Before the OE window opens; distribute at least 2 weeks before elections are due.
On or before the first day; new hires typically have 30 days to elect.
Reissue updated materials promptly when costs or plan options change.
| Trigger | Timing | Notes |
|---|---|---|
| Annual open enrollment | Before OE window opens | Employees need time to compare options; distribute at least 2 weeks before elections are due. |
| New hire onboarding | On or before first day | New hires typically have 30 days to elect coverage; they need cost info before they can decide. |
| Mid-year plan change | As soon as finalized | If costs or plan options change outside of open enrollment, reissue updated materials promptly. |
| Qualifying life event | When event is reported | Employees adding dependents mid-year should receive current cost information so they can make informed changes. |
- Rate sheet from your carrier or broker: Full monthly premium by plan and coverage tier (employee only, employee + spouse, employee + children, family). Your broker should send this before renewal.
- Employer contribution amounts: How much the company pays toward each tier. If you contribute a flat dollar amount, this is easy; if you contribute a percentage, calculate the employee share for each tier.
- Pay period count: How many pay periods per year (typically 26 for biweekly or 24 for semimonthly). Divide the monthly employee cost by the appropriate fraction to get the per-paycheck deduction.
- Plan design details: Deductibles, out-of-pocket maximums, copays, and coinsurance for each plan. Available in the carrier's rate proposal or the Summary of Benefits and Coverage (SBC).
- Dental and vision plan details: Same data points: premium, employer contribution, and key benefit features (annual max, frequency, allowances).
- HSA contribution (if applicable): If you offer an HDHP with an employer HSA contribution, include that amount; it effectively reduces the employee's out-of-pocket cost and should factor into the comparison.
- Format: PDF is the most common format; it preserves the layout across devices. A printed handout works well for in-person OE meetings. Both is fine.
- Timing: Distribute before the OE election window opens; at least 10 to 14 days is a reasonable target so employees have time to review and compare options.
- New hires: Include in the onboarding packet or email the PDF directly with a link to enroll. New hires typically have 30 days from their start date to elect coverage.
- HR portal: Post the current year's highlights sheet in a place employees can return to it, not just in the initial enrollment email.
- Language access: If a significant portion of your workforce is not English-proficient, consider a translated version or at minimum offer to walk through it with those employees.
- Dated copyA dated PDF copy of each year's benefits highlights sheet, saved in your HR files.
- Distribution recordEmail send date, OE packet date, or new-hire onboarding checklist noting the highlights sheet was provided.
- Mid-year updatesIf costs change mid-year, retain a copy of the updated sheet and the date it was distributed.
- Supporting figuresBroker confirmation or rate sheet from the carrier supporting the figures shown, useful if the math is ever questioned.
Common traps
FAQs
Is a benefits highlight sheet legally required?
No. There is no federal law requiring a separate benefits highlights document. However, the Summary of Benefits and Coverage (SBC), which is required, covers clinical plan design but does not show your employer contribution or the employee's actual cost. The highlights sheet fills that gap.
Can I just point employees to the SBC instead?
The SBC is a required document and employees should receive it, but it isn't designed to help employees compare costs. It shows benefit structure (deductibles, copays) but not what the employee will actually pay per paycheck. A highlights sheet is a separate, practical tool that complements the SBC.
Do I need a separate document for each plan, or one combined sheet?
One combined document that puts all plans side by side is almost always better. Employees need to compare options to make a decision; sending separate documents for each plan makes that harder, not easier.
- Multiple contribution tiers by employee class: Some employers contribute differently for full-time vs. part-time employees, or for different employee groups. If so, create separate cost columns or separate highlights sheets for each class; one sheet with conflicting numbers causes confusion.
- Employer HSA contributions on an HDHP: Show the employer HSA contribution as a line item in the HDHP column. Consider adding a note showing the effective first-dollar deductible after the employer HSA deposit; it makes the HDHP option much more competitive on paper.
- Defined contribution / private exchange model: If you give employees an allowance to shop on a private exchange, the highlights sheet becomes a description of the allowance and how to use it rather than a traditional side-by-side comparison.
- Waiver incentives: If you offer employees a cash payment or HRA contribution for waiving coverage, note that on the highlights sheet as an alternative to enrollment; some employees will prefer it.
Fill in the bracketed fields with your plan data. Use one column per plan option. Distribute with your open enrollment packet and include in your new-hire onboarding materials.
Medical Coverage
| [Plan Name, e.g., PPO] | [Plan Name, e.g., HDHP] | |
|---|---|---|
| Carrier | [Carrier Name] | [Carrier Name] |
| Network | [e.g., BlueCare Network] | [e.g., National PPO] |
| Individual Deductible | $[Amount] | $[Amount] |
| Family Deductible | $[Amount] | $[Amount] |
| Out-of-Pocket Max (Individual) | $[Amount] | $[Amount] |
| Primary Care Visit | $[Copay] / [X]% after deductible | [X]% after deductible |
| Specialist Visit | $[Copay] / [X]% after deductible | [X]% after deductible |
| Emergency Room | $[Copay] / [X]% after deductible | [X]% after deductible |
| Generic Rx | $[Copay] | $[Copay] after deductible |
| HSA Compatible? | No | Yes |
Monthly Costs, Medical
| Coverage Tier | Total Premium | Employer Pays | Employee Pays / Month | Employee Pays / Paycheck* |
|---|---|---|---|---|
| Employee Only | $[Amount] | $[Amount] | $[Amount] | $[Amount] |
| Employee + Spouse | $[Amount] | $[Amount] | $[Amount] | $[Amount] |
| Employee + Child(ren) | $[Amount] | $[Amount] | $[Amount] | $[Amount] |
| Employee + Family | $[Amount] | $[Amount] | $[Amount] | $[Amount] |
*Based on [26 / 24 / 52] pay periods per year. Deducted pre-tax.
Dental Coverage
| [Plan Name] | |
|---|---|
| Carrier | [Carrier Name] |
| Annual Maximum | $[Amount] per person |
| Preventive (Class I) | [X]%, no deductible |
| Basic Restorative (Class II) | [X]% after deductible |
| Major Restorative (Class III) | [X]% after deductible |
| Orthodontia (if included) | [X]%, lifetime max $[Amount] |
| Employee Only / Mo. | $[EE Cost] ($[Employer] employer / $[Employee] employee) |
| Employee + Family / Mo. | $[EE Cost] ($[Employer] employer / $[Employee] employee) |
Vision Coverage
| [Plan Name] | |
|---|---|
| Carrier | [Carrier Name] |
| Eye Exam | $[Copay] / 1x per [12/24] months |
| Frames Allowance | Up to $[Amount] / year |
| Contact Lens Allowance | Up to $[Amount] / year (in lieu of glasses) |
| Employee Only / Mo. | $[EE Cost] ($[Employer] employer / $[Employee] employee) |
| Employee + Family / Mo. | $[EE Cost] ($[Employer] employer / $[Employee] employee) |
This summary highlights key plan features. For full benefit details, refer to the Summary of Benefits and Coverage (SBC) or the plan document provided by your carrier.