Add Enrollment

A member or employee will meet the stipulated requirements set forth by the Group Customer in order to participate and/or qualify for coverage/benefits. Based on the parameters defined by the Group Customer, particular plans are offered to the member/employee at a particular point in time (enrollment period).

Enrollment periods:

  • Open: specific number of months for enrollment
  • Qualified Life Event: open window based on marriage, divorce, birth of a child
  • Auto: Noncontributory benefits that do not require enrollment by the member

Accessing the Enrollment Screen

The Enrollment link will be displayed once a member has been placed in an Eligibility Class, normally using an evaluation activity. Based on configuration of the Enrollment Screen, it can be accessed in several ways:

  • Open the Customer record, navigate to the Enrollment Screen via the Enrollment link on the Entity Navigation list.
  • The user can add Enrollment details via the Agreement screen.
  • Short cut options are available in the hamburger menu of Client Search Results, Group Customer Relationship Screen etc.

Enrollment Screen Layout / Steps to Enroll:

The Enrollment Screen is divided into sections:

  1. The top layer of the screen allows the user to filter the enrollment records for the client by Start and End date.

  2. The grid that displays below the filter show the plans / coverages that the client can enroll.

  3. On clicking the Coverage check box, the user can select the coverages in which the client wishes to enroll.

  4. The last section of the screen is dedicated to data detail display of the Enrollment Activity based on the Product selection. Each time a product/coverage is selected, the screen refreshes to display the activity fields associated with the Enrollment activity including policy, coverage, and role information.
  5. New clients can be created during this process for designation of roles. By selecting data in the Plan Eligible Classes and using/selecting Enroll, the user can enroll clients into multiple products within the same Enrollment screen.
Important   Highlight the desired coverage, populate the necessary Enrollment Activity Fields, and select Enroll. Repeat this course of action until all the enrollments have been achieved.
  1. The user can select Save or Enroll for the Enrollment record depending on the level of completeness. There are three possible Enrollment statuses: Active, Pending, and Shadowed.
    • Save will place the Enrollment in "Enrollment Pending" with an Enrollment Activity (at the Client Level) in "Enrollment Pending" status.
    • The user may revisit the pending Enrollment record and delete the record from the Eligible Enrollment table online using the Trash can Action Icon .
    • Enrollment elections will be stored when the user selects Save/Submit.

To process the Enrollment that is currently pending:

  • The user will revisit the pending Enrollment record on the Eligible Enrollment table, select the pending record, and select Enroll.
  • When the Enroll button is selected the execution of the Enrollment activity occurs at the client level and the record is updated from Enrollment Pending to Active.
  • The Enrollment Date will be copied back to the Eligible Enrollment table to display the individual as enrolled in coverage.

Enrollment Status:

  • When Save is selected on the Enrollment Screen, an Enrollment Activity in "Enrollment Pending" status will be added to the client being enrolled.
  • When the Enrollment Activity is in "Enrollment Pending" status it will not be available for processing or manually processed within cycle.
  • When the Enroll button is selected on the Enrollment Screen the Enrollment Activity will change from Enrollment Pending to Active.
  • When the activity is in "Enrollment Pending" status no actions icons are available and all actions must be performed on the Enrollment Screen.
  • When a user accesses the Enrollment Screen in an attempt to add multiple coverages under the same plan a validation error message will be triggered and displayed on the screen.

Miscellaneous Screen Details:

  • Record enrollment data and elections can be saved even with partial completion by selecting Save.
  • Access to the Screen is security based.
  • A TimeStamp will be stored/saved for each record.
  • The Enrollment Screen will become disabled (fields and buttons) when a user accesses the screen for a client who already has an Active Enrollment record.
  • Enrollment Activity at the Client level is non-reversible.