How Enrollment Rules Are Calculated

Enrollment rules limit enrollment elections based on current participant enrollment.

Settings That Affect Enrollment Rules

Two settings affect enrollment rules:

  • The person's enrollment status

  • The selected enrollment option

The following table lists and describes the enrollment statuses.

Enrollment Status

Description

Current

Participants who are enrolled in the benefits object

New

Persons who aren't currently enrolled

The following table lists and describes the enrollment options, which determine whether enrollment is possible for the next period.

Enrollment Option

Description

Can choose

Persons can make new elections.

Can keep

Participants can keep their current elections.

Can keep or choose

Participants can:

  • Keep their current elections

  • Make new elections

Keep or choose, starts new

Participants can:

  • Keep their current elections

    They must explicitly reelect coverage amounts, even if the coverage amount remains the same.

  • Make new elections

Coverage ends at the configured end date for the processed life event and restarts the next day.

Choose only

Participants must make an explicit election to remain enrolled.

Keep only

Participants must keep their current elections.

Lose only

Participants must disenroll from their current elections.

Assign automatically

Enroll participants automatically. Participants can't disenroll.

Nothing

Persons can't make elections for the benefit object.

Formula

Use a formula that you defined previously to determine electability based on enrollment status. The formula must be of the type Enrollment Opportunity.

How Enrollment Rules Are Interpreted

Each enrollment rule represents a combination of options.

The following table provides two examples.

Enrollment Rule

Option Combination

Current - keep only; new - nothing

Current participants must retain their set of elections to stay enrolled. Unenrolled persons can't make elections for this benefits object.

Current - nothing; new - assign automatically

Current participants can't make elections for the benefits object. Unenrolled persons are enrolled automatically and can't disenroll.