The plan configuration Policy Info tab includes the basic policy information such as the carrier, policy number, plan name, and plan dates. The setup components on this tab are the same across all benefits, but some fields may vary based on plan type.
Plan name: Input the name of the plan. For example, BlueChoice HMO. This is the plan name displayed to employees during enrollment, and when viewing plan overview information from the employee homepage.
Carrier: Select the corresponding carrier from the drop-down list. If a carrier is not listed, users can submit new carrier requests to our support team.
Plan type: Select the corresponding plan type. Drop-down options will vary across benefits, and some plans may only have one plan type available.
Start date and End date: Input the policy start and end date.
A plan can be configured as either a single year policy, or a multi-year policy. See below explanations/examples for each.
Single Year: The policy Start date through the End date equals 1 full year (12 months). For example, 01/01/2017 - 12/31/2017
Multi-Year: The policy Start start through the End date equals greater than 1 year, such as 3 years. For example, 01/01/2017 - 12/31/2019
In most cases, plans are configured as single year policies. However, some plans, such as voluntary products with three-year rate guarantees, may be configured as multi-year policies. Regarding open enrollment, single year policies can be renewed and the new plan can be included in the upcoming enrollment period. Multi-year plans that are not ending do not need to be renewed each year and they can still be included in the enrollment period so that employees may change elections.
- Both Short policy years (less than 12 months - e.g. 01/01/2017 - 04/30/2017) and Extended policy years (more than 12 months - e.g. 01/01/2017 - 04/30/2018) will cause incorrect employee per pay deductions. The system determines employee per pay deductions by counting out 12 months from the policy Start date, and then referencing the number of pay dates/deductions listed on the payroll calendar (of the employee's assigned payroll group) for those 12 months - regardless of the plan End date.
- If a policy needs to be extended, it's best to go ahead and extend the plan for a full 12 months. Once a decision has been made on what will happen with the plans, the end date can be shortened.
Example: A group has a policy from 12/1/2017-11/30/2018. The group receives a 4 month extension from the carrier, and the policy now ends 2/28/2019. You would want to keep the policy end date as 11/30/2018 and renew the plans for 12/1/2018-11/30/2019. If the policy changes on 2/28/2019, you may change the policy end date.
- EN's ACA tracking/reporting feature cannot determine correct eligibility for employees if plans are configured as multi-year policies. If using the system for ACA tracking purposes, plans must be configured as single year policies.
- Changes made to plan Start and/or End dates after employees have enrolled may yield unexpected results. It is recommended that users confirm policy dates for accuracy prior to activating enrollment.
Disable renewed from link: This field references open enrollment change reports and is only reflected on renewed plans. When checked, open enrollment change reports will include all plan changes (rates, plan name, plan ID, etc.). When unchecked, only "true" enrollment changes will be reported (coverage level change, add dependent, etc.)
Policy #: Input the policy number. This is the group/policy number reflected on employee insurance cards.
System Limitation! Currently, policy # is not a reportable field
Situs: Coming soon
Carrier Plan Code: An internal carrier code used by carriers to associate EN plan type with plan type in their system. For example, code 1234 represents Medical PPO $10 RX and $250 deductible. This field is only used when transmitting file feeds to a carrier. Leave blank if file feeds are not configured.
Bill Options: Carrier billing option that is only used when transmitting file feeds to a carrier. Leave blank if file feeds are not configured.
Processing Type: Used to track the method enrollments are being transferred to the carrier. The menu is preconfigured but should include all common methods. Once a Processing Type is selected, the plan will be added to the associated report under the Enrollment Processing Overview.
Generate Universal Enrollment PDF: When checked, the system will generate a universal PDF enrollment form that can be sent to carriers. Policy # is required when enabling this option. Refer to the following article for more information on EN's universal PDF enrollment forms: System Generated Employee Enrollment Forms
Carrier Plan Name: Used in conjunction with the universal PDF enrollment form, this is the official plan name given by the carrier and will display on the enrollment form.
Carrier Form: Coming soon
Carrier Form Group Size: Coming soon
Annual Policy Fee: If the plan includes a policy fee, input the annual amount. The system automatically divides this annual amount by 12 to calculate monthly fee, and divides by the number of pay periods as defined under the company payroll calendar to calculate per pay fee. These amounts are then added to employees' total monthly and per pay costs.
Supported plan types: Voluntary Life, Voluntary AD&D, Voluntary Life & AD&D, Critical Illness (Life), Permanent Life, and Voluntary STD.
Issue Age Policy: An issue age policy is an age-banded plan where employee/spouse rates do not change as they age unless a change in coverage occurs. If plan is issue age, also indicate whether coverage changes should be re-rated or stacked. For additional information on Issue Age policies, please refer to the following article: Issue Age Policies
Supported plan types: Accident, Cancer, Critical Illness (Medical), Hospital Indemnity, Voluntary Life, Voluntary Life & AD&D, Critical Illness (Life), Permanent Life, Voluntary STD, Voluntary LTD
Warning! This setting can't be changed once employees begin enrolling in the plan, so it is advised to double check with the carrier prior to activating employee enrollment. If these settings need to be changed later, premier users can reach out to the support team for assistance. However, please note that all employee enrollments will need to be removed in order to correct the plan configuration.
Activating Employee Enrollment
Before employee enrollment can be activated/turned on, the plan must reflect a Complete status - meaning all required fields have been completed. Plan setup status icons are reflected next to the plan name and are always visible when in plan configuration. Users can also access the plan setup checklist, which identifies completed/incomplete fields, at anytime by clicking on the plan's status icon.
Incomplete (must complete the missing required fields before activating enrollment)
Complete (all required fields are complete and enrollment can be activated)
Go Activate Enrollment (only appears once during initial plan setup to notify users that enrollment can be turned on for the first time - click icon to quickly navigate back to the Policy Info tab)
When a new plan is configured and all required fields are completed, a banner will appear at the top of the Policy Info tab to let users know the plan is ready and employee enrollment can be activated/turned on. Users can turn enrollment on/off at anytime by clicking Turn on/off enrollment.
Additionally, once there are active enrollments in a plan, changes made to the plan configuration may require an eligibility and/or rate recalculation in order to update those existing enrollment records.
Eligibility Recalc -- Changes made to plan settings that impact employee/dependent eligibility
Benefit/Rate Recalc -- Changes made to plan settings that impact employee/dependent benefits and/or costs
Refer to the following article for more information on plan changes and recalcs: Plan/Payroll Changes and Recalculations
Ending plans can be renewed for the new year by clicking Renew. If a group is staying with the same plan and carrier, users should renew the plan. By renewing a plan, a "copy" of the current plan is created and linked to the new plan. This process better identifies OE changes for the upcoming year. EN does not recommended copying an ending plan, adding a brand new plan, or extending the plan End Date for renewal purposes.
When renewing a plan, users have the option to rename it, set the plan dates, and confirm which plan communication pieces (like documents) to carry over with the renewed plan. Users can also change all plan fields such as carrier, rates/contributions and benefits.
This is particularly important when it comes to open enrollment reporting and tracking "true" changes. When a plan is copied or added new for the upcoming year, the system will report all enrollments from the old to the new plan as a change, such as plan and plan ID changes, even if an employee re-enrolls with the same coverage. Additionally, if the carrier changed plan rates for the new year, the system will report these new rates as an employee plan cost change.
When a plan is renewed, the system will only report "true" changes by default, such as a change in coverage level or a dependent that was added/dropped. It is beneficial to only report on these types of enrollment changes, as it provides groups with more accurate open enrollment change reporting. However, if desired, users do also have the option to include all changes (not just "true" changes) for a renewed plan by checking the box next to Disable renewed from link on the renewed plan's Policy Info tab. When checked, all changes, including plan IDs and carrier rates, will be included in the open enrollment change reports. When unchecked (default), only those "true" enrollment changes will be reported.
Deleting a Plan
To delete a plan, click the edit icon on the Policy Info tab, then click the trash can on the bottom right of the page.
Plan delete is disabled if plan has active employee enrollments. If no real employees have enrolled, it's possible that a demo employee is enrolled in the plan.To check for this, go to the company Employees tab > Add Demo Employee > list demo employees. To remove demo employee enrollments, simply go into the demo's enrollment flow and decline the plan.
Plan delete is also disabled for plans that were set to Passive Enroll for an OE period, even if all plan enrollments were deleted.
Note! If plan has active enrollments that need to be deleted, users can submit a ticket to support requesting to have the enrollments removed. Keep in mind this will completely remove the enrollment records from the system, and it can't be undone. For that reason, users must provide both the plan name and plan ID in the ticket when submitting the delete request. Users can surface the plan ID by going to the company's Benefits tab > Plan List and hovering their mouse over the plan name.