When there is an enrollment in Employee Navigator, the record is automatically included in the carrier feed as long as it follows the business rules of the plan. However, what happens on the feed if there is a declined enrollment?
- If an employee doesn’t enroll in benefits and declines coverage, the record will not be included in the feed, as there was never an enrollment.
- If an employee does enroll in benefits but then later declines the same benefit, the record will be included with the enrollment date and also with a termination date. The termination date and the length of time the record stays on the carrier feed is determined by 2 of the carrier level options set and controlled by Employee Navigator:
- Carrier Option 1 - Terminated records: The record will stay on the carrier feed based on the days set for this option. The terminated record will drop after the termination date has passed the set number of days
- Example: Cigna Healthcare has a 14 day terminated record option. Terminated records will drop from the carrier feed 14 days after the termination date has passed.
- Carrier Option 2 - Null Coverage: This is set to send one of 2 options for terminated records, the termination date sent is one day prior to the effective date as a default Example:(2/1/2016-1/31/2016) or will transmit a termination date equal to the effective date (2/1/2016-2/1/2016)
Example 1: Employee Test Record enrolled in coverage during new hire process 3/1/16 but changed the next day to decline coverage. Carrier option is set to send same day effective/termination date and a terminated records drop option of 14 days. Record will pass as 3/1/16-3/1/16 and drop from the feed after 3/14/16
Example 2: Employee Test Record never enrolled in coverage during new hire process. No record will be transmitted on carrier feed
Example 3: Employee Test Record enrolled in coverage during new hire process 3/1/16 but changed the next day to decline coverage. Carrier option is set to send termination date one day prior to effective date and the carrier setting for terminated records has the drop option of 14 days. Record will pass as 3/1/16-2/29/16 and drop from the feed after 3/14/16