHP is no longer permitted to provide benefits for COVID-19 testing and treatment without a deductible (or with a deductible below the minimum deductible for an HDHP); and
  • For plan years beginning on or after Jan. 1, 2025, an HDHP is no longer permitted to provide benefits for telehealth or other remote care services before plan deductibles have been met.


Due to these changes, employers with HDHPs should take these steps for plan years beginning in 2025:


  • Confirm that HDHPs will not pay benefits for COVID-19 testing and treatment before the annual minimum deductible has been met;
  • Confirm that HDHPs will not pay benefits for telehealth or other remote care services (except for preventive care benefits) before the annual minimum deductible has been met; and
  • Notify plan participants of any changes for the 2025 plan year regarding COVID-19 testing and treatment and telehealth services through an updated SPD or SMM.


EBHRA Limit

An excepted benefit health reimbursement arrangement (EBHRA) is an employer-funded health care account that reimburses employees for their eligible medical expenses on a tax-free basis. Employers can use EBHRAs to supplement their traditional group health plan coverage and help employees with their out-of-pocket medical expenses, including deductible, copayment and coinsurance amounts. Employers of all sizes may offer EBHRAs. Although an employer must offer a traditional group health plan, employees are not required to enroll in the employer’s group coverage (or any other type of coverage) to be eligible for the EBHRA.


Only employers can contribute to HRAs, including EBHRAs. EBHRAs are subject to a maximum amount that may be made newly available for the plan year. This maximum amount is adjusted annually for inflation. For 2024 plan years, the contribution limit is $2,100. This limit increases to $2,150 for plan years beginning in 2025.


Employers that sponsor EBHRAs should take the following steps:


  • Decide how much will be contributed to the EBHRA for eligible employees for the 2025 plan year, up to a maximum of $2,150; and
  • Communicate the EHBRA’s annual benefit amount to employees as part of the open enrollment process.


Mental Health Parity – Required Comparative Analysis for NQTLs

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires parity between a group health plan’s medical/surgical benefits and its mental health or substance use disorder (MH/SUD) benefits. These parity requirements apply to financial requirements and treatment limits for MH/SUD benefits. In addition, any nonquantitative treatment limitations (NQTLs) placed on MH/SUD benefits must comply with MHPAEA’s parity requirements. For example, NQTLs include prior authorization, step therapy protocols, network adequacy and medical necessity criteria.


MHPAEA requires health plans and issuers to conduct comparative analyses of the NQTLs used for medical/surgical benefits compared to MH/SUD benefits. This analysis must contain a detailed, written and reasoned explanation of the specific plan terms and practices at issue and include the basis for the plan’s or issuer’s conclusion that the NQTLs comply with MHPAEA. Plans and issuers must make their comparative analyses available to specific federal agencies or applicable state authorities upon request. In recent years, the U.S. Department of Labor (DOL) has made MHPAEA compliance a top enforcement priority, with a primary focus being MHPAEA’s parity requirements for NQTLs. Considering this information, employers should take the following step:


  • Reach out to health plan issuers (or third-party administrators) to confirm that comparative analyses of NQTLs will be updated, if necessary, for the plan year beginning in 2025.


Prescription Drug Benefits – Creditable Coverage Determination

The Inflation Reduction Act of 2022 (IRA) includes several cost-reduction provisions affecting Medicare Part D plans, which may impact the creditable coverage status of employer-sponsored prescription drug coverage beginning in 2025. For example, effective for 2025, Medicare enrollees’ out-of-pocket costs for prescription drugs will be capped at $2,000.


Employers that provide prescription drug coverage to individuals who are eligible for Medicare Part D must inform these individuals and the Centers for Medicare and Medicaid Services (CMS) whether their prescription drug coverage is creditable, meaning that the employer’s prescription drug coverage is at least as good as Medicare Part D coverage. These disclosures must be provided on an annual basis and at certain other designated times, including when there is a change to a prescription drug benefit’s creditable coverage status.


Previously, CMS stated that one of the methods for determining whether coverage is creditable (the “simplified determination” method) would no longer be valid as of calendar year 2025, given the significant changes made to Medicare Part D by the IRA. However, CMS subsequently decided that it will continue to permit the use of the simplified determination methodology, without modification, for calendar year 2025 for group health plan sponsors who are not applying for the retiree drug subsidy.


Due to these developments, employers should take the following steps:


  • Confirm whether their health plans’ prescription drug coverage for 2025 is creditable or noncreditable as soon as possible to prepare to send the appropriate Medicare Part D disclosure notices; and
  • Continue to utilize the simplified determination method for determining whether prescription drug coverage is creditable for 2025, if applicable.


Open Enrollment Notices

Employers who sponsor group health plans should provide certain benefits notices in connection with their plans’ open enrollment periods. Some of these notices must be provided at open enrollment time, such as the SBC. Other notices, such as the WHCRA notice, must be distributed annually. Although these annual notices may be provided at different times throughout the year, employers often choose to include them in their open enrollment materials for administrative convenience.


In addition, employers should review their open enrollment materials to confirm that they accurately reflect the terms and cost of coverage. In general, any plan design changes for 2025 should be communicated to plan participants either through an updated SPD or an SMM.


Summary of Benefits and Coverage

The ACA requires health plans and health insurance issuers to provide an SBC to applicants and enrollees each year at open enrollment or renewal time. Federal agencies have provided a template for the SBC, which health plans and issuers are required to use. To comply with the SBC requirements, employers should include an updated SBC with open enrollment materials.


Take note that the plan administrator is responsible for providing the SBC for self-funded plans. For insured plans, the issuer usually prepares the SBC. If the issuer prepares the SBC, an employer is not required to also prepare an SBC for the health plan, although they may need to distribute the SBC prepared by the issuer.


Medicare Part D Notices

Group health plan sponsors must provide a notice of creditable or noncreditable prescription drug coverage to Medicare Part D-eligible individuals covered by, or who apply for, prescription drug coverage under the health plan. This creditable coverage notice alerts individuals about whether their prescription drug coverage is at least as good as the Medicare Part D coverage. The notice generally must be provided at various times, including when an individual enrolls in the plan and each year before Oct. 15 (when the Medicare annual open enrollment period begins). Model notices are available on the Centers for Medicare and Medicaid Services’ website.


Annual CHIP Notices

Group health plans covering residents in a state that provides a premium subsidy to low-income children and their families to help pay for employer-sponsored coverage must send an annual CHIP notice about the available assistance to all employees residing in that state. The DOL has provided a model notice. Employers should confirm they are using the most recent model notice, as the DOL updates it regularly.


Initial COBRA Notices

COBRA applies to employers with 20 or more employees who sponsor group health plans. Group health plan administrators must provide an initial COBRA notice to new participants and certain dependents within 90 days after plan coverage begins. The initial COBRA notice may be incorporated into the plan’s SPD. A model initial COBRA notice is available from the DOL.


SPDs

Plan administrators must provide an SPD to new participants within 90 days after plan coverage begins. Any changes made to the plan should be reflected in an updated SPD booklet or described to participants through an SMM. Also, an updated SPD must be furnished every five years if changes are made to SPD information or the plan is amended. Otherwise, a new SPD must be provided every 10 years.


Notices of Patient Protections

Under the ACA, group health plans and issuers that require the designation of a participating primary care provider must permit each participant, beneficiary and enrollee to designate any available participating primary care provider (including a pediatrician for children). Additionally, plans and issuers that provide obstetrical/gynecological care and require a designation of a participating primary care provider may not require preauthorization or referral for such care. If a health plan requires participants to designate a participating primary care provider, the plan or issuer must provide a notice of these patient protections whenever the SPD or similar description of benefits is provided to a participant. If an employer’s plan is subject to this notice requirement, they should confirm that it is included in the plan’s open enrollment materials. This notice may be included in the plan’s SPD. Model language is available from the DOL.


Grandfathered Plan Notices

If an employer has a grandfathered plan, they should make sure to include information about the plan’s grandfathered status in plan materials describing the coverage under the plan, such as SPDs and open enrollment materials. Model language is available from the DOL.


Notices of HIPAA Special Enrollment Rights

At or before the time of enrollment, an employer’s group health plan must provide each eligible employee with a notice of their special enrollment rights under HIPAA. This notice may be included in the plan’s SPD.


HIPAA Privacy Notices

The HIPAA Privacy Rule requires covered entities (including group health plans and issuers) to provide a Notice of Privacy Practices (or Privacy Notice) to each individual who is the subject of protected health information (PHI). Health plans are required to send the Privacy Notice at certain times, including to new enrollees at the time of enrollment. Also, at least once every three years, health plans must either redistribute the Privacy Notice or notify participants that the Privacy Notice is available and explain how to obtain a copy.


Self-insured health plans must maintain and provide their own Privacy Notices. However, special rules apply for fully insured plans, where the health insurance issuer, not the plan itself, is primarily responsible for the Privacy Notice.


Special Rules for Fully Insured Plans

The sponsor of a fully insured health plan has limited responsibilities with respect to the Privacy Notice, including the following:


  • If the sponsor of a fully insured plan has access to PHI for plan administrative functions, they are required to maintain a Privacy Notice and provide the notice upon request; and
  • If the sponsor of a fully insured plan does not have access to PHI for plan administrative functions, they are not required to maintain or provide a Privacy Notice.


A plan sponsor’s access to enrollment information, summary health information and PHI that is released pursuant to a HIPAA authorization does not qualify as having access to PHI for plan administration purposes.


Model Privacy Notices are available through the U.S. Department of Health and Human Services.


WHCRA Notices

Plans and issuers must provide a notice of participants’ rights to mastectomy-related benefits under the WHCRA at the time of enrollment and on an annual basis. The DOL’s compliance assistance guide includes model language for this disclosure.


SARs

Plan administrators required to file Form 5500 must provide participants with a narrative summary of the information in Form 5500, called a summary annual report (SAR). Group health plans that are unfunded (that is, benefits are payable from the employer’s general assets and not through an insurance policy or trust) are not subject to the SAR requirement. The plan administrator generally must provide the SAR within nine months of the close of the plan year. If an extension of time to file Form 5500 is obtained, the plan administrator must furnish the SAR within two months after the close of the extension period. A model notice is available from the DOL.


Wellness Program Notices

Group health plans that include wellness programs may be required to provide certain notices regarding the program’s design. As a general rule, these notices should be provided when the wellness program is communicated to employees and before employees provide any health-related information or undergo medical examinations. These notices are required in the following situations:


  • HIPAA Wellness Program Notice—HIPAA imposes a notice requirement on health-contingent wellness programs offered under group health plans. Health-contingent wellness plans require individuals to satisfy standards related to health factors (e.g., not smoking) to obtain rewards. The notice must disclose the availability of a reasonable alternative standard to qualify for the reward (and, if applicable, the possibility of waiver of the otherwise applicable standard) in all plan materials describing the terms of a health-contingent wellness program. The DOL’s compliance assistance guide includes a model notice that can be used to satisfy this requirement.
  • Americans with Disabilities Act (ADA) Wellness Program Notice—Employers with 15 or more employees are subject to the ADA. Wellness programs that include health-related questions or medical exams must comply with the ADA’s requirements, including an employee notice requirement. Employers must give participating employees þ a notice that tells them what information will be collected as part of the wellness program, with whom it will be shared and for what purpose, as well as includes the limits on disclosure and the way information will be kept confidential. The U.S. Equal Employment Opportunity Commission has provided a sample notice to help employers comply with this ADA requirement.


ICHRA Notices

Employers may use individual coverage health reimbursement arrangements (ICHRAs) to reimburse their eligible employees for insurance policies purchased in the individual market or for Medicare premiums. Employers with ICHRAs must provide a notice to eligible participants about the ICHRA and its interaction with the ACA’s premium tax credit. In general, this notice must be provided at least 90 days before the beginning of each plan year. Employers may provide this notice at open enrollment time if it is at least 90 days prior to the beginning of the plan year. A model notice is available for employers to use to satisfy this notice requirement.


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Is Your Workforce Prepared for Severe Weather?

January 23, 2026
Severe weather can disrupt business operations faster than almost anything else. From winter storms and flooding to extreme heat, wildfires, and hurricanes, these events don’t just impact buildings and schedules; they impact people, payroll, compliance, and decision-making in real time. For employers, the question isn’t if severe weather will affect your workforce, but whether you’re prepared when it does. Organizations that plan ahead are better positioned to protect employees, maintain trust, and avoid costly missteps when conditions change quickly. Preparation Starts Before the Weather Hits When severe weather develops, decisions often need to be made quickly. Power outages, road closures, and evacuation orders can disrupt normal operations with little warning. The best way to navigate these moments is to lay the groundwork ahead of time, so you’re not starting from scratch when conditions change. Start by taking a proactive approach: Identify the types of severe weather most likely to affect your workforce based on geography and job roles Outline clear safety and response plans so employees know what to do and who to contact Communicate expectations in advance, including how closures, remote work, and updates will be handled Preparation isn’t about anticipating every possible outcome. It’s about giving your organization a reliable framework to make decisions calmly, communicate clearly, and adapt as circumstances evolve. Understanding Your Responsibility as an Employer As an employer, you are responsible for providing a work environment that keeps people safe, even when conditions outside your control create added risk. Workplace safety laws, including OSHA’s General Duty Clause, require you to address recognized hazards that could lead to serious harm, and severe weather can quickly introduce or intensify those hazards. Beyond OSHA, additional state and local regulations, industry-specific standards, and insurance requirements may come into play depending on where and how your employees work. Taking time to understand how these obligations align with your policies, procedures, and day-to-day operations helps you respond more confidently when weather conditions threaten employee safety. Assessing Risk Across Your Workforce No two workforces face the same risks. A meaningful severe weather plan starts with understanding how geography, job duties, and work environments affect exposure. Key questions to consider include: What types of severe weather are most common where employees live and work? Which roles are essential during disruptions, and which can be performed remotely? How could weather events impact commuting, utilities, or workplace safety? Once you have a clearer picture of these risks, document practical safety measures, outline contingency plans, and clearly identify points of contact. When employees know who to reach out to and what steps to follow, they can respond more confidently and safely as conditions change. Communication When It Matters Most Power outages, spotty internet, and overwhelmed phone networks can make it difficult to reach employees at the exact moment guidance is needed. Thinking through communication ahead of time, even at a high level, can make a meaningful difference when conditions change quickly. Start by deciding how you will share updates if your usual tools are unavailable. This might mean designating an alternate way to send messages, choosing a single place where updates will be posted, or clarifying who is responsible for communicating next steps. Even a simple, centralized approach can help employees know where to look for information and what to expect if they don’t hear from you immediately. Clear direction, shared as early as possible, reduces uncertainty and helps employees make safe decisions without guessing. When people understand how and when updates will be provided, they’re better equipped to respond calmly, even if communication is delayed or limited. Attendance, No-Shows, and Real-Life Constraints Severe weather can prevent employees from reporting to work for reasons beyond their control, including unsafe travel conditions, school closures, or power outages. While attendance policies play an important role in normal operations, emergencies often require a more flexible approach. How these situations are handled can shape employee trust long after the weather clears. Allowing for management discretion during severe weather events gives leaders the ability to respond thoughtfully to individual circumstances. Taking time to understand what employees are dealing with, communicating expectations clearly, and offering reasonable alternatives when possible can go a long way. Flexibility during these moments not only supports safety, but also reinforces engagement, loyalty, and confidence in leadership. When Employees Don’t Feel Safe Traveling Even when your workplace remains open, some employees may not feel safe commuting. Encourage open, honest conversations so concerns can be addressed early, and be prepared to offer practical alternatives such as temporary remote work, adjusted schedules, or time off when appropriate. It’s also helpful to understand what support may already be available through your business insurance coverage, as some policies include provisions for lodging, travel, or temporary relocation for employees in critical roles. Reviewing these options with your insurance advisor ahead of time can provide clarity and help you make timely, confident decisions when severe weather impacts operations. Closures and Pay Weather-related closures raise important wage and hour questions. Nonexempt employees generally must be paid only for hours worked, though employers may choose to pay or require PTO use based on policy. Exempt employees are typically entitled to their full salary for any week in which they perform work, even if the business closes for part of the week. Clear policies and consistent application are essential to avoiding payroll and compliance issues. Leave Protections and Legal Considerations Severe weather may trigger eligibility for various job-protected leaves, including: Family and Medical Leave Act (FMLA) Military or National Guard service Disability accommodations State-specific emergency leave laws Be prepared to recognize when these protections apply and provide required notices in a timely manner. Workplace Injuries During Severe Weather If an employee is injured while working during severe weather, immediate medical care should always be the top priority. Once the situation is stabilized and the employee is safe, ensure the injury is reported properly in line with workers’ compensation requirements and, where applicable, OSHA recordkeeping rules. After the initial response and reporting are complete, take time to review what happened. Looking closely at the circumstances and identifying any corrective steps, whether that involves adjusting procedures, equipment, or scheduling, can help you reduce the risk of similar incidents in the future and reinforce a safer work environment overall. Extended Disruptions: Layoffs, Furloughs, and Alternatives When severe weather leads to prolonged disruptions, you may need to evaluate options such as temporary layoffs, furloughs, or reduced schedules. Each of these paths comes with important considerations, including how pay, benefits, unemployment eligibility, and employee morale may be affected. Taking the time to document your decisions, apply them consistently, and communicate clearly with employees can help reduce confusion and protect both your workforce and your organization during an already challenging time. Flexible Scheduling as a Safety Tool Alternative schedules can help protect employees when conditions are unsafe at certain times of day. Adjusted start times, split shifts, or temporary remote work arrangements can reduce risk while maintaining operations. Flexibility is often one of the most effective tools you have as an employer during severe weather events. Supporting Employees Beyond the Workplace Severe weather affects employees at home as well. Consider offering: Emergency supplies or safety resources Temporary lodging or travel assistance Crisis-related financial support Mental health support is also critical. Access to employee assistance programs, wellness benefits, and time off can help employees manage stress during and after a disaster. Staying Alert as Conditions Evolve Government responses to severe weather can shift quickly and may include emergency declarations, executive orders, or new employment requirements. Staying aware of changes in the jurisdictions where your employees work helps you adjust policies and practices as needed. After the immediate disruption, encouraging volunteer or community support efforts can also help reinforce a culture of care and resilience. So, Is Your Workforce Ready? Severe weather may be unpredictable, but your response to it doesn’t have to feel like a scramble. When you take time to plan ahead, communicate clearly, and lead with flexibility, you give your organization a steadier footing to protect your workforce and keep operations moving when disruptions occur. At Simco, we help employers align HR, payroll, benefits, compliance, and commercial insurance so they’re ready when the unexpected happens. If you’re unsure whether your current policies or systems are prepared for severe weather, our team is here to help. Click here to get in touch.

Simco Insurance & Wealth Management’s 2025 Year in Review

January 7, 2026
At Simco Insurance & Wealth Management, 2025 was a year defined by refinement. Rather than chasing growth for growth’s sake, our focus was on designing better systems, improving the rhythm of our work, and removing friction from the moments that matter most to our clients. Every adjustment was made with one priority in mind: creating an experience that feels organized, responsive, and genuinely supportive for the individuals and families we serve. This recap highlights the operational progress and strategic shifts that shaped our year. For our clients, these efforts show up as clearer communication, smoother appointments, and more confident guidance. For those getting to know Simco Insurance & Wealth Management for the first time, it offers a look at how we’re intentionally preparing our team, tools, and processes to meet rising expectations with care and consistency. Designing Retention With Intention One of the most meaningful accomplishments this year was the development of an automated retention process focused on high-impact client touchpoints. By taking a closer look at recurring needs and communication patterns, the team built a system that strengthens relationships while reducing dependence on manual follow-up. This structure helps ensure consistency and follow-through, even during our busiest periods. As a result, we’re able to stay more connected, responsive, and proactive, reinforcing trust and delivering a more reliable client experience. A More Strategic Approach to AEP Planning Preparation for the Annual Enrollment Period (AEP) 2026 began earlier and more strategically than ever before. In September, the team launched a strategic early booking initiative, starting one full month ahead of the industry norm. The goal was twofold: maximize retention of existing clients while preserving capacity to support new business. The outcome exceeded expectations. More than 75% of existing clients were booked before AEP officially began , creating breathing room, reducing pressure, and allowing agents to focus fully on each client interaction. Just as importantly, this initiative produced a measurable, repeatable system that can be refined and reused for future AEP cycles. Visibility That Drives Accountability To support better planning and performance, the team developed a Book of Business Tracker that provides real-time visibility into client retention and new enrollments. This tool created clearer accountability for agent performance while also improving forecasting and decision-making throughout AEP. With better data came better conversations, better pacing, and more confident leadership. Communication and Automation That Protect Relationships Clear, timely communication is essential during periods of change. In 2025, the team produced and automated targeted emails for clients losing their plans, ensuring they were informed early and guided through next steps. These systems helped protect client relationships, reduce uncertainty, and reinforce Simco’s reputation for calm, proactive service, even in complex or time-sensitive situations. Reimagining the Client Appointment Experience Much of the year’s progress focused on improving the flow and efficiency of daily client interactions. The scheduling process was redesigned to eliminate bottlenecks, overlapping appointments, and unnecessary delays. The result was a smoother daily rhythm, shorter wait times, and a noticeably calmer office environment. Additional improvements included: Creating cubicle-based laptops to help clients complete CareValue forms efficiently Developing confirmation emails with embedded surveys so clients can submit doctors and medications in advance Tracking visits versus enrollments to ensure clients move fully through the process Together, these enhancements cut average appointment time by 50% , effectively doubling agent capacity while preserving quality and care. Strengthening Data Accuracy and Operational Support Behind the scenes, the team focused on maintaining clean, reliable data by entering missing client information and policy details on behalf of agents when needed. Repetitive processes were streamlined through automation and shared resources, reducing friction and freeing agents to focus on client relationships rather than administrative tasks. Every workflow was designed with scalability in mind: systems that can be replicated, measured, and improved year after year. Working on the Business, Not Just in It Throughout 2025, the Simco Insurance & Wealth Management team embraced the Traction principle of working on the business, not just in it. Continuous improvement, team empowerment, and thoughtful system design guided every decision. Each change reinforced Simco’s Core Values and Vision, ensuring that every client touchpoint reflects consistency, clarity, and care. Our Path Forward Into 2026 The work completed this year has created a stronger foundation for what’s next. With smarter systems, clearer data, and a more intentional client experience, we are positioned to serve individuals and families with even greater confidence in 2026 and beyond at Simco I&WM. Thank you to our clients for your trust, and to our team for the dedication and care that made this progress possible. We’re so proud of what we’ve built, and even more excited about where we’re headed! This year-in-review report was developed by Shena Edington-Bright, Team Lead at Simco Insurance & Wealth Management.

Simco’s 2025 Year in Review

January 5, 2026
As the business landscape continues to evolve, so does Simco. While 2025 may have looked like a year of quiet focus from the outside, it was anything but. Behind the scenes, our teams were strengthening the systems and structures that support our HCM / payroll, benefits, HR, retirement, and commercial insurance services, all with one goal in mind: to deliver a smoother, more dependable, and more proactive client experience. This recap offers a high-level look at what we’ve been building. If you're part of our existing client community, you’ll see how these investments enhance the service you receive every day. And for prospective partners and the broader market, consider this a window into how Simco is evolving to meet the growing expectations of the modern employer. A Stronger Foundation for the Future Much of our work throughout 2025 focused on reinforcing the operational backbone of Simco: the processes, tools, and training that enable our teams to support clients with consistency and confidence. We refined and standardized the core elements of our service model, including: Onboarding processes: creating a smoother, more predictable start for new clients by clarifying steps, responsibilities, timelines, and handoffs, ensuring everyone begins their Simco partnership with full visibility and support. Day-to-day service workflows: enhancing how requests are managed, tracked, and communicated so that clients experience faster responses, fewer delays, and a more proactive approach to problem-solving. Renewal experiences across multiple service lines: strengthening the structure behind annual renewals so they are more organized, timely, and transparent, with clearer communication and better preparation on both sides. By strengthening the infrastructure that supports every client interaction, we’re ensuring that growth never comes at the expense of quality. Communication That Sets Clear Expectations One of the most meaningful shifts this year came from improving the clarity and cadence of communication. Whether you're a current Simco client or exploring us as a potential partner, you’ll see a growing emphasis on: Setting expectations early: ensuring clients understand timelines, responsibilities, next steps, and key milestones upfront so there’s no confusion as projects or service requests move forward. Addressing issues proactively: identifying potential challenges before they surface, communicating them quickly, and offering solutions early to prevent disruptions. Creating more transparency in every interaction: providing clearer insights into processes, status updates, and decision-making so clients always know where things stand and what’s happening behind the scenes. This work helps eliminate surprises and creates a smoother, more predictable experience. Technology That Makes Service Smarter 2025 also brought strategic technology upgrades designed to improve accuracy, efficiency, and visibility. Some key milestones include: Expanded use of integrations and automations across platforms like isolved Enhanced reporting and improved data accuracy New tools to support onboarding, renewals, and Open Enrollment The build-out of our new CRM, rolling out internally to employees in January 2026 For our clients, this CRM will grow into a client-facing portal that ultimately brings our services together in one place. It will give you clearer visibility into service activity, smoother access to support, and a more connected experience across everything you work with us on. We’re genuinely excited about what this unlocks, not just in terms of upgrading technology, but in how it helps us close gaps, improve communication, and support you more seamlessly across all areas of your business. A More Coordinated Open Enrollment Season The Simco Benefits Team completed Open Enrollment two weeks faster than the previous year, thanks to strengthened planning, better communication, and tighter internal coordination. This improvement reflects our broader goal: to create processes that scale with growing demand while remaining predictable and client-centered. A Strategic Shift: Separating Our B2B and B2C Divisions In 2025, we completed the structural separation of our consumer-facing services, Simco Insurance & Wealth Management, from our core B2B operations. This was not simply an internal reorganization, but a strategic step toward honoring the very real differences between the needs of businesses and the needs of individuals and families. Employers require scalable systems, predictable processes, and deep operational support. Individuals, on the other hand, seek personalized guidance, protection, and long-term financial clarity. By creating space for each division to develop independently, we positioned both sides of our organization to serve their audiences with greater intention and expertise. As our service offerings have expanded, so has the complexity of the problems we solve. The separation enables our B2B team to focus fully on the demands of an employer environment, including compliance, data accuracy, HR workflows, benefits strategy, service scalability, and beyond. At the same time, the B2C division can continue developing its advisory capabilities, client education tools, and one-to-one support models. Both sides continue to share the same core values, high standards, and service philosophy, but each now has the room to innovate in ways that make the most sense for the communities they serve. We want to ensure that whether you’re engaging with Simco as an employer, or with Simco Insurance & Wealth Management as an individual or family, you’re connected to a team built specifically for your needs without losing the warmth, consistency, or integrity that define the Simco brand. Growing Without Losing What Makes Us, Us and What This Means for Those We Serve 2025 was a year of meaningful expansion for Simco through new partnerships and client relationships. But growth alone isn’t the metric we celebrate, it’s sustainable growth. Behind the scenes, we focused on building structure and scalability so that every new relationship receives the same level of attention and consistency our long-standing clients expect from us. Whether you're already part of the Simco family or seeing us for the first time, here’s what our 2025 investments translate to: More consistency in how we serve Greater proactivity in identifying and addressing issues Enhanced accuracy and efficiency throughout every process Improved capacity to support continued growth and complexity A stronger, smarter foundation for the years ahead To our current clients: thank you for trusting us with your business. Everything we built this year was designed to enhance the experience you rely on. To those learning about Simco for the first time: consider this a preview of the service structure we believe all employers should expect, both today and in the future. Looking Ahead to 2026 We’re entering the new year with momentum, clarity, and a renewed commitment to continuous improvement. The work we completed in 2025 positions us to deliver an even more streamlined, transparent, and dependable experience in 2026 and beyond. Thank you for being part of our journey and for giving us the opportunity to support yours. This year-in-review report was developed by Elisha Everson, Director of Operations at Simco.

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