Insurance Enrollment Forms Follow Up

HRQ

I'll try to make this easy to follow, feel free to ask questions if it's not;

- Ee requested, and was given, enrollment materials. We never received completed forms back from her.

- Five months after her separation, employee produces copies of completed forms. Claims she gave them to her direct supervisor and she intentionally did not enroll her, to save money.

- Employee reports us to DOL for COBRA violation. Had she been enrolled, she would have been eligible for COBRA

We do not have a good system for notifying newly eligible employees of forms/waivers we have or haven't received.

There is a long list of complaints from this former ee, but my question is specifically about insurance benefits;
- Do you confirm receipt (or lack) of enrollment forms and waivers in writing?
- Have you ever had to prove that an employee did NOT enroll, when you have no waiver or other documentation to prove it? How did you do it?

We do not offer electronic enrollment. All bene's notifications and enrollment are on done on paper.

ritaanz

Employee's are offered insurance coverage at the time of hire. They have 30 days to accept or waive. I keep the forms and give the employee the brochure or certificatres describing the benefits. I remind the employee within one week that they have not completed the forms. In week 3, I ask the supervisor to send the employee to HR and by that time they either accept or waive and sign the form in my presence.

dlail

Employees must complete forms by hand (which we use to enroll on line). Even though we don't send actual enrollment forms to employees, all benefit forms we use have a signature line for declining the benefit. I follow up, producing additional enrollment forms if necessary.
I would think the individual providing the forms would be responsible for following up. If that happens to be a manager or someone other than the individual who completes actual enrollments, between them they need to devise some type of tickler. A reminder of the legal ramifications of not following through might be a motivator.

Good luck. I hope you have some SOPs, if the DOL comes knocking.

joannie

We have a new hire checklist listing all forms required to be returned to HR. If forms are not back in 10 working days, I e-mail supvr requesting return in 3 business days. If not returned in 3, next e-mail is to operations director. He give supvr 2 business days. If not back then, new forms are sent to supvr along with ee paycheck and instructions that forms must be completed before check can be released. BTW, the ops director personally handles the supvr evaluations, so their part in the non-completion of the forms affects their eval. We've handled this way for 4-5 years now and have always gotten the completed forms back the day after payday. Money is a great motivator.

System

That's a good system, provided that it's legal in your state to withhold a paycheck for that reason. That practice would be unlawful in a lot of states.

System

By the way, I don't think the employee has a COBRA claim here. Since there were no benefits to continue, you had no continuation coverage obligations. A person isn't eligible for COBRA benefits if they weren't enrolled in the employer's health plan. There seems to be no dispute that she wasn't enrolled. Case closed. Whether she should have been enrolled in health insurance is a separate issue, and it's not something the DOL would be involved in. She'd have to file some other cause of action, but unless she worked there for an extremely short time, I think she'd have a hard time establishing that she really wanted to enroll if she went months without insurance but just happened not to say anything about it until after she was terminated.

Lisa In Iowa

Do you pay the full cost for employee insurance benefits. If not, if the employee had signed up for the coverage, she should have noticed that premiums were not coming out of her paycheck and followed up.

That being said, our benefit forms require either an enrollment or a declination. Either way, one of the boxes must be checked and the form must be signed. If the employee does not provide the signed forms, our Benefit Administrator follows up with them via e-mail. If that does not work, we work with the employee's supervisor to collect the forms. If it is escalated to a supervisor, we receive the forms.

Good Luck!

njjel

The ee's personnel folder stays on my desk until we have received all required info. One of which would be either a denial of insurance coverage or the enrollment form for coverage. The stack is reviewed each week and the ee's are hounded to get the forms in or sign a denial of coverage.

HRQ

A major challenge for us is our volume. Because of our turnover, we hire around 700 people per year. We also have quite a bit of FT/PT toggling, because of school year vs summer. We are multi-site, all local, I am at the corp office. There are two of us in my department.

Passing the follow up responsibility to the location supervisors may be an option. I'd like to avoid that by using a better system. Passing it on to hte supes would just move the problem: rather than following up myself, I'd be managing 29 people and whether or not they are following up.

We are looking at switching from inhouse payroll software (which is quirky and unpredictable, by the way) to outsourcing to ADP. It's significantly more expensive, but far more efficient. Unfortunately, we are also having a bad year, financially.

Among other things, ADP's system would allow us to provide online bene's enrollment. This would ensure every ee KNOWS about the bene's and we can prove it. It also streamlines many of our currently inefficient processes. Of course we would need a workaround for those without computer access. Adding a kiosk or making a computer available at the schools is not an option.

My CEO said he does not see the importance of being able to prove every employee was given the opportunity to enroll/waive bene's. Said it's their problem if they don't notice that we didn't start charging them, or that they didn't get an insurance card.

I told him the burden of proof would be on the employer, and we are also providing poor customer service to our employees. Not because of my department's lack of knowledge or ability, but because of lack of resources.

[b][i]So, he suggested I ask you guys: have you ever had to prove an employee did NOT turn in their forms? What was the situation, what was the outcome, the consequences, etc?[/i][/b]

joannie

Q,
We have never had to prove ee didn't turn in forms, so I really don't know how you could prove they didn't. Perhaps some type of waiver would work. Upon employment, you could have the ee sign off on statement:

"Insurance enrollment or declination forms are to be returned no later than 10 days after date of hire. If corporate office has not received properly completed enrollment forms, it will be deemed ee has voluntarily declined coverage."

Then with the 1st paycheck after completed forms were due back, if still not received, you could include notice:

"Completed benefits forms were not received within alloted timeframe. YOU ARE NOT COVERED BY BENEFITS. If there has been a mistake, contact HR immediately. Failure to notify HR will be considered as a voluntary declination of coverage."

Any of you legal minds out there see why something like this would not protect the company?

NeedCoffee

HRQ - I don't know if this is what you're looking for, but here goes:

I had to prove an employee did NOT turn in forms at the last open enrollment we had. Employees were instructed to return forms ONLY if they were making changes to their existing elections. This particular employee came to us after the enrollment period was up, and said we were charging him too much for his premiums since he had switched to a lower plan. The employee was "pretty sure" he returned his forms to me.

Employee ended up not getting changes processed because we had no way to prove that he submitted a form at open enrollment. Had we required all employees to submit new forms, regardless of whether they were making changes, it would have been INCREDIBLY labor intensive, but would have helped in a situation like this.

In the end, the employee was told it was HIS responsibility to submit forms by the deadline. All departments were given reminders when the deadline was approaching, therefore HR had done its duty. I simply cannot contact every single employee to ensure they wanted changes made.

What are the consequences?? Employee will have to wait until next open enrollment to make changes, and I have revised our open enrollment process.

Hope this helps.

HRQ

It does help - thank you, ladies.

After open enrollment, I send out confirmation letters to all employees. I do have to rely on the managers to actually hand them out, however.

It's time intensive, but saves me the trouble of following up for waivers. I run a list of all ee's, and mail merge into a memo;
- eligibility status (PT - ineligible's still get a letter to confirm they are not eligible)
- prices, level of coverage, etc of their elections
- cafe plan election or waiver (assume waived if no form received)
- note that forms were not received therefore ee has no coverage, or coverage did not change, depending on their situation

This gives them the opportunity to say "Hey! I sent in forms!" while there is still time to do something about it.

It's a lot of work but has definitely helped with employee satisfaction and my own sanity, after open enrollment is over.

My problem is still with new hires, PT/FT changes, etc throughout the year.

I guess as long as there are no legal consequences for our own failure to follow up, then it is "just" poor customer service to our ee's.

In this particular case, the ee alleges we purposely withheld bene's and did other (untrue) things because she is jewish. It's an extremely big deal for which we've already spent over $25,000 in atty fees defending ourselves and it will not be over any time soon. It's not pretty.

Beverlee

I, too, keep incomplete personnel files within reach, and post it notes tabbed with the deficiancies. We have 50-60 new hires each year- so at any given time, I have 5-6 files on hand.

I usually give them a few days- depending on their shift- to take materials home to compare w/ spouse coverage, etc. I also give them a return by date, in writing, on the materials, which do not include the actual enrollment form. After a week or two, I may phone or send a note to them. I will send one more memo before the 30 days are up. Only 1 time in 11 years have I not had a response. When the ee said she had turned in her form, I showed her the two memos requesting the info, and requesting her signature on the form itself- and the note I wrote to myself (on her enrollment form) on the 31st day saying I had phoned and left a message on her machine that she was considered to have declined her health insurance.

Our ees are usually very good at completing this info- if they chose to waive our health insurance they will receive an FSA contribution.

I have many more ees who "forget" to return info to their files such as beneficiaries info, I-9 requirements, and retirement information.

I just reached over and counted, I have 4 incompletes on my desk today. Each will get a reminder of some type tomorrow. I just add another sticky note when I made contact, or a copy of the memo itself.

Lauri

All of our new employees are signed up for everything on their first day of employment. They are required to have insurance unless they choose to waive it, even if they are married and on a spouse's plan, once hired as a full-time employee our insurance becomes their primary insurance and at no cost to the employee.
There is obviously to much room for error if you don't get all the required paperwork up front, if you give them a timeline, things tend to slip through the cracks and you end up in situations like this one.