Rollback Automatic Refund/Write Off on Reinstating a Group Policy or Individual Membership

If a terminated fully-insured group policy or individual membership is reinstated, the system checks whether an automatic refund/write off instruction exists for the policy or membership. If an automatic refund/write off instruction exists for the policy or membership, the system behaves in the following manner:

Refund/Write Off Request Exists (Y or N) Automatic Refund/Write Off Instruction Status System Behavior
N Pending or Valid

The system does the following:

  • Changes the status of the automatic refund/write off instruction to Canceled

  • Sets the automatic refund/write off instruction reason to the reason code which is specified in the Instruction Cancel Reason on Reinstatement attribute of the automatic refund/write off field mapping.
Y Pending Completion

The system does the following:

  • Changes the status of the automatic refund/write off instruction to Canceled

  • Sets the automatic refund/write off instruction reason to the reason code which is specified in the Instruction Cancel Reason on Reinstatement attribute of the automatic refund/write off field mapping.

  • If the refund/write off request is in the Processed or Approval in Progress status, then

    • The appropriate log entry is added to the refund/write off request.

    • The status of the refund/write off request is changed to Rejected.

    • The automatic refund/write off instruction reason is set to the reason code which is specified in the Refund Request Reject Reason on Reinstatement or Write Off Request Reject Reason on Reinstatement attribute of the automatic refund/write off field mapping, respectively.

  • If the refund request is in the Hold status, then

    • The appropriate log entry is added to the refund request.

    • The status of the refund request is changed to Voided.

    • The automatic refund instruction reason is set to the reason code which is specified in the Void Status Reason for Refund Request on Reinstatement attribute of the automatic refund/write off field mapping.
Y Completed

The system does the following:

  • If the write off request is in the Processed status, then

    • The appropriate log entry is added to the write off request.

    • The status of the write off request is changed to Canceled.

    • The status of the automatic write off instruction is changed to Canceled

    • The automatic write off instruction reason is set to the reason code which is specified in the Instruction Cancel Reason on Reinstatement attribute of the automatic refund/write off field mapping.

  • If the refund request is in the Processed status, then no action is taken against the refund request and automatic refund instruction.