Entering Health Benefits Data in HRS

Overview

This procedure will cover how to correctly use enrollment codes/reasons to add coverage, add dependent, remove dependent, cancel coverage, and change health plan, which drives the health vendor interfaces: State Group Health, Delta Dental, and VSP. Therefore, accuracy and consistency are important in maintaining this information.

Process Considerations:

You may click on the links below to navigate directly to a section:

Instructions for Entering Health Insurance for New Hires

Self Service Enrollment

  1. Notify Employee of Enrollment Opportunities
  2. Employee enrolls via Self Service
    a.  Review and Update Employee Information
    b.  Review and Update Benefits Personal Data.
    c.  Enter Dependent Information if applicable
  3. Employee receives Confirmation Statement
  4. Review Retro Reviewing Retro Benefits in HRS

Paper Application(s) Enrollment

  1. Notify Employee of Enrollment Opportunities
  2. Employee turns in Paper Applications to Administrator
  3. Review and Update Employee Information through Maintaining Person Data - Biographical Details in HRS
  4. Review and Update Benefits Personal Data through Entering and Updating Benefits Personal Data in HRS
  5. Enter Dependent Information if applicable through Adding and Updating Dependents in HRS
  6. Review Job Data/Benefit Program Participation to ensure event is consistent with system data. Reviewing the Health Application in Relation to Job Data and Benefit Program Participation in HRS
  7. Before creating ADM event, check for existing event in On-Demand Enrolling, Changing, or Canceling Coverage Using On Demand Event Maintenance in HRS
  8. Create ADM event on BAS Activity Table Adding Events to the BAS Activity Table in HRS
  9. Process the ADM event Enrolling, Changing, or Canceling Coverage Using On Demand Event Maintenance in HRS
    a. Use ADM Event Date defined in Event Table
    b. For other plan type Event Dates please refer to UW System HR Life Event Changes 
  10. Review Enrollments Review Benefit Enrollments in HRS
  11. Review Retro
  12. Distribute forms according to Benefit Application & Form Distribution Chart

Instructions for Adding Coverage, Adding a Dependent, Removing a Dependent, Changing a Benefit Plan, or Canceling Coverage for New or Existing Employees

  1. Receive application from employee (within # of days defined by Event Table) Overview of Enrollment Codes and Reasons Job Aid for HRS
  2. Review and Update Employee Information
  3. Review and Update Benefits Personal Data
  4. Review Job Data/Benefit Program Participation to ensure event is consistent with system data
  5. Before creating ADM event, check for existing event in On-Demand
  6. Create an ADM Event to add/change/cancel any and all applicable plans.
    a. Use ADM Event Date defined in Event Table
    b. For other plan type Event Dates refer to UW System HR Life Event/Employee Changes charts
  7. Process the ADM Event
  8. Review Enrollments on "Enroll in Benefits" for all applicable plan types
  9. Review Retro
  10. Distribute forms accordingly
*Please note for UW Madison departments, please forward those applications needing additional processing to Madison Benefit Services (OHR).

The information provided here is meant to be a quick snapshot of policy and process as they are related to the events listed to assist you in keying in applications. For more specific information, you may reference the Department of Employee Trust Fund's Health Insurance Administration Manual.


Additional Resources

Related KBs:

Related Links:

Get Help



Keywordsadd coverage new hire transfer from another state agency transfer state agency birth retire return from leave LOA re-enroll reenroll enroll adoption ETF SGH ETF health health health app application insurance state group health national medical support notice marriage DP domestic partner spouse to spouse change subscriber LOC loss of coverage paternity acknowledgement event date effective date Enrollment Code Enrollment Reason Plan Types Health 10 12 13 14 legal ward It's Your Choice IYC event dates event ADM OnDemand on demand ETF Interface BN, Benefits BN, Benefits   Doc ID16496
Ownererinn b.GroupUW–Shared Services
Created2011-01-08 19:00:00Updated2023-08-15 10:20:34
SitesUW–Shared Services
Feedback  0   0