Examples of Reinstatement Rules
Use reinstatement rules to control how you want to restore participant elections when you back out and reprocess a life event. The examples in this topic show how each reinstatement rule works in different scenarios.
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 Employee Plus Spouse 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. |
Reinstate All If No Electability Change for Life Event
This table shows how the reinstatement rule restores elections based on different scenarios.
|
Scenario After Reprocessing Open Event |
Result |
|---|---|
|
Same electable choices and rates |
Reinstates elections because there is no change in the electable choices |
|
Same electable choices, but different rates:
|
Doesn't reinstate elections because the electable family and employee only choices have different rates, even though the participant didn't elect those offerings originally |
|
Different electable choice:
|
Doesn't reinstate elections because the new InFusion Medical Employee Only Plan B electable choice replaced the previous electable choice, even though the participant didn't select that offering |
|
Additional electable choices:
|
Doesn't reinstate elections because InFusion Medical Family Premium is a new electable choice |
Reinstate If No Change for the Backed Out Enrollment
This table shows how each reinstatement rule restores elections based on different scenarios.
|
Scenario After Reprocessing Open Event |
Result |
|---|---|
|
New electable choices:
|
Reinstates elections because even though there is a new electable choice, there is no change in the electable choice that the participant elected originally |
|
Same electable choices, but different rates:
|
Doesn't reinstate elections because the electable choice, InFusion Medical Employee Plus Spouse, which the participant originally elected has a different rate value |
|
Different electable choice:
|
Doesn't reinstate elections because the new InFusion Medical Employee Only Plan B electable choice replaced the previous electable choice, even though the participant didn't select that offering |
|
Same electable choices, but different rates:
|
Reinstates elections because even though some offerings have different rates, the rate of InFusion Medical Employee Plus Spouse, which the participant elected originally, is unchanged |
Reinstate If Electability Exists for the Backed Out Result
This table shows how each reinstatement rule restores elections based on different scenarios.
|
Scenario After Reprocessing Open Event |
Result |
|---|---|
|
Same electable choices, but different rates:
|
Reinstates elections with the changed rates for InFusion Medical Employee Plus Spouse, which the participant originally elected |
|
Different rates for existing electable choices, and a new electable choice:
|
Reinstates original participant elections with the changed rate for InFusion Medical Employee Plus Spouse, even though there is also a new electable choice, InFusion Medical Employee Only Premium |
|
Fewer electable choices:
|
Doesn't reinstate elections because InFusion Medical Employee Plus Spouse, which the participant originally elected, is no longer an electable choice |
Reinstate if Electability Exists for the Backed Out Result, Else Apply Defaults
|
Scenario After Reprocessing Open Event |
Result |
|---|---|
|
Same electable choices, but different rates:
|
Reinstates elections with the changed rates for InFusion Medical Employee Plus Spouse, which the participant originally elected |
|
Different rates for existing electable choices, and a new electable choice:
|
Reinstates original participant elections with the changed rate for InFusion Medical Employee Plus Spouse, even though there is also a new electable choice, InFusion Medical Employee Only Premium |
|
Fewer electable choices:
|
The participant is enrolled using the defaults. That's because InFusion Medical Employee Plus Spouse, which the participant elected originally, is no longer an electable choice. Depending on how you configured the defaults, the participant will be enrolled in, for example, InFusion Medical Employee Only |
Never Reinstate
This reinstatement rule ensures that reprocessing doesn't restore elections under any condition.