Eligibility Management

em-tilesThe Web Benefits Design employee eligibility management system for enrollment/benefits administration can accommodate complex logic regarding eligibility, waiting periods, and benefit start dates that may differ by product and EOI rules for voluntary life, voluntary STD, voluntary LTD, and critical illness/cancer. Clients specify their unique employee eligibility rules.

Our online enrollment system is highly effective for open enrollment and/or year-round eligibility transactions and qualifying events (new hires, life status changes, terminations, etc.). Our cutting edge online enrollment system also offers the following features:

  • Different EOI rules based on different employee groups
  • Increments of a certain dollar amount (usually $5K or $10K)
  • Multiples of salary
  • Different rates based on age, gender, and tobacco usage
  • Minimums and maximums
  • Age reductions
  • Logic based on employee vs. spouse vs. child EOI requirements

When employees enroll online, they will see their allowed amount with a per paycheck cost specific to them and their selections. In addition, the system will tell the client when an EOI is necessary based on the logic programmed into the system. If an EOI is necessary, the system will show the amount elected, amount approved, and amount pending, along with the associated costs for each option.

Reports are readily available through the online enrollment system for any employees with a pending amount. For a small additional fee, your WBD team can assume the role of “monitoring” all EOI/pending requests. Reports can be generated on a weekly basis and will be sent to the employees still pending approval. Once approval is confirmed or denied, the system user (WBD or the client), can easily access the employee’s record and approve/decline the pended request.

The online system will be able to show system history as to when the request was originally submitted, when EOI notifications were sent, and when the request was ultimately approved or declined.

As part of the extended service, WBD can send out notifications after open enrollment reminding all employees with pending amounts that an EOI must be submitted and approved—or their request will be closed-out for the remainder of the year. To increase employee communication and use of the system, this service is highly recommended.
At any time, only the amount approved will be transmitted within a Carrier or payroll feed.
In the event that employee dependent verification is also required, the system can be configured to pend changes made during that session within our platform.