The U.S. Department of Labor (DOL) has launched an investigative initiative aimed at employer and insurance company practices concerning life insurance benefits requiring Evidence of Insurability (EOI). Instances of life insurance claims being denied due to unapproved EOIs have prompted this scrutiny. Employers and insurance companies failing to ensure EOI completion could potentially breach ERISA fiduciary duty, leading to penalties and legal consequences.
The Role of EOI
When employers offer employees life insurance beyond guaranteed issue (GI) limits, EOI becomes necessary to validate good health. However, discrepancies arise when premiums are deducted but EOIs are not submitted to the insurer. This situation leaves employees without the coverage they believe they have.
Mitigating Breach of Fiduciary Duty
BAS and MyEnroll360 offer a solution to help employers navigate the EOI process and avoid ERISA fiduciary breaches. By following best practices, employers can safeguard against penalties and potential lawsuits:
- Configure EOI Rules: MyEnroll360 sets up EOI rules and GI limits for various enrollment scenarios.
- Automated Approval: MyEnroll360 automates approval up to the GI amount and pending the rest until EOI approval.
- Streamlined EOI Submission: MyEnroll360 facilitates EOI completion through online portals or mailed documentation.
- Employee Engagement: MyEnroll360 sends EOI forms or links to employees for completion.
- Approval Workflow: Employers act on carrier approvals or denials within MyEnroll360.
- Data Reconciliation: BAS aids employers by reconciling insurer-provided data to confirm enrollments or rollbacks.
Secure Compliance with MyEnroll360
MyEnroll360 provides an integrated, secure solution to manage the EOI process, safeguarding against potential legal liabilities, penalties, and fiduciary duty breaches. Employers can trust BAS to ensure proper EOI completion and life insurance coverage alignment. For comprehensive assistance, reach out to your account manager or contact solutions@basusa.com.
Clients - to learn more contact your BAS account manager.
Others - to learn more contact sales@basusa.com or 800.945.5513.
Benefit Allocation Systems (BAS) provides best-in class, online solutions for: Employee Benefits Enrollment; COBRA; Flexible Spending Accounts (FSAs); Health Reimbursement Accounts (HRAs); Leave of Absence Premium Billing (LOA); Affordable Care Act Record Keeping, Compliance & IRS Reporting (ACA); Group Insurance Premium Billing; Property & Casualty Premium Billing; and Payroll Integration.
MyEnroll360 can Integrate with any insurance carrier for enrollment eligibility management (e.g., Blue Cross, Blue Shield, Aetna, United Health Care, Kaiser, CIGNA and many others), and integrate with any payroll system for enrollment deduction management (e.g., Workday, ADP, Paylocity, PayCor, UKG, and many others).
