Employee Navigator can be configured to generate a pdf Enrollment Form which can be submitted to a Carrier to document an employee enrollment. The Enrollment Form uses a universal template designed to include all necessary Employee, Dependent, Plan, and Enrollment information needed by the Carrier to process the enrollment in their system. An electronic signature and date stamp is added to the form to certify the employee’s enrollment selections. The Employee Enrollment form can be generated for enrolled individuals in any medical model plan.
All current and previous forms will be stored in Employee Navigator to provide a historical record of each enrollment.
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Supported Enrollment Events:
- New Hire
- Open Enrollment
- Newly Eligible
- Life Events - when processed by the Employee only
Single Enrollment Record:
- Separate forms are generated for each benefit enrollment even when multiple benefit plans are under the same Carrier
Employee Enrollment Form generation is triggered when an enrollment record changes from Pending to Current status. Company settings must be configured to pend enrollment records for this process to occur. Enrollment records move from pending to current status when 1) The employee selects the Agree button on the Enrollment Summary or 2) The HR user approves any pending enrollments.
Each plan for which an Employee Enrollment form should be generated must be configured as such.
See the instructions below to setup the Company Enrollment and Plan settings to generate Employee Enrollment Forms.
To generate pdf Enrollment Forms for New Hires, Newly Eligible Employees, and during Open Enrollment:
From the Company Benefits tab > SETTINGS > Enrollment > Pending new hire enrollments > select one of the following options:
- Pending Until All Completed – select this option if new hires enrollment elections do not require HR approval. Form generation will be triggered when the employee selects "Agree" on the Enrollment Summary.
- Pending Until HR Approves – select this option if new hire enrollment elections should remain in Pending status until HR has approved the elections. Form generation will be triggered when HR approves the pending enrollments.
To generate pdf Enrollment Forms for employees completing a Life Event:
From the Company Benefits tab > SETTINGS > Life Events > select Life Event category from drop down menu > Edit a Coverage Reason (Life Event) > Approval Required > select the check box
*NOTE: Employee Enrollment Forms will NOT be generated for New Hires and Newly Eligible employees or during Open Enrollment if this field is set to Active When Selected.
To turn on form generation for a medical model plan:
From the Company Benefits tab > BASIC > Plan List > select any Medical Model Plan
Once in the plan go to POLICY INFO > Policy Info > use the “pencil” icon to edit > Generate Universal Enrollment PDF > select the check box
Additional Plan Fields populated on the Enrollment Form
POLICY INFO > Policy Info > use the “pencil” icon to edit >
- Policy # - Maps to the "Group Number" field on the Enrollment Form
- *Note: this field is required for most carriers.
- Carrier Plan Name - Maps to the "Plan Name" on the Enrollment Form
- Used to accurately display the Carrier Plan name in the Enrollment Form when the Plan Name used by the Employer is not the same.
- Ex: ER refers to plan as "2017 Bronze Medical Plan", actual Carrier plan name is "Empire HMO 6350, Bronze, NS, INN, Pediatric Dental, Dep 25"
Access Employee Enrollment Forms
After a form has been generated for an employee enrollment, the form can be accessed at the individual employee level, or all forms for the company can be accessed from the same page.
PDF Enrollment forms will be named in the following format:
Access Individual Employee Enrollment Forms:
From the Company Home or Employees tabs > search for employee > employee Documents > EMPLOYEE DOCUMENTS
NOTE: HR Users with Permissions set to “Mask SSN” will see Employee Enrollment Forms on the Employee Documents page.
Access Company Enrollment Forms:
From the Company Reports tab > BENEFIT REPORTS > Employee Enrollment Forms
Manage Employee Enrollment Forms
The Company Employee Enrollment Forms Page (accessed as shown above) provides visibility to all Employee Enrollment Forms generated for the company along with basic form and download information.
By default, the first 250 Enrollment forms (sorted by the date they were generated from most recent to oldest) will be displayed. Search for a specific employee, or narrow your search by form status, date generated, carrier, or the enrollment event through which the form was generated. Once set, click Apply Filters to view the refined list.
Manage Enrollment processes from this page using the tools discussed below.
From the list of forms, users can select individual forms to be downloaded or "Select All". After selecting the desired forms, click the Download Forms button.
All selected forms will be downloaded and sent to one compressed (zipped) folder named EN_UniversalForms_Date_Time. Individual forms can be opened from this folder or the entire file can be sent to the carrier.
NOTE: HR Users with Permissions set to “Mask SSN” will be restricted from downloading forms. The message "Download is unauthorized due to 'Mask SSN' permission" will be displayed on the page.
Update Form Status:
The Status of Employee Enrollment Forms can be updated and used to track the user workflow.
- NEW - forms will be in "New" status until they are downloaded or the status of the form is updated manually.
- DOWNLOADED - The status of a "New" form will be updated to "Downloaded" by the system when it is downloaded for the first time from the Employee Enrollment Forms page. A download date is added to the record at this time.
Use to track workflow progress if desired. The status options available and the suggested usage is shown below:
- SENT - sent to Carrier
- VERIFIED - confirmed with Carrier
- INCORRECT - incorrect/invalid
- DISMISSED - no longer needed
Again, these are suggested definitions for each status. Users can define their own workflow and assign a status to each step to track task completion.
- If the status of a form is manually updated prior to the first download, the form will not auto-update to "Downloaded" so as not to overwrite the selected status used for tracking.
- Once a form has been moved out of "New" status, it cannot be set back to "New".
- The download date will also be populated if an employee views the enrollment form from their Employee Homepage > Resources > Documents > Employee Documents. The form status will not be updated when viewed from the Employee Documents page so as not overwrite the tracking status.
Generate New Forms for an individual employee
There may be times when an employee profile is updated with new information and the user would like to regenerate the form to reflect the new data. For example, an employee's Job Title was not initially entered in the Employee profile, but has since been added and this should be reflected on the Enrollment Form. In this case, the employee profile can be updated and a new form generated. There is no reason that the employee would need to process their enrollment again.
To generate a new form for the employee,
From the Employee Enrollment Forms page, click the "Generate New" link next to the selected enrollment form.
When the new form is generated, the Enrollment Information, Electronic Signature, and Signed on date will not change and will still reflect the most recent enrollment records.
Bulk Generate Forms for all employees enrolled in a plan
Do you need to produce forms for all employees in a plan? This may occur because the PDF Enrollment forms were not available when employees first enrolled, or the Company and Plan settings were not configured as necessary to trigger the form generation. Additionally, this option can be used if a change is made to the plan information such as the addition on the Carrier Plan Name or the Policy Number.
When using the Bulk Generate Tool, you will have have the flexibility to select the enrollment event that will be indicated on all bulk generated forms. Since the Bulk Generate tool can be used to generate Employee Enrollment Forms when the employee has not gone through the standard enrollment process, this selection is made by the user. The selection made during this process does not change the event history in the system, it is simply used to manually set the enrollment event indicated on the form.
NOTE: The process of selecting the enrollment event when using the Bulk Generate tool will override the actual enrollment event during which the employee enrolled in coverage. This could result in an inaccurate reflection of the enrollment process, therefore this process should only be used in cases where the enrollment form was not auto-triggered to generate during the enrollment process. User should be careful to consider their selections of the enrollment events to be indicated on Employee Enrollment Forms when using the Bulk Generate tool.
To use the Bulk Generate tool to generate forms for employees,
From the Benefits tab > BASIC > Enrollment Tools > Plans with Employee Enrollment Forms > next to the desired plan, select Generate > under "Generate Form", select the desired employees, or use the Select all option > Generate > select from the dropdown list of enrollment events > Generate
Bulk Generated forms can be accessed on the Employee Enrollment Forms page. The generation event will be noted on the Enrollment Forms list will be noted as "Bulk Generated".
The "Signed" and "Signed by" data on the Enrollment Forms list and on the generated form will be pulled from the most recent modification of the employee's elections.
When a new Employee Enrollment Form is generated, notifications are included on the Company Home Page and quick access to links to the Employee Enrollment Forms page is enabled. Wall Feeds can also be configured to trigger upon form generation.
Company Home Page Notifications
On the Company Home Page > PENDING HR APPROVAL > New Employee Enrollment Forms
- Stat is pulling from Employee Enrollment Forms in "New" Status
- Link will be active only if there are "New" forms
Company Employees Page Stats
On the Company Employees Page > BENEFIT STATS > New Employee Enrollment Forms
- Stat is pulling from Employee Enrollment Forms in "New" Status
- Link will be active only if there are "New" forms
To configure Wall Feeds to trigger when a new Employee Enrollment Form is generated, follow the steps below.
From the Company Wall tab > Feed Setup > Add or Edit Feed > Triggers > select the Event Groups triggers from the drop down menu > select Enrollment PDF Form Created
Wall Notifications will display as shown below:
Configure wall feeds to email a notification to specified users to alert the user of a new form which needs to be processed.
For complete instructions on the setup and management of wall feeds, see the articles below:
Questions and Disclosures
Questions and Disclosures will populate on the PDF Employee Enrollment Form when they have been created at the Vendor level only. These items can only be added by the Carrier themselves or by Employee Navigator. Underwriting Questions, Knockout Questions and Disclosures can be compiled on the vendor profile into a "Carrier Form".
Exception: When underwriting questions are created by the carrier they can be flagged as "Contains HIPAA Information", if the employee response could contain information protected by HIPAA. When this option is selected, visibility restrictions are applied to the employee responses. These responses will not be generated on the enrollment form and will be replaced with the text "This answer is protected by HIPAA".
If a Carrier Form exists for the carrier selected on the plan configuration, it will be available from the Plan > POLICY INFO > Policy Info > Carrier Form drop down selector. Once a Carrier Form has been selected, access the "?" icon to view the list of Questions and Disclosures included on the form.
TIP! A common use for the Carrier Forms is to include California Mandatory Arbitration language on the PDF Employee Enrollment Forms. Employee Navigator has added Carrier Forms to include this disclosure to a number of California Carriers. For more information on California Arbitration Language and an up to date list of the supported Carriers, see California Arbitration Language Disclosures.
Q: What does the PDF Employee Enrollment Form look like?
A: See attached sample forms
- Populated form: "C_Columbus_Anthem BCBS of OH_NewHire_Anthem Gold PPO_2017_04_12_040432.pdf"
- Blank Form: "Blank_PDF_EmployeeEnrollmentForm.pdf"
Q: Why didn't Employee Enrollment Forms generate when the employees enrolled?
A: Check the following settings:
- Were the "Pending New Hire Enrollment" settings set to "Pend Until All Completed or "Pending Until HR Approves? (see details)
- Was the "Generate Universal Enrollment PDF" box checked off on the plan? (see details)
Q: Which plan models are considered "Medical Model Plans" and can be set to generate a PDF Employee Enrollment Form?
A: The Medical Model Plans are listed below:
- Supplemental Medical
- Critical Illness (basic model only)
- TRICARE Supplement
- Identity Protection
- Laboratory Services
- Hospital Indemnity
Q: What fields are included on the Universal PDF Employee Enrollment Form
A: See the attached document titled "Employee Enrollment Forms - Included fields.pdf"
Q: Which carriers are accepting the Universal Employee Enrollment Form?