We understand that some scenarios may arise where employee enrollments don't follow the company's standard plan rules and an override is needed. Likewise, enrollments may have been added/dropped unintentionally and those records need to be fixed. We provide several different tools, listed below, to help you manage enrollments in these types of scenarios.
Backdate the Election
This tool is located on the enrollment pages within the (NH/OE/Modify) enrollment flow and is used to backdate employee effective start dates. Navigate to the specific benefit step in the enrollment flow and click backdate the election? at the bottom of the page (above the Save & Continue button). Input the new date and click Set to save.
Example of when to use this:
- An ee is reflecting an effective date of 10/1/15 according to DOH and plan eligibility rules, but HR is overriding plan eligibility rules so ee is eligible on 9/1/15 instead.
Note: This tool only supports backdating ee elections, so the new date must be equal to or before the current date. This tool is not available for Voluntary Disability and Voluntary Life model plans.
Modify Current Enrollments
This tool is located on an ee's Employee Management tab and is used to modify current enrollments due to data entry errors.This should only be used to correct enrollment records, as changes made through Modify overwrite an ee's current election back to the original effective date (NH or last OE effective date). No history of the change is recorded.
Examples of when to use this:
- Admin user accidentally enrolled an ee in medical coverage during NH enrollment, but the ee actually declined. Modify will replace the current benefit election with a declination record, as if the ee never enrolled.
- EE accidentally enrolled in family instead of ee + child dental coverage during OE and didn't realize the mistake until OE was over and closed out in EN. Modify will replace family coverage with ee + child back to OE effective date.
Note: This tool can also be used to manually add (current) existing coverage for ees much like the import tool does in bulk.
If the above options do not work, the Enrollment Editor can be used to modify the enrollment. This tool is located on the company's Home tab and is used to modify plan start/end dates, end plans that can't be dropped under the life events tool, and to override benefit/costs on VL/XTD plans. This tool supports current and open enrollment data and can be used to both backdate and future date ee elections. Additionally, this tool can manage specific dependent enrollments separately.
Examples of when to use this:
- EE originally enrolled with an effective date of 9/1/15 but plan eligibility rules were wrong and enrollment start dates need to reflect 10/1/15.
- EE benefit should have been dropped 5 months ago but wasn't (life events tool won't allow changes outside of 30 day window).
- Need to override an ee/dependent VL benefit amount and/or cost.
- Need to change a dependent's effective start/end date separate from ee's enrollment data.
The Enrollment Editor should only be used if the enrollment could not be corrected using the above methods. For more info on the enrollment editor, check out this article: Enrollment Editor Tool
For normal circumstances, like life events, admin should be using the Update Benefits tab on ee records to add/drop coverage for ees and their dependents. Some examples include: an ee loses other coverage, adding a newborn, dropping a dependent that is eligible for other coverage, or dropping ee coverage because spouse gains coverage at their employer.