Dependent Eligibility Management

Posted by BAS - 17 November, 2022

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BAS can manage dependent eligibility for an employer to ensure only approved dependents are added to benefits. MyEnroll360 offers a complete and tightly knit dependent verification processing eco-system to ensure employees have a quick and easy way to add dependents, employees know how to submit dependent verification, and information is reviewed according to employer-specific eligibility rules.

The dependent eligibility verification process in MyEnroll360 is a two-phased process:

(1) Phase 1 applies controls when a dependent is added to MyEnroll360 either through the Dependent Manager Application or the Enrollment Wizard. When a dependent is added through either application, these applications will prompt the user about the dependent eligibility rules and instruct about the process for the user to submit documentation to substantiate the dependent’s eligibility. Users have two options for submitting their dependent verification documents:

Option 1: Print a personalized fax/mail coversheet that identifies the employee and their dependent with a bar code on the form and provides instructions for mailing or faxing the required dependent verification documents. The bar code ensures the automatic assignment of the documents to the employee’s specific dependent when the form and documents are either mailed and BAS subsequently scans them into MyEnroll360 or faxed into MyEnroll360, for automatic employee/dependent assignment.

Option 2: Use the Dependent Manager or Enrollment Application to upload electronic versions of the dependent verification documents, which automatically assigns such documents to the employee’s dependent’s account for review.

If a dependent is added to the system, the dependent is not added to the employee’s benefit(s) until the reviewing administrator approves the dependent’s eligibility. Importantly, if the dependent is added within the Enrollment Wizard and assigned to specific benefits, only after the administrator’s approval will the dependent be added to the employee’s benefit(s).

Further, MyEnroll360 will adjust the employee’s Family Status Tier (e.g., Single, Parent/Child, Family) automatic based on the employee’s current active coverage Family Status Tier vis-à-vis the Family Status Tier required due to the addition of the dependent.

(2) Phase 2: Review and processing of Dependent Verification Documentation. Clients may choose one of two service levels: (1) Client or (2) BAS manages the review and processing of dependent verification documentation.

The Dependent Manager Application affords the administrator a centralized application for the review and approval of all submitted employee dependent eligibility verification documents. Administrators can be assigned to manage one, multiple, or all client locations/divisions employee’s submissions. The client may assign any number of administrators to this role.

The Dependent Manager Application lists all employees and their dependents who are pended for eligibility review. Administrators select a single dependent from the list at which point the application presents images of the submitted verification documents. Upon review of the documents, the administrator has three (3) status disposition options: (1) Approve Eligibility, (2) Decline Eligibility and (3) Maintain the Pending Status and Request more information from the employee.

Approve Eligibility: If the dependent was set up through the Enrollment Wizard Application, the dependent is released from pending status into active status and assigned any benefits the employee designated. If the dependent was added from the Dependent Manager Application, the dependent will be released into active status. Regardless of the method used to enter a dependent, the approval process includes sending the employee an automated email confirming the approval of the dependent.

Decline Eligibility: If the dependent was set up through the Enrollment Wizard Application, the dependent is released from pending status into terminated status and all pending benefit assignments are terminated. If the dependent was added from the Dependent Manager Application, the dependent will be terminated. Regardless of the method used to enter a dependent, the approval process includes sending the employee an automated email confirming the declination of the dependent.

Request Additional Information: If the administrator determines additional information is needed from the employee about the pending dependent before making a final disposition decision, the Pending Dependent Eligibility Manager application provides the administrator with a means of writing an email to the dependent describing the additional requirements. MyEnroll360 manages the storage and sending of such email and sends a copy of the email to the processing administrator.

Topics: MyEnroll360 Feature, Dependent Audit, Dependent Verification, MyEnroll360, MyEnroll360 News


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