Coverage Information includes status details, employee-specific dates affecting enrollment as well as information regarding approved/guaranteed issue amount.
For companies using the Onboarding feature the employee's ONBOARDING STATUS will display whether the employee has completed the onboarding requirements or not. If the employee needs to re-enter their onboarding information the Reset option can be used so the next time the employee logs in they will be prompted to complete onboarding steps.
The NEW HIRE ENROLLMENT STATUS option will display whether the employee completed their new hire enrollment requirements. If the employee needs to re-enter their new hire enrollments, the Reset option can be used so the next time the employee logs in they will be prompted to complete their new hire enrollment requirements.
ENROLLMENT STATUS identifies whether an employee has not started, is in progress or has completed their enrollment based on the Progress Report settings on the Benefits page.
BENEFIT COST FACTOR can be entered if the total rate or employer's contribution can be calculated based on a percentage or factor of the total rate or employer contribution. This field can be used if an employer's contribution varies based on an employee's FTE status or if the total rate varies based on a plan RAF factor.
If an employee's benefit effective date should be different than the effective date calculated by new hire waiting period, the actual benefit effective date should be used in the BENEFIT ELIGIBLE DATE field. The BENEFIT ELIGIBLE DATE would be used in circumstances when employee statuses change from part-time to full-time or when an effective date override needs to occur. Note that this date overrides all other dates - new hire waiting period, open enrollment, and life events. Please use caution when populating this field.
UNLOCK ENROLLMENT DATE will default to the employee's hire date. The system will give employees 30 days from their effective date to make their initial new hire election. If the employee is outside of this window and it is not open enrollment, the employee would need to create a life event to make any benefit changes. If the COMPANY WIDE LOCK ENROLLMENT DATE is populated on the Benefits > Enrollment Dates page, the UNLOCK ENROLLMENT DATE will need to be populated with a current date in order for the employee to make a qualifying life event change. The employee will be able to make a life event change within 30 days of the UNLOCK ENROLLMENT DATE. Employee access can also be locked or unlocked for each employee on a mass basis by configuring the settings on the Benefits > Enrollment Dates page.
Employee's Previous Coverage would be typically entered by the employee and accessed here.
Employee or family member Medicare elections would also be entered by employees and accessed here.
Guarantee Issue amounts are enforced based on plan rules, however if Guarantee Issue Amounts vary based on an employee's previous election status or separate open enrollment rules, the specific Guarantee Issue amount that applies to an employee at a point in time can be entered. For example, if the employee enrolled under Guarantee Issue as a new hire, and they are allowed to elect an additional $10,000 during open enrollment, the additional allowed amount can be entered into the Guarantee Issue Amounts field.
Enrollments in plans that look at an employee's age on Original Effective Date to calculate a rate will be listed in this section.