Examples of Configuring Certification Requirements

The following examples illustrate how to associate enrollment and benefits-based certification requirements with benefit offerings.

General Enrollment Certification Requirement

Scenario: A life insurance plan requires participants to provide a proof of good health, which they obtain from their physicians.

• The guided enrollment process provides a reminder about the pending certification during enrollment.

• Enrollment processing immediately suspends enrollment and applies the interim coverage, if any.

• The interim coverage remains in effect until the participant provides the certification.

Setup: On the Plan Certifications page in the Plan Configuration work area:

1. On the Enrollment Certifications tab, General Configuration subtab, create a certification requirement.

2. Select the Required and Suspend enrollment check boxes.

3. Set a due date for the certification.

4. Define interim coverage for the plan, if not already defined, on the Plan Enrollments page.

Life Event Enrollment Certification Requirement

Scenario: A life insurance plan requires new hires to provide proof of good health or evidence of insurability certification. Existing participants who are updating benefits during open enrollment don't have to provide proof.

• The guided enrollment process provides a reminder about the pending certification during new hire enrollment.

• Enrollment processing immediately suspends new hire enrollment in the plan, with no interim coverage, until the new hire provides the certification.

Setup: On the Plan Certifications page in the Plan Configuration work area:

1. On the Enrollment Certifications tab, Life Event subtab, create a certification requirement for the New Hire life event.

2. Select the Required and Suspend enrollment check boxes.

3. Set a due date for the certification.

Don't define interim coverage.

Benefit Certification Requirement

Scenario: A life insurance plan exceeding 100,000 USD coverage requires proof of good health or evidence of insurability certification. Plans with coverage below that amount don't require certification.

• The guided enrollment process provides a reminder about the pending certification during enrollment in the plan with coverage exceeding 100,000 USD.

• Enrollment processing immediately suspends enrollment and applies the interim coverage, if any.

• The interim coverage remains in effect until the participant provides the certification.

Setup: On the Plan Certifications page in Plan Configuration work area:

1. On the Benefit Certifications tab, General Configuration subtab, create a certification requirement.

2. Select the Required and Suspend enrollment check boxes.

3. Set a due date for the certification.

4. Define interim coverage as a plan with coverage equal to 100,000 USD on the Plan Enrollment page.

Tip: You can also define benefits certification requirements for a particular life event using the Life Event subtab. For example, you require certification for the Gain Dependent life event if coverage exceeds 100,000 USD.