BN - Benefits Billing Delinquency Report

GENERAL DESCRIPTION:

Benefits billing functionality provides the ability to charge employees directly for insurance benefits as opposed to having them pay through payroll deduction. Once an employee is enrolled in benefits billing, they are invoiced on a monthly basis. If an employee does not remit payment by the due date, they will be listed on the Delinquent Accounts Report. The UWSC Benefits Team prepares and distributes the monthly Delinquency Report around the 15th of each month to the institutions. This procedure covers how to work the benefit billing delinquency report and what action is required by the institution due to non-payment or the employee's decision to let coverage end.

PROCESS CONSIDERATIONS:

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


RESPONSIBILITIES OF THE INSTITUTION

1. The institution must review the monthly Delinquency Report, make their comments in Column B “Campus Action Plan” and then return the report to the UW Service Center within 5 working days. Please follow the instructions in the email.  Common Action Plans institution can respond with include:
a. Paid in Full (Employee)
b. Cancel/Lapse (if not paid)
c. Payment Plan (please explain what the payment schedule is)
d. Take by Payline
e. See WiscIt (add WiscIt #)
BB Situations
2. When reviewing the employee, look to see if a payment has been made or if there's been any insurance or job data changes by review the following HRS screens:
a. Review Employee Balances (Main Menu > Benefits > Benefits Billing > Manage Acct Status and Balance > enter Empl_ID, click Search)
b. Enroll In Billing (Main Menu > Benefits > Benefits Billing > Manage Acct Status and Balance > enter Empl_ID, click Search)
c. Job Data (Main Menu > Workforce Administration > Job Information > enter Empl_ID, click Search)
d. Insurance Enrollment screens/Base Benefit Pages (Main Menu > Benefits > Enroll In Benefits > enter Empl_ID, click Search)
3. The centralized Delinquency Notice is mailed from the UWSC on the 15th of each month. These are available in Cypress for 6 months. The campus may follow-up with the employee if they wish, but it is not required.

4. Around the first of the month following, institutions will receive the finalized Delinquency Report, indicating what action has been taken with their employees. 

5. If the employee reaches out to the institution that they cannot afford to pay the charges and an employer error occurred, which caused a significant amount of past premiums to be owing, the institution may establish a payment plan with the employee.  If there is a payment plan and the employee is set up in Benefits Billing, please forward a copy of the plan to the UWSC Benefits Team so we can monitor the payments.

6. If an employee had their insurance terminated for non-payment of premium, then as of September 1, 2019 the UWSC will prepare and mail the final written communication to the employee. A copy will be provided to the institution and attached to the Delinquency Report ticket. This is considered a voluntary loss of coverage so COBRA provisions do not apply.

General Information that will be provided to the employee:

a. If the insurance is lapsed for non-payment while on Leave of Absence (LOA):
A Termination of Insurance letter (sent out by UWSC) will inform the employee of the effective date that their insurance(s) have been lapsed. If they are within their grace period, the letter will indicate the date the check must be received by the UW Service Center to restore their coverage. Otherwise, the employee has 30 days from returning to work from their LOA to submit applications to their institution to to restore their coverage(s). *
b. If the insurance is cancelled for non-payment of premium by active employee:
A Termination of Insurance letter will inform the employee the effective date that their insurance(s) have been cancelled regardless of whether they are within their 30-day grace period or not.  If they are within their grace period, the letter will indicate the date the check must be received by the UW Service Center to restore their coverage(s). *
c. If the insurance is cancelled for non-payment of premium by a terminated employee:
A Termination of Insurance letter will inform the employee the effective date that their insurance(s) have been cancelled.  Typically in this situation, the grace period has expired. The employee will have no COBRA/Continuation rights since this is considered a voluntary cancellation, even though they had received a COBRA Notice earlier. *
d. If the insurance is cancelled for non-payment of premium by a retiring employee:
If the employee has retired and has outstanding charges, the institution needs to let the employee know the consequences of not paying those charges. If their health insurance is cancelled, they will no longer be eligible for a certification of their Sick Leave Credit, since the employee must be covered under an ACTIVE State Group Health plan at time of retirement.   Any other insurances we cancel, they will not be eligible for continuation, even if they did receive a Continuation form. (This includes the State Group Life insurance plan.)
6. See Related Links section below for sample Delinquency Notice and Termination of Insurance Letter.


*Benefits Billing: Coverage Lapse for Non-Payment, Payment Grace Periods and Reinstatement of Coverage Provisions for Active Employees:

If payment is not received by the last business day of the month prior to the coverage month, the insurance will be terminated for non-payment. We may only reinstate coverages if the employee makes FULL payment within 30 days from last paid through date (the life insurances have 31 days and AD&D 60 days). The insurance will remain cancelled/lapsed until there is either an Annual Benefit Enrollment (ABE) opportunity, or if the employee has a Qualifying Event that would allow them the opportunity to re-enroll.

Examples:
  1. Current date is March 30, 2018.  The employee’s last paid through Coverage Month is 1/1/2018 - 1/31/2018 (1712 billing period). The grace periods have already expired, so they have no reinstatement rights.

  2. Current date is March 15, 2018.  The employee’s last paid through coverage month is 2/28/2018 (1801 billing period). They are still within the 30 days, so they have reinstatement rights if we receive their payment by March 30, 2018.


RESPONSIBILITIES OF THE UW SERVICE CENTER

  • Prepare the Benefits Billing Delinquency Report for all Institutions around the 15th of each month 

    • The report will be split and emailed to each institution
    • UWSC will add our suggested action in Column C “UWSC Comments”
  • The automated Delinquency Notices will be created, printed, and mailed on the 15th of each month from the UWSC to employees with delinquent accounts. A copy of the notice will be placed in Cypress for 6 months.
     
  •  As institution’s Action Plans are received, we will add them to the central (system-wide) Delinquency Report
  • Around the 15th of the month Delinquency Notices will be created and stored in Cypress. The UWSC will print these notices and mail to the employees. 

  • Towards the end of the month, we will review the central Delinquency Report and determine what action is required and add our comments in Column A under “Action Taken By UWSC” and email the FINALIZED Delinquency Report to each institution.
  • For employees marked Cancel/Lapse, we will terminate the employee's insurances in HRS, communicate the cancellation to the vendors, inactivate the Benefits Billing enrollment, and adjust any open charges to $0.00. 
    • Note:  terminated employees require the use of Correct History to cancel their insurances
  • If required, we will process refunds to employees, or add Payline Adjustments to collect missing premiums via payroll deduction.

  • At the end of the month, if payment has not been received, we will prepare and mail the Termination of Insurance letter to the employee and provide a copy to the institution.

  • The UWSC will prepare and mail the final letter to the employee letting them know their insurance has been cancelled/lapsed due to non-payment.
  • If an employee with terminated insurance sends payment within the grace period, we will reinstate their insurances, communicate the reinstatement to the vendors, re-activate the Benefits Billing enrollment, adjust Benefits Billing charges, allocate the payment, and notify the institution.
    • If payment is not received timely, the insurance CANNOT be reinstated.  We will return the check to the employee and send an email to the Institution informing them of the final decision.

ADDITIONAL RESOURCES

Related KBs:
Related Links: