Open Enrollment is an annual window (usually in the fall) when employers and the government (Medicare & the Affordable Care Act – ACA) allow employees/consumers to elect or change their benefit options. This can include health, dental, life insurance, and possibly other ancillary benefits ranging from legal services to pet insurance.

Typically, you can only enroll in benefit plans outside the open enrollment window IF you are either a new employee or experience a qualifying life event. Qualifying life events generally include:

• Changes in household (marriage, death, divorce)
• Loss of insurance
• Changing residence
• Birth or adoption of a child
• Turning 65 for Medicare

Important Note for 2026: Several significant changes take effect that make active enrollment and careful planning more critical than ever before.

Most Common Open Enrollment Mistakes

It may feel like open enrollment is just another routine task on your to-do list that can be checked off without much thought. However, given the importance of these benefits to you and your family, and the potentially significant cost, it is worth your time to review and compare all options. Common mistakes include:

• Missing the deadline
• Defaulting to the prior year’s benefits (especially critical for 2026 due to major ACA changes)
• Over or underinsuring
• Passing up tax-free savings
• Assuming everyone should be on the same plan
• Ignoring added benefits
• Not budgeting for potential premium increases (particularly important for 2026 ACA enrollees)
• Forgetting to add your newborn. You are required to add your newborn to your health insurance within 30 days of birth to be covered by your plan.

Preparation for Open Enrollment

The good news is that most of the needed information is available online through your employer insurance portal or various government websites. To prepare for open enrollment, we suggest the following:

• Calculate your medical cost of care for the current year, including co-pays, deductibles, monthly payroll deductions, prescriptions, and any other out-of-pocket expenses. Then, compare plans using this information. Obviously, you will not know what the future will bring, but you can make an educated decision.
• If you are married and you both have employer-sponsored health insurance, use the exercise above to compare your plans. Determine if you should be covered under the same plan or enroll individually under your respective employer’s plans.
• Make a list of prescriptions and pharmacies to determine whether your needs were met.
• List questions for the new year. How have your needs changed this year?
• Review your expected childcare/eldercare expenses if you have the option to fund a Flexible Savings Account.
• Determine whether you are eligible for 401(k) or other retirement plan catch-ups.
• Make sure to take advantage of all employer matches.
• Review whether you have sufficient disability and life insurance. If additional coverage is warranted, research whether to obtain additional coverage through an employer plan or through private insurance.

Review your Options

It may be that your employer is offering an HDHP (high-deductible health plan) in addition to, or in lieu of, a more traditional health plan. If you are in good health, consider whether a HDHP is right for you. These plans allow you to fund an HSA (Health Savings Account), which is a tax-advantaged way to save and invest in current and future qualified medical expenses.

2026 HSA Contribution Limits

For 2026, HSA contribution limits continue to increase:

• Individual coverage: $4,400 (up from $4,300 in 2025)
• Family coverage: $8,750 (up from $8,550 in 2025)
• Catch-up contribution (age 55+): Additional $1,000

To be eligible for an HSA in 2026, your high-deductible health plan must have:

• Minimum deductible of $1,700 for individual or $3,400 for family coverage
• Maximum out-of-pocket limit of $8,500 for individual or $17,000 for family coverage

New for 2026: Certain high-deductible ACA Marketplace plans will become HSA-eligible, giving more people access to these tax-advantaged accounts.

2026 FSA Contribution Limits

Healthcare Flexible Spending Accounts (FSAs) limits are expected to continue increasing:

• Healthcare FSA/Limited Purpose FSA (for individuals covered under a HDHP plan): Projected $3,350-$3,400 (awaiting IRS announcement)
• Dependent Care FSA: $7,500 for married filing jointly, $3,750 for individual taxpayers
• FSA Carryover limit: Projected $670-$680 (20% of contribution limit)

2026 401(k) and Retirement Plan Limits

Retirement contribution limits for 2026 (awaiting final IRS announcement):

• 401(k) employee contribution limit: Projected $24,500
• Standard catch-up contribution (age 50+): Additional $8,000
• Super catch-up contribution (ages 60-63): Additional $11,250
• Total contribution limit (employee + employer): Projected $72,000
• IRA contribution limit: $7,500
• IRA catch-up contribution (age 50+): Additional $1,000

Important Note: Starting in 2027, high earners (those making $145,000+ in the previous year) will be required to make catch-up contributions to many employer retirement plans on a Roth (after-tax) basis.

Medicare Parts B and D Open Enrollment

Medicare has open enrollment for existing Medicare enrollees who want to change their coverage. We recommend speaking with a Medicare expert if you are considering changing your current coverage. Some important points are:

• The open enrollment period is October 15 – December 7 (every year) for Original Medicare which includes Medicare Parts A, B, & D. The new plans are effective January 1 of the following year. (For those already enrolled in a Medicare Advantage (Part C) plan and want to change their plan, the open enrollment period is January 1 – March 31.)
• It allows for switching from Medicare Advantage (Part C) to Original Medicare (Part A, B, & D) or from Original Medicare to Medicare Advantage.
• For those covered by Medicare Part D, open enrollment is the time to review your current prescription plan and determine if it is still the best fit in terms of coverage and cost.

Open Enrollment for the ACA – 2026 Coverage

CRITICAL NOTICE: Major changes are taking effect for 2026 ACA coverage that may significantly impact costs and enrollment options.

2026 Open Enrollment Dates

Open enrollment for 2026 coverage runs from November 1, 2025 through January 15, 2026 in most states.

Important Deadlines:

• December 15, 2025: Last day to enroll for January 1, 2026 coverage start date
• January 15, 2026: Final deadline for 2026 coverage (coverage starts February 1)

Major Changes for 2026

Enhanced Subsidies Are Expiring

The enhanced premium tax credits (subsidies) that have made ACA coverage more affordable since 2021 are scheduled to expire December 31, 2025 unless Congress acts to extend them:

• Monthly premium costs could increase dramatically – some reports indicate average premiums may increase by 75%
• Some people will lose subsidies entirely (those above 400% of federal poverty level)

Enrollment Restrictions

• Year-round enrollment eliminated: Low-income individuals (below 150% of federal poverty level) will no longer be able to enroll throughout the year
• DACA recipients no longer eligible for ACA marketplace coverage
• $5 minimum premium: Auto-renewed $0 premium plans will require at least $5/month unless you actively renew

Higher Out-of-Pocket Costs

• Individual out-of-pocket maximum: Increases to $10,600 (from $9,200 in 2025)
• Family out-of-pocket maximum: Increases to $21,200 (from $18,400 in 2025)

Recommendation: Do not Wait – Enroll Now

DO NOT delay enrollment while waiting for Congress to act on subsidies. Here is why:

1. Open enrollment deadlines are firm – missing them means no coverage
2. Congressional action is uncertain and may not happen before December 31, 2025
3. If subsidies are extended, they may be applied retroactively
4. Coverage is essential – the risk of being uninsured outweighs uncertainty about subsidies

Action Steps for 2026

1. Actively review and compare plans – do not auto-renew
2. Budget for higher costs – calculate premiums without enhanced subsidies
3. Consider different plan levels – Bronze plans with HSA eligibility may become more attractive
4. Gather income documentation early
5. Enroll by deadlines regardless of subsidy uncertainty

Qualifying Life Events to Enroll in an ACA Plan

• Loss of a job/health insurance
• Loss of a spouse
• Medicare eligibility
• Birth or adoption of a child
• Marriage or divorce

State-Specific Open Enrollment Dates for 2026 Coverage

While most states follow the November 1, 2025 – January 15, 2026 timeline, some state-based marketplaces may have different end dates. Check with your state marketplace for specific deadlines.

Important: Starting with 2027 coverage, the open enrollment window will be shortened to November 1 – December 15 in most states.

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Mosaic FI, LLC is a State of Illinois registered investment adviser. The opinions expressed herein are those of the firm and are subject to change without notice due to changes in the market or economic conditions and may not necessarily come to pass. Any opinions, projections, or forward-looking statements expressed herein are solely those of Jenifer Aronson and Leslie Meisner, may differ from the views or opinions expressed by other areas of the firm, and are only for general informational purposes September 29, 2025.Mosaic FI, LLC has provided links to various other websites. While Mosaic FI, LLC believes this information to be current and valuable to its clients, Mosaic FI, LLC provides these links on a strictly informational basis only and cannot be held liable for the accuracy, time sensitive nature, or viability of any information shown on these sites