Why Automation is the Future of Open Enrollment in US Healthcare

February 15, 2021
Image of a doctor's stethoscope against blank insurance claims forms.

What is open enrollment?

In the United States Healthcare industry, ‘open enrollment’ refers to the time, typically towards the end of the year, when individuals can change their Health Insurance plans without a life-changing event (such as getting married and change in employment status) allowing them to do so.

Open enrollment for 2021 was originally scheduled from 1st November 2020 to 15 December 2020, with new coverage taking effect on 1st January 2021. However, President Biden re-opened open enrollment in the ACA for 2021, citing the COVID-19 pandemic as an emergency situation. The new open enrollment period is from February 15th, 2021 to May 15th, 2021. The effective dates may vary if your insurance is covered by your employer and there are further variations by state, so be sure to check before making any changes.

How does it usually work?

The traditional open enrollment period for Healthcare changes involves a lot of paperwork and teams of employees from HR at corporate companies to Healthcare providers and Insurers being overwhelmed with admin to ensure individual’s Healthcare details have been completed by the given deadline with all accurate details.

This is a high-pressure environment, it involves a lot of data entry, high chances of human error and repetition. This criteria lends itself very well to automation, however, the following report states only 33% of Healthcare providers in 2018 had significant investment in AI – we will come back to this point shortly.

See also: How Medical Claims Processing Transforms Patient Healthcare

The current situation

The Covid-19 pandemic has made 2020 one of the most unpredictable and unique years in living memory. It has had a huge impact on people from all walks of life, in all situations. Due to the pandemic’s ongoing unpredictability, now is an important time for the US Health Insurance industry.

A 2018 report from Aflac states that 93% of employees stick to their existing plans year to year. The result of this might mean you are overpaying or missing important benefits so at the best of times it’s advisable to dedicate some time to find out all options with the team responsible for looking after this area within your company.

Open enrollment this year is likely to see an additional strain on the HR departments at businesses as well as Insurance companies. Employers need to ensure they are protecting their staff and giving employees time to ask questions; employees must consider their benefits and understand their options.

What’s the solution?

If departments at corporations and Healthcare providers can set themselves up in the best way possible to avoid a strenuous period every year, why wouldn’t they? RPA is already being used to support healthcare providers and 15% of ‘healthcare revenue cycle leaders’ plan to invest in the next year. When used effectively RPA can provide invaluable support to a team by mimicking how a human carries out tasks. It is incredibly effective at completing data entry, removing human error, improving the speed at which these repetitive tasks are completed and saving valuable hours in the working day.

If RPA and Intelligent Automation are adopted across the board, it could allow more time for education on the best options for individual’s healthcare as employees previously responsible for considerable admin will have more time to dedicate to one to one interaction. It could also be a step towards relieving a stressful period industry-wide and allow for more engaging, stimulating work for the team.

See also: Healthcare Automation: The Secret Impact of AI in Medicine


A digital transformation is a huge change for any organization and it can take time to see results. There are many options and finding the best solution to fit your team is vital.

At Roots Automation, we do much of the heavy lifting to make this as smooth a transition as possible, we pre-train your Digital Coworker in just a few weeks so they are familiar with your team’s process from their first day. The Digital Coworkers have machine learning capabilities which enable them to learn from your team and improve in their role, as a human colleague would. We strive to make the transformation a profitable one and our customers typically see a 250% ROI from their first automation and every automation thereafter.

Get in touch to find out more: info@rootsautomation.com

Originally published on October 19th, 2020 and updated on February 15th, 2021.

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