Enrollment Editor Tool

What is the enrollment editor tool?

The enrollment editor can be used to modify plan start / end dates, drop plans that can't be dropped under the life events tool and to override benefit / cost amounts on voluntary life and disability plans. Changes made via the enrollment editor will display under the Notes section of  the ee's Employee Management tab. Events are also created and stored on the ee's Events tab.

This tool can also be used to change / drop dependent enrollments. Just search for the ee and choose the dependent from the Then select employee or dependent drop-down. This is particularly useful when dependents need to be dropped from basic / voluntary life plans.

Both Current and Open enrollments can be modified using this tool. Toggle between the two (during an active OE season) via the Enrollments drop-down (visible once dropped on an ee's record within the enrollment editor).

Common uses

• Override enrollment effective start / end dates
• Drop enrollments when life events tool can't be used
• Override voluntary life / disability benefit amounts and costs

*Note! The Enrollment Editor should only be used if all other options have been exhausted. If you're getting costs/benefits/dates that are different than what you are expecting, you should be double checking to confirm you plan is configured correctly as overrides can potentially cause larger issues in the future.  

For more information on alternative options for correcting/modifying enrollments, please see Modify/Override Employee Enrollments

Things to Keep in Mind

• You must enter a note when making changes / dropping coverage - we suggest adding who requested the change and/or the reason for the change
• Changing an ee's effective dates will change dates for all enrolled dependents - so make the ee change before changing dependent records if different
• Benefit amounts/costs can't be changed for VL/VXTD enrollments while still pending approval of EOI - they must be approved prior to modifying

**Limitations**

Before we get into how to use the Enrollment Editor, it is important to mention there are certain scenarios where the Enrollment Editor should not be used:

• HSA/HRA/Cafeteria enrollments aren't supported(even though they display on-screen) - so overriding effective dates and contribution amounts won't actually update the ee's record.
• Benefit and cost overrides may not carry over each year during OE.
• Active enrollment (save of page in OE enrollment flow):  Replace grandfathered amounts according to plan design and requires a re-do of the overrides once OE is closed out.
• Passive enroll:  Grandfathered benefits will roll over for the new year, but cost overrides may still require a re-do of the override once OE is closed out, as the OE closeout process checks ee costs against plan design and adjust accordingly.
• Cost overrides will only update the Employee Cost amounts on employee records. Plan Costs will not update. Because the Carrier Billing Reports pull Plan Cost values, users are advised to audit those reports and manually process any adjustments that may be needed.

Third Party Applications

• The partner system is the system of record. EN is only the display platform. Changes should be made in the partner system and then brought into EN through the bridge/sync. Changes made in EN do not transmit to the partner system, therefore changes made using the enrollment editor DO NOT actually change the coverage as far as the carrier is concerned. 
• Any changes made to third party enrollments with the enrollment editor is at best a temporary change. An enrollment ended/changed in EN will be reinstated on the next bridge/sync unless the change is made in the partner system too.  

834 EDI

• If the Ended On Date was backdated via the enrollment editor more than the specified amount of days defined in the "Days from Termination" of the carrier options (7, 14, or 30 depending on the carrier), the terminated enrollment will not appear on the file. See 834 Carrier Platform Options for more details.

Example: Let's say an employee had a life event on 10/1/2018, but it's 12/11/2018 and you can only process the life event 30 days out. Coverage is ended on 11/11/2018 via life event and the Enrollment Editor is used to backdate the termination effective 10/1/2018. If the Ended On Date is changed to 10/1/2018, this terminated enrollment will not appear on the file. The Ended On Date should always be the date the change was processed. 

 

Data Exchange

COBRA

If your group is connected to a COBRA TPA, be cautious when dropping enrollments via Enrollment Editor as not all drop reasons will trigger a COBRA event. As best practice, we recommend using the life events and the termination tool whenever possible. For more details, see Events that trigger COBRA on the Qualifying Event File. 

As mentioned above with 834 EDI, data exchange enrollments can also be affected by a change in the "Ended On Date". If an Ended On Date needs to be modified, it's best to reach out to our Data Exchange Team for further review prior to changing the date. 

How To

Change Enrollment Start Date

Click on the hamburger menu under the Editing Tools column and select Change. Enter the new Coverage Started override date and add an Event Note for making the change (required).

Change (Ended) Enrollment Dates / Reason

Click on the hamburger menu under the Editing Tools column and select Change. Enter the new Coverage Started and/or Coverage Ended override date(s). You can also change the End Reason and Ended On Date, then add an Event Note for making the change (required).

Change Benefit Amounts

Click on the hamburger menu under the Editing Tools column and select Change. Under Benefit Override, check the box next to Override? to open up the Benefit Amount and Override Date fields. Input the override information and add an Event Note for making the change (required under both Coverage Dates and Benefit Override sections when processing a benefit override).

Change Costs

Click on the hamburger menu under the Editing Tools column and select Change. Under Cost Override, check the box next to Override? to open up the Employee Cost and Override Date fields. Input the override information and add an Event Note for making the change (required under both Coverage Dates and Benefit Override sections when processing a benefit override).

Drop Enrollment

Click on the hamburger menu under the Editing Tools column and select Drop. Enter the Coverage End date and select the drop Reason from the drop-down.

Note: You can only extend an end date 90 days in the future.

Withdraw

If an enrollment needs to be declined retroactively, you can use the Withdraw option. You'll be presented with the normal decline reasons that are displayed in the employee's enrollment. The enrollment will be ended with an end date one day prior to the coverage effective date. 

Remove Conflicting Enrollments

Conflicting enrollments occur when more than one enrollment for a particular benefits gets entered into the system. While this is rare, it does happen. We display the below error message on-screen in the enrollment flow:

Two or more enrollment records were found. Use the enrollment editor to archive conflicting enrollments.

The enrollment editor is used to determine the correct enrollment and remove the other ones. Conflicting enrollments are flagged as conflict in red under this tool. Most conflicts are duplicates of the same enrollment, but some may have differences in the plan, cost or coverage level. Click on the hamburger menu to Show Details on the conflicting enrollments and determine which should be kept and removed. Then click Remove, input the reason for removing (we suggest including the word conflict) and hit Save.

Removed enrollments can be viewed under the ee's Employee Management tab > Employee Data Sheet > Enrollments. Check the box next to removed to display removed enrollments. These aren't pulled into reports and don't display anywhere else on the ee's record.

 

 

FAQ

I'm getting the following warning message when modifying dates:  Warning!  This request exceeds the acceptable time frame permitted to process electronic changes by your plan. It is your responsibility to request this exception be processed by your plan.

Don't worry! You can still modify the date, the system is just reminding you that the change you're about to process exceeds the normal 30 day window permitted by most carriers. Just remember that you're responsible for requesting this exception with the carrier. Go ahead and hit Save, it'll work.