2026 Open Enrollment

Frequently Asked Questions

• What is Open Enrollment?

  Open enrollment is the designated period when employees can enroll in, make changes to, or cancel their health insurance and other benefits. It’s a crucial time for employees to review their needs and choose the plans that best fit them for the upcoming year.

• What if I miss Open Enrollment?

  If you miss open enrollment, you can only make changes if you have a qualifying life event including losing health coverage, getting married, or birth of a child. You are able to change your health savings account and retirement contributions at any time throughout the year without a qualifying life event though.

• What is the difference between PPO and HDHP?

  High-deductible health plans (HDHPs) offer lower monthly premiums but higher deductibles, while preferred provider organizations (PPOs) typically have higher monthly premiums but lower deductibles. With HDHPs, you will be responsible for paying all costs associated with health care, such as office visits and prescriptions until you have met your deductible whereas with PPO plans, you will pay co-pays for health costs such as office visits and prescriptions. When choosing between an HDHP and a PPO, it is important to consider your health status, expected medical needs, and financial situation.

  Watch a short video to learn more about PPO and HDHPs.

• Can you help me understand some of the common key terms when it comes to health insurance?

  Understanding what a premium, co-pay, deductible, and out-of-pocket maximum is important in order to help you use your benefits effectively. Watch this short video to learn more about these key terms.

• What is HealthPartners doing to inform members about the change to the Pharmacy Benefit Administrator?

  As a reminder, HealthPartners has made the decision to transition to a new partner, Express Scripts, Inc beginning January 1, 2026 to help administer their pharmacy benefits. As part of this transition, all members will receive a new ID card prior to January 1, 2026.

  HealthPartners is doing what they can to ensure a seamless transition for members, which includes the following touchpoints prior to January 1, 2026:

  • FAQ pages and alerts on their public website
  • Pre-recorded phone calls and personalized reminders
  • Pharmacy networks are being notified of the transition ahead

  HealthPartners encourages all members to download the HealthPartners mobile app so you can access your most current ID card anytime, from anywhere.

• What is the difference between an HSA and an FSA?

  An HSA is a type of tax-advantaged savings account where you set aside money through payroll deductions to help pay for medical expenses, like prescription medications, office visits, or other expenses related to diagnosing, treating, or preventing illnesses. HSA funds can roll over at the end of the year and have higher contribution limits. To be eligible to participate in an HSA, you must be enrolled in Macalester’s high deductible health plan.

  An FSA is another type of tax-advantaged savings account where you set aside money through payroll deductions to help pay for qualified medical expenses. FSA funds have a “use-it or lose-it” rule and only allow for a small amount to rollover at the end of the year. So, during open enrollment you’ll have to decide how much money you want to set aside for the year, which can be difficult to predict.

  The main difference between an HSA and an FSA comes down to flexibility. With an HSA, there are higher contribution limits compared to an FSA, and HSAs are portable, which means you can take the account with you if you were to switch jobs or leave the workforce. You’re also able to roll over your remaining balance from year to year with an HSA, while an FSA doesn’t allow for that same flexibility.

  Watch a short video to learn more about the difference between HSA’s and FSA’s

• What is a dependent care FSA?

  A dependent care FSA is a pre-tax account that allows you to set aside money to cover eligible dependent care expenses, including daycare, preschool, after-school programs, summer day camps, and eldercare. Eligible dependents include children under age 13 and qualifying relatives over age 13 who are unable to care for themselves due to a physical or mental condition.

• Am I eligible for a Health Savings Account if I am not enrolled in Macalester’s high deductible health plan?

  No, you must be enrolled in Macalester’s High Deductible Health Plan (HDHP) in order to enroll in the Health Savings Account and receive the employer contribution. The HSA is designed to work in conjunction with the HDHP, so only employees who are actively enrolled in that plan are eligible.

• What are the 2026 limits for HSA and FSA?

  2026 HSA Limits

  • Employee Only – $4,400
  • Family – $8,750
  • Catch-up (age 55+) – $1,000

  2026 Healthcare FSA Limits: $3,400

  2026 Dependent Care Limits: $7,500.

• What can I use my HSA dollars on?

  You can use your HSA dollars on any any number of medical supplies, from prescriptions and eye glasses to chiropractors, hearing aids, bandages, SPF 15+ sunscreen, and acupuncture.  Review the Qualified Medical Expenses list for specific items.  You can also use your HSA dollars to pay for qualified expenses for your dependent family members even if they are not on your health insurance.

   

• Do I need to re-enroll in my HSA for 2026?

  Short answer – yes!

  As a result of updating our employer HSA model when you log in to Bswift to complete your enrollment, your HSA election will appear as “waived.” If you’re participating in the High Deductible Health Plan (HDHP), please be sure to make an active HSA election so that both your contributions and the employer contributions are correctly set up.

  We have prepared these instructions to help provide guidance as you make your HSA election.

  We will be auditing all HDHP enrollees to ensure that HSA elections are made so that the employer contribution is set up.

  Please reach out to [email protected] if you have any questions. 

• How much can I contribute to my retirement in 2026?

  The 2026 standard limit is $24,500. Those who are age 50+ are able to contribute up to $32,500. Those who are age 60-63 are able to contribute up to $35,750.

• What is Nice Healthcare?

  Nice Healthcare is a primary care clinic that offers you and your family unlimited virtual and in-home visits with clinicians. If you are enrolled in one of Macalester’s health plans, you are automatically enrolled in Nice. Your spouse/domestic partner and children up to age 26 can also use Nice even if they’re not enrolled in a health plan through Macalester.  Macalester covers 100% of the premium so there is no monthly cost to you or your family members.

  Nice Healthcare is a clinic that comes to you! They offer:

  • Same-day chat and video visits: Diagnosis, prescriptions, treatment plans, care guidance, referrals, and more – care when you need it from anywhere you happen to be.
  • In-Home Visits: Need a blood draw, a rapid test, a physical exam, or any other in-person need? Nice will come to you with 35 free labs and physical tests!
  • Full-Service Prescriptions: Nice integrates with nearly every pharmacy in the country and provides white glove support to make your prescription experience simple. Plus, Nice provides 550+ medications for free.
  • Virtual Physical Therapy: You’ll get access to licensed physical therapists who are trained to diagnose and treat virtually, allowing you to get better without the hassle of endless in-person visits.
  • Virtual Mental Health Therapy: Nice mental health therapists focus on prevention, helping you to self-manage your mild to moderate mental health needs. Don’t wait to start feeling better!
  • In-Home X-ray and EKGs: Nice can send a mobile imaging technician right to your home to conduct x-rays, EKGs.

  Use the Nice Healthcare app to schedule visits, chat with clinicians, attend video visits, review treatment plans, upload documents, and more. Watch the Getting Started with Nice Healthcare video to learn more about their offerings.

• Am I able to make changes to benefit elections outside of Open Enrollment?

  The Open Enrollment period allows you to make changes to your benefit elections without requiring a qualifying event. After the Open Enrollment period, you are only able to make changes if you have a qualified life event (QLE). Common examples of a qualified life event are: marriage, divorce, birth or adoption, a spouse or domestic partner gaining or losing coverage, and death. If you think you have a qualifying life event, please reach out to the HR department within 30 days of the event. We do require documentation in order for the QLE to be made.

  Watch a short video to learn about Qualified Life Events.

  There are two benefits that you are allowed to update though without needing a QLE. These two benefits are Health Savings Account contributions and Retirement contributions. These can be updated anytime throughout the year. You are able to make these updates within the benefits portal. Once you have submitted that request, someone from HR will review and approve the request.

• How do I find in-network providers for our Health, Dental, and Vision plans?

  You’ve most likely heard the term “in-network” when it comes to Macalester insurance plans, but what does that mean exactly? When facilities, healthcare providers, pharmacies, and suppliers are in-network that means our insurance company has contracted with them to provide services. Typically, you will receive better coverage and pay less when you go to a provider in-network versus out-of-network. HealthPartners, Delta Dental, and VSP Vision Care make it easy to find providers who are in-network to help you make the best decision for you and your covered family.

  HealthPartners:  You can search for doctors and medical practitioners, clinics, hospitals, surgical centers, etc. Be sure to select the plan network called ‘Open Access Network’.

  Delta Dental:  You can search for General Dentists, Oral Surgeons, Orthodontists, Periodontists, etc. When selecting the plan network, there are two options: Delta Dental PPO and Delta Dental Premier. As a reminder, the Delta Dental PPO Network will provide you with the best level of coverage.

  VSP Vision Care: You can search for eye doctors by location, office, and name.

• I am reaching Medicare eligibility age; can Macalester help me navigate through this process?

  Macalester’s Human Resource team gets this question a lot but it is not an area that our team specializes in and by regulation cannot advise on it. What we have done is partnered with an amazing company called The Breitenfeldt Group and they can be your go-to resource. They are committed to helping you with your health insurance needs. If you are seeking Medicare guidance and/or education, their licensed advisors will help you plan and review all options available. Together you will create a roadmap to guide you on what steps to take and when to take them. This resource is available to spouses, domestic partners, family members, and friends. And the best part is, there are never any fees for their services!

  Visit our Planning for Medicare webpage to learn more about The Breitenfeldt Group.

• What do the Identity Protection and Legal Plan benefits offer and how can they assist me and my family?

  LegalShields Identity Protection helps individuals and families protect their personal information and responds to identity theft incidents. Some key features of the plan include:

  • Identity Theft Monitoring – provides real-time alerts for suspicious activity and other potential theft indicators.
  • Identity Restoration Services – if identity theft were to occur, members have access to dedicated identity theft restoration specialists who will assist in restoring their identity.
  • Credit Report Access – monitor credit reports from major credit bureaus, receive access to their credit reports annually, and tools to track and understand their scores over time
  • Fraud Detection – scans the dark web for stolen or personal information and receives notifications if personal data is found on the dark web.
  • Bank and Credit Alerts – monitors bank and credit card accounts for unusual activity, helping to catch fraud early.

  MetLife’s legal plan also helps individuals and families with access to legal services at an affordable price. Some key features of the plan include:

  • Access to a variety of legal services and attorneys – the plan covers a wide range of legal matters including: will and estate matters, document preparation, family law, and real estate matters. You will also have access to a network of over 18,000 qualified attorneys.
  • Unlimited initial consultations – there are no restrictions on how often you can utilize the plan.

• What can employees do to help keep healthcare costs in check?

  • Use in-network providers, rather than out-of-network providers. Typically, you will receive better coverage and pay less when you go to a provider in-network versus out-of-network.
  • Commit to preventive care and take care of your health. Investing in preventive care can catch health issues before they become serious, lower healthcare costs, save money in the long run, and improve overall health and well-being.
  • Use Nice Healthcare. Going through Nice Healthcare for primary care will reduce your costs, as well as reduce claims on Macalester’s group health plan. Nice Healthcare offers over 550 medications at no cost to participants. Check out their Rx and Pharmacy services to see if a medication you are currently taking can be prescribed by Nice.
  • Use in-network providers, rather than out-of-network providers. Typically, you will receive better coverage and pay less when you go to a provider in-network versus out-of-network.
  • Be a wise consumer of healthcare. Use the lowest level of care that matches your need (virtual care, medical clinic, urgent care, emergency room)
  • Consider the High Deductible Health Plan (HDHP) – Folks who participate in the HDHP are able to enroll in a Health Savings Account.  Macalester contributes 48% of the plan’s deductible over the calendar year to help cover eligible expenses.

• What happens if my spouses open enrollment period is different from Macalesters?

  We understand that not all employers have the same open enrollment period but our goal is to provide benefits information to employees as soon as possible so they can make informed decisions for themselves and their families. However, Macalester does not have control over the timing of other employers’ open enrollment periods. Therefore, once our open enrollment period is over, no other changes can be made unless it is for a qualifying life event.

  This means employees will need to make the best decisions they can based on the information available by the end of our open enrollment period.

• How does the new Minnesota Paid Leave program affect short-term disability (STD) coverage for medical leaves?

  The new Minnesota Paid Leave program will provide paid benefits similar to what short-term disability traditionally offers for medical leaves. With this new state benefit in place, many employees may find that they lo longer need to rely on short-term disability (STD) coverage to bridge the pay gap. Employees can receive STD benefits at the same time as Minnesota Paid Leave benefits; however, the amount you receive from STD will be adjusted to ensure that the combined total does not exceed the amount you would normally receive from STD alone.

• How can I learn more about Minnesota Paid Leave?

  There are two sites that you are able to visit to learn more about Minnesota Paid Leave:

  1. Visit Macalester’s Minnesota Paid Leave webpage
  2. Visit the Department of Employment and Economic Development webpage