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. 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:
  • Benefits billing statements are mailed on a monthly basis around the 20th.

  • Payments are due by the 10th of the month prior to the coverage month. (If late invoicing, the 10th of the month following the first invoice.) 
  • If payment not received by the 14th of the month, it is considered delinquent.
  • An active employee’s insurance will be cancelled for non-payment of premium if premiums are not paid timely.  If the insurance is cancelled, the employee may only have their insurance reinstated if they make payment in full within 30 days from the last paid through date.


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. Reach out to your employees in writing to let them know that payment has not been received and their insurance will be terminated if payment not received by the end of the month. An initial phone call is acceptable, as long as you follow-up in writing/email.

4. Around the first of the month following, institutions will receive the finalized Delinquency Report. Institutions will want to review immediately to see if there is any action they must take. 

5. If an employee had their insurance terminated for non-payment of premium, the Institution must make the final written communication to the employee. This is considered a voluntary loss of coverage so COBRA provisions do not apply.

a. If the insurance is lapsed for non-payment while on Leave of Absence (LOA):
Inform the employee the effective date that their insurance(s) have been cancelled regardless of whether they are still within their 30 day grace period. If they are within their grace period, indicate the date the check must be received by the UW Service Center to restore their coverage. That they will have 30 days from returning from their LOA to restore their coverage(s). *
i. ICI claims and premium waiver
If the employee is on a Medical Leave waiting for the claim to be approved, the institution needs to let the employee know that they are required to continue paying the premium until the decision is made.  If the insurance is terminated for non-payment of premium prior to the claim being approved, the employee may not be eligible for benefits.
ii. Life Insurance premium waivers

If the employee is on a leave waiting for the request for premium waiver to be approved, the Institution needs to let the employee know that they are required to continue paying the premium until the decision is made. 
b. If the insurance is cancelled for non-payment of premium by active employee:
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, 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:
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 we cancel the health insurance, 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 able to continue into retirement. (This includes the State Group Life insurance plan.)
6. Samples letters are available on the Benefits Billing landing page on the UWSC website.  See Additional Resources below.


*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 BENEFITS TEAM:
  • 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”
  • As institution’s Action Plans are received, we will add them to the central (system-wide) Delinquency Report
  • 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
  • If an employee with terminated insurance sends payment within 30 days from last 'paid through date', 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 to let them know what actions have been taken.
    • 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:



Keywords:late bill, drop coverage, delinquent account, benefits billing, lapse in coverage, delinquency report, SGH, Plan Type 10, 10, ICI, SGL, Dental WI, VSP, UIA,   Doc ID:82438
Owner:Samantha Q.Group:Human Resource System (HRS)
Created:2018-05-24 11:26 CDTUpdated:2018-06-01 08:40 CDT
Sites:Human Resource System (HRS)
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