Examples of Override and Reinstatement Rules
Use combinations of override and reinstatement rules to control restoration of participant elections when you back out and reprocess a life event.
The examples in this topic show how each override rule works in various scenarios when the reinstatement rule is Reinstate if electability exists for the backed out result.
Main Scenario Dates and Events
The following main dates and events apply to all examples in this topic:
|
Date |
Event |
|---|---|
|
November 1 to 28, 2015 |
Open enrollment period for the new plan year that starts on January 1, 2016. Worker experiences the open event with the following electable choices:
|
|
November 15, 2015 |
Worker enrolls in the InFusion Medical offering |
|
November 20, 2015 |
Administrator backs out and reprocesses the open event. Reprocessing restores worker elections based on the reinstatement rule and the generated electable choice data. |
Override the Rates If No Change
The administrator set up this override rule along with the Reinstate if electability exists for the backed out result rule. Before making changes to the rate definition and reprocessing the open event, the administrator overrides the rate of the InFusion Medical offering to 5250 USD.
This table shows how the configured rule combination restores elections based on different scenarios.
|
Scenario After Reprocessing Open Event |
Result |
|---|---|
|
Same electable choices and rates |
Reinstates elections with the override value of 5250 USD for InFusion Medical because the electable choice data is unchanged |
|
Same electable choices, but with different rates:
|
Reinstates elections, applying the new rate value of 5500 USD rather than the override value of 5250 USD |
Always Use Overridden Rates
The administrator set up this rule along with the Reinstate if electability exists for the backed out result rule. Before making changes to the rate definition and reprocessing the open event, the administrator overrides the rate of the InFusion Medical offering to 5250 USD.
This table shows how the configured rule combination restores elections based on different scenarios.
|
Scenario After Reprocessing Open Event |
Result |
|---|---|
|
Same electable choices and rates |
Reinstates elections with the override value of 5250 USD for InFusion Medical |
|
Same electable choices, but with different rates:
|
Reinstates elections with the override value of 5250 USD for InFusion Medical even though the rate of the benefit offering that the participant elected originally changed to 5500 USD |
|
Fewer electable choices:
|
Doesn't reinstate elections because InFusion Medical, the participant's original election, is no longer an electable choice |