Examples of How Intervening Life Events Impact Reinstatement Rules
Use reinstatement rules to control restoration of participant elections when you back out and reprocess an event.
If an intervening life event occurs that requires you to back out the original life event, later reprocessing reinstates elections:
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If the participant didn't make any new elections or change existing elections in the intervening life event
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If no action items or certifications were created
Main Scenario Dates and Events
The following main dates and events apply to all examples in this topic:
|
Date |
Events |
|---|---|
|
November 1 to 28, 2015 |
Open enrollment period for the new plan year that starts on January 1, 2016. The participant experiences the open event with the following electable choices:
|
|
November 5, 2015 |
Worker enrolls in InFusion Medical for Employee Only, which costs 5000 USD effective for the new plan year. |
|
November 20, 2015 |
Participant experiences a marriage life event. Administrator backs out the open event to process the marriage life event. The life event provides the InFusion Medical for Employee Plus Spouse electable choice, which costs 7500 USD per year. |
|
November 21, 2015 |
Administrator reprocesses the open event |
Reinstatement of Elections after Processing an Intervening Event
This table shows how each reinstatement rule restores elections based on different scenarios.
|
Scenario After Reprocessing Open Event |
Result |
|---|---|
|
The participant makes no elections in the intervening life event. The electable choices for the open event remain unchanged. |
Reinstates elections if you selected one of the following reinstatement rules for the open event:
|
|
The participant makes no elections in the intervening life event. New electable choices are available for the open event and the rates of some existing electable choices changed:
|
Reinstates elections only if you selected the Reinstate if electability exists for the backed out result reinstatement rule for the open event |
|
The participant elects to enroll in the InFusion Medical for Employee Plus Spouse offering during the intervening life event. New electable choices are available for the open event and the rates of some existing electable choices changed:
|
Doesn't reinstate elections even if you selected a reinstatement rule because the participant made elections in the intervening life event |
|
The participant makes no elections in the intervening life event. The open event includes new electable choices, an action item was created, and some rates changed:
|
Doesn't reinstate elections even if you selected a reinstatement rule because the open event reprocessing created an action item |