How Action Items Are Processed

The configuration of action items determines what happens during enrollment processing. For example, failure to provide required action items can result in suspended enrollment or simply cause delinquent items to appear in benefits administration reports.

Settings That Affect Action Item Processing

The following action item settings affect processing:

Setting	Description
Suspend Enrollment	When enabled, notifies participant of pending action item during enrollment and causes suspension of enrollment until the item is completed.
Determination Rule	Determines when the item is required, such as always or only for initial enrollment.
Due Date	Determines when the item starts appearing on audit and error reports generated by enrollment processing.

Interim coverage setup also affects enrollment processing, as described in the next section. You define interim coverage for a plan or option on the Plan Enrollment page using the Benefit Plan Details task in the Plan Configuration work area.

How Action Items Are Processed

If enrollment processing suspends enrollment due to incomplete action items, it then applies interim coverage, if configured. No further life event processing takes place until the participant completes the action items.

Note: Incomplete or past-due action items for one benefits relationship don't stop processing of events for another benefits relationship for the same worker.

Reporting of pending action items and certificates occurs as part of enrollment processing. Benefits administrators can use these reports to follow up as required.

Process	Reporting
Close enrollment action items	The audit log includes any: Past-due required action items Incomplete action items that you configured to suspend enrollment
Close enrollment	The audit log includes any: Past-due required action items Incomplete action items that you configured to suspend enrollment
Participation evaluation	The error report contains any incomplete action items that you configured to suspend enrollment for a participant.

The following scenarios illustrate subsequent life events processing for a participant with an open action item.

Suspension Results in No Further Life Event Processing

Scenario:

1. On January 1, 2015, you process the Add a Child life event with an occurred date of January 1, 2015, and make corresponding elections.

2. An action item, configured for suspension, is generated with a due date of January 30, 2015. The participation evaluation process suspends the enrollment and applies the configured interim coverage.

3. You process the Relocation event on January 15, 2015.

Result:

• The Relocation event can't process until you resolve the suspension for the Add a Child event.

• The action item associated with the Add a Child event appears on the audit report after action item processing.

• The participant's name appears on the error report after participation evaluation processing.

• Contact the participant and attempt to resolve the action item. After you mark the action item as complete, enrollment for the Add a Child event completes and you can process the Relocation event.

Suspension of Beneficiary Designee Only

Scenario:

1. On January 1, 2015, you process the Add a Child event with an occurred date of January 1, 2015, and make corresponding elections.

2. An outstanding action item for beneficiary designation, configured for suspension, is generated with a due date of January 30, 2015. The participation evaluation process suspends the enrollment for the beneficiary designee.

3. You process the Relocation event on January 15, 2015.

Result:

• The participation process evaluates the Relocation event for enrollment opportunities even though an outstanding action item exists. This is because the action item exists only for the beneficiary designation, not for the entire offering.

• You can process future life events for the participant.

Suspension with No Interim Coverage

Scenario:

1. On January 1, 2015, you process the Add a Child event with an occurred date of January 1, 2015, and make corresponding elections.

2. An action item, configured for suspension, is generated with a due date of January 30, 2015. The participation evaluation process suspends the enrollment, but no interim coverage exists.

3. You process the Relocation event on January 15, 2015.

Result: The Relocation event can't process until you resolve the suspension for the Add a Child event.

Subsequent Life Event Processing Causes Previous Life Event to be Backed Out

Scenario:

1. On January 10, 2015, you process the Add a Child event with an occurred date of January 10, 2015 and make corresponding elections.

2. An action item, configured for suspension, is generated with a due date of January 30, 2015. The participation evaluation process suspends the enrollment and applies the configured interim coverage.

3. On January 15, 2015, you process the Relocation event with an occurred date of January 1, 2015.

Result: Life event processing backs out the Add a Child event, along with any pending action items. It processes the Relocation event, unless the timeliness setup for the life event prevents life events from backing out in this situation.

Termination Processing After Suspension

Scenario:

1. On March 1, 2015, you process the Marriage life event and make corresponding elections.

2. An action item, configured for suspension, is generated with a due date of March 30, 2015. The participation evaluation process suspends the enrollment and applies the configured interim coverage.

3. You process the Termination event on March 20, 2015.

Result: The participation process evaluates the Termination event even though there is a pending action item from the Marriage life event.