Terminate By Omission Enrollment Files

Most of our customers submit insurance enrollment files using the concept of Term-By-Omission. In other words, if an employee appears in the enrollment file, he should either be newly enrolled or continue his enrollment. If a previously enrolled employee no longer appears in an enrollment file, then his enrollment should be terminated due to the omission of his name in the enrollment file. The default method of creating an enrollment file within the HRM Software utilizes this concept when creating an enrollment file for you to export to your Insurance Carrier or T.P.A.

Newly Eligible and Newly Terminated Enrollment Files

More and more of our customers now need to create two different sets of enrollment information to meet the enrollment requirements of their Carrier or T.P.A. They need to provide a list of those employees who are newly enrolling in coverage, as well as a list of those employees who are now being terminated from coverage. This concept is not currently supported by an automated process within the HRM Software, but the software is already capable of providing the Newly Eligible and Newly Terminated information in separate Excel format files. These two files can then both be exported to the Insurance Carrier or T.P.A. as is, or the information within these files can manipulated and combined into one spreadsheet file, if necessary, and then exported to the Insurance Carrier or T.P.A. Please note the following instructions:

To Determine Newly Enrolled:

  1. Run your Eligibility Report as Usual.
  1. Open your Benefit Eligibility Review window.
  1. In the “Coverage Start On:” Field, enter the Date that newly enrolling employees begin their coverage and press the ‘Tab’ key. (For example: If you ran the Eligibility for hours of service during the month of November, the date entered should be 12/01/2015.)
  1. This will filter the results to show only those who are starting coverage on the date entered.
  1. Next, click on the Customize button at the bottom of the window. In the Customize Report Settings dialog box that opens, enter a title for this report, such as ‘Newly Enrolling Employees’ in the Title field.
  1. Then click on the “Columns” button and a Select Report Columns Dialogue box opens. In this box you will see a list of Available Fields and a second list of Selected Fields. You can add and remove the fields you wish to appear on the Excel spreadsheet as well as place them in the correct column order by moving the fields up and down the list. Only those fields that are in the Selected Fields List will be included in the Excel spreadsheet. When you are finished, click Ok.
  1. Then click Ok on the Customize Report Settings dialog box.
  1. Next click on the “Export” button in the lower right hand corner and select a location and File name in which to save your Excel Spreadsheet. When done click Save.
  1. If you have a licensed copy of Excel on your PC the file will be created and save and will open on your desktop automatically.

To Determine Newly Terminated:

  1. Run your Eligibility Report as Usual.
  1. Open your Benefit Eligibility Review window.
  1. In the “Coverage End On:” Field, enter the Date that newly terminating employees end their coverage and press the ‘Tab’ key. (For example: If you ran the Eligibility for hours of service during the month of November, and the employee is no longer going to be insured, the date entered should be 11/30/2015.)
  1. This will filter the results to show only those who are ending coverage on the date entered. (In the example above, those who are continuing coverage or are newly eligible are going to have a Coverage End On Date of 12/31/15, so they won’t appear in a list of those whose coverage is ending on 11/30/2015.)
  1. Next, click on the Customize button at the bottom of the window. In the Customize Report Settings dialog box that opens, enter a title for this report, such as ‘Newly Terminating Employees’ in the Title field.
  1. Then click on the “Columns” button and a Select Report Columns Dialogue box opens. In this box you will see a list of Available Fields and a second list of Selected Fields. You can add and remove the fields you wish to appear on the Excel spreadsheet as well as place them in the correct column order by moving the fields up and down the list. Only those fields that are in the Selected Fields List will be included in the Excel spreadsheet. When you are finished, click Ok.
  1. Then click Ok on the Customize Report Settings dialog box.
  1. Next click on the “Export” button in the lower right hand corner and select a location and File name in which to save your Excel Spreadsheet. When done click Save.
  1. If you have a licensed copy of Excel on your PC the file will be created and save and will open on your desktop automatically.

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