BN - Cancel Coverage Job Aid

Cancel Coverage Job Aid is a master list of all enrollment codes and reasons related to cancelling coverage for SGH and other benefits.

Procedure At-A-Glance
Category: State Group Health, Benefit Enrollments
Audience: Campus Benefit Administrators
Overarching Process: To Cancel Coverage for State Group Health
Navigation: Benefits > Manage Automated Enrollment > Events > On-Demand Event Maintenance
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General Description

This procedure will cover how to correctly use enrollment codes/reasons to cancel coverage, which drives the ETF Health Interface. Therefore, accuracy and consistency are important in maintaining this information.

Process Outputs

  • N/A

Process Considerations

  • HRS screens should be updated whenever a new Health Insurance Application ET-2301 form is submitted by employee.

Cancel Coverage - Health Data Entry Steps

1. Receive application from employee (within # of days defined by Event Table)
2. Review and Update Employee Information through HR - Maintain Employee Data - Biographical Details.
3. Review and Update Benefits Personal Data through BN - Benefits Personal Data.
4. Review Job Data/Benefit Program Participation to ensure event is consistent with system data. BN - Review Health Application in relation to Job Data/Benefit Program Participation
5. BN - Update Event Status / Review Existing Events
6. Add an ADM Event to add dependent to any and all applicable plans BN - Adding Events to the BAS Activity Table.
    a. Use ADM Event Date defined in Event Table
    b. For other plan type Event Dates please refer to Effective/Event Dates UWSA Life Event/Employment Changes charts
7. Process the ADM Event BN - Processing an ADM Event for Health Insurance.
8. Review cancellation on "Enroll in Benefits" for all applicable plan types:
    A.  BN - Review Health Benefits Enrollments
    B.  BN - Review Life and AD/D Benefits Enrollments
    C.  BN - Review Disability Benefit Enrollments
    D.  BN - Review Spending Account Enrollments
9. Distribute forms according to Benefit Application and Form Distribution Chart

Cancel Coverage Detailed Event Table

 Enrollment Code / Event
 Description Required Forms
 Receive Forms Within
 ADM Event Date
 Death of Subscriber
Employee has passed away

 No application needed. Please contact UWSC immediately to notify of death.
 N/A  Process Death Event in OnDemand

Single - end of calendar month for which death occurred. (System default)
Family – through the last day of the month for which the premiums was deducted. (Not optional. UWSC will manually correct coverage end date.)

Death of Employee Resources
 Retirement Employee retires from UW

 No application needed
  N/A  Process Retire Event in OnDemand
 Termination of Employment
Employee terminates employment with UW  No application needed
 N/A Process Term Event in OnDemand
Termination Reference

 Transfer to State Agency Reference
 Transfer to/from State Authority Reference
 Optional Plans Provided at Other State Agencies
Due to Leave of Absence
 Employee is on LOA and wishes to cancel coverage
 1. ETF Health Insurance Application 30 days of LOA
 First of the month following receipt of application
Leave of Absence Reference
Eligible for Other Coverage
 Employee is eligible for other coverage
 1. ETF Health Insurance Application.
 2. Copy of medical ID card or letter from health plan indicating effective date of other coverage.
 30 days of other eligible coverage
 First of the month following receipt of application
Post Tax Deductions
Employee is in a post-tax position and may cancel at anytime.

 1. ETF Health Insurance Application
 Anytime First of the month following receipt of application
Premium Increase
 Employee's FTE has decreased (at least by 5%) and therefore, insurance premiums have increased.
 1. ETF Health Insurance Application 30 days of premium increase
 First of the month following receipt of application
Less Than Half Time Employment
Employee is going to part-time employment.

 1. ETF Health Insurance Application 30 days of part-time employment
 First of the month following receipt of application
Lapse of Coverage
 For UWSC Use
 1. No application needed N/A First of the month following the end of the last coverage month for which premiums were paid
Benefits Billing Non-Payment
 For UWSC Use
 1. No application needed N/A First of the month following the end of the last coverage month for which premiums were paid
 Disability Approval - (Non-ICI)
Employee's disability is approved. Coverage is continued as an annuitant without lapse upon approval of a disability benefit.

 1. No application needed
 N/A First of the month following receipt of application.
 Due to Spouse-to-Spouse Transfer
 Cancellation is allowed due to status change under the plan language (contract) or HIPPA qualifying event if premiums are deducted pre-tax. 1. ETF Health Insurance Application 30 days of qualifying event
 First of the month following receipt of application, in coordination with the enrollment of coverage with the spouse.
 It's Your Choice
 Coverage end date is December 31.
 1. ETF Health Insurance Application Open Enrollment Period

*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

Related Policies, Job Aids and Forms

Related Policies

Related Job Aids
Related Forms

Keywords:cancel coverage, term, retire, retirement, termination, eligible for other coverage, post tax, death, LOA, ETF, SGH, ETF health, health, health app, application, insurance, spouse to spouse, event date, effective date, premium increase, less than half time, lapse of coverage, benefits billing, non-payment, disability approval, IYC, It's Your Choice, state group health, cancel, events, ETF Interface, enrollment code, enrollment reason, plan types, 10, 12, 13, 14,   Doc ID:16750
Owner:Samantha Q.Group:Human Resource System (HRS)
Created:2011-02-03 19:00 CDTUpdated:2016-08-08 13:47 CDT
Sites:Human Resource System (HRS)
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