Employee Eligibility Issues
Issue: NH's effective start date is incorrect.
- Check the ee's benefit eligibility data under Benefits Summary> Benefit Eligibility. If Hired Eligibility Date is incorrect, then it's likely the plan eligibility rules aren't setup correctly. Fix plan design if needed and don't forget to recalc the plan eligibility under Benefits> Rate, Eligibility & Bulk Enrollment Tools.
- EE’s DOH is wrong or a change was made to ee’s DOH after initially enrolling. Go to Benefits Summary> Benefit Eligibility and hit the recalculate button to recalc ee’s eligibility.
- Note 1: Our system counts DOH as day 0 when calculating waiting period rules. If your carrier counts DOH as day 1, you could subtract 1 day from the waiting period rules to accommodate, but remember - this is a workaround, so it's recommended that you audit your enrollment data to ensure it's reflecting the effective date you want.
- Note 2: Changes made to plan eligibility rules and/or ee profiles (even when ee/plan eligibility is recalced) will not apply to enrollments already processed. If ee already enrolled in the plan, you'll need to modify the start date using the enrollment editor. Check out our article on this tool here: Enrollment Editor Tool
Issue: Can’t override ee’s effective date using the HR override tool on enrollment page.
Reason: A change was made to ee’s DOH after initially entered into system. Go to Benefits Summary> Benefit Eligibility and hit ‘confirm’ button to recalc ee’s eligibility. Then go into enrollment page, decline benefit and resave to unset old values. Go back in and re-enroll in benefit, enter HR override date and save the page.
Issue: EE was able to enroll ineligible (over age 26) dependent in coverage.
Reason: Dependent and/or Student Age Not Eligible fields are blank in the plan setup. Even if the same age applies to both, you must have an age entered in both fields in order to apply rules correctly.