Many plans establish minimums and maximums for coverage offered as well as guaranteed issue amounts. When coverage is calculated using a percentage, rounding rules may be necessary. Different salary or volume-based plan may or may not need these limits based on Employee Benefit. To ensure that EaseCentral matches the carrier, set all amounts and rules as established in the plan summary.

 

Minimum and Maximum (where applicable)

  1. Add the MINIMUM as the lowest whole amount available.
  2. Add the MAXIMUM as the highest amount offered.



Guaranteed Issue and Guaranteed Issue Max X Earnings (where applicable)


1.    Add GUARANTEED ISSUE amount cited in plan summary. 

  • Guaranteed Issue sets the limit where evidence of insurability is not required.
    • Coverage under this amount will be automatically approved.
    • Any coverage over the Guaranteed Issue will be pended.
    • The approved and pending premiums display to the employee.



2.    If applicable, add GUARANTEED ISSUE MAX X EARNINGS. 

  • Guaranteed Issue Max X Earnings is used when the amount described above is determined not by a set amount, but by a calculation determined using 1, 2 or more times the employee’s salary.


  • If evidence of insurability rules are different outside the initial enrollment window, employee-specific guarantee issue amounts may be entered in the employee's Profile > Coverage page.



  • For example, a plan is established with a maximum guaranteed of $50,000 at time of hire only; based on the plan summary, any amount an employee elects at open enrollment is subject to evidence of insurability.
  • If the employee was originally enrolled and was guaranteed or approved for $50,000 as a new hire, his Guaranteed Issue amount in his Profile > Coverage page can be entered as $50,000.
  • At enrollment, any amount elected over the Guaranteed Issue Amount in the employee's Profile > Coverage page is pending and the employee is prompted to complete appropriate Evidence of Insurability forms.


Rounding (where applicable)

 

Because coverage may be calculated, rounding can be required.


1.    Select how the carrier will round the coverage.


  • Otherwise, this field can be left blank.

2.    If GI is to be rounded, mark ROUND GUARANTEED ISSUE as Yes, use same rounding rules.