Create Benefit Package: Step 2 - Plan Configuration: Step 2.5 - EOI

Evidence of Insurability (EOI), is an application process in which you provide information on the condition of your health or your dependent's health to get certain types of insurance coverage.

Many times, benefits that require EOI, have a Guarantee Issue Amount. The Guarantee Issue Amount is the amount of insurance that will be issued to an insured person without evidence of insurability.

Benefits that have Guarantee Issue amounts and/or require Evidence of Insurability, such as Voluntary Life, can be configured on the EOI Rules tab for each Plan.

The configuration within this tab is dealing with change events and the ability for employees to view and elect amounts over guaranteed issue where evidence of insurability is needed. Configuration is done by a series of questions.

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Format for Guaranteed Issue

As you progress through the setup of your EOI Rules, you will be prompted with options for the format of the Guaranteed Issue.

Coverage/Benefit amount

Used when guaranteed issue is set at a specific coverage amount. 50000 may be entered into all three boxes depending on the event that the benefit plan will be offered.

Coverage Level - Level Rank Field

Administrators may select what coverage level rank (usually 1-50) that the employee will receive Guaranteed Issue at. The level selected and typed in will be the last level that EOI is not needed.

Multiple of Compensation

Chosen when employees get guaranteed issue at 1.5 times compensation and any coverage over that requires EOI. 1.5 would be typed in these boxes. Employees can still elect a higher amount they are just unable to receive election until EOI form is completed, submitted to carrier and approved.

If Compensation rounding was used in the "Premium/Benefit Amt Rules" tab of benefit level, then administrators will need to pay attention to rounding rule and rounding value.

Administrators can always require EOI is coverage was previously waived. (Not recommended for new hire events since default coverage should be waive.) Usually checked for Open enrollment and all other events.

Allowing level rank increase will give employees the option to move up 1 or 2 levels from current election within event and still not require EOI. Any other increase would require EOI gain in the event this has been selected for.

Glossary

Level rank is a field that is configured as part of the Benefit Option Name (coverage level) Typically the Level Rank will be he same as the Display Order for the Benefit Option Name. The exception to this is for Waive coverage, where Waive is recommended to have a Level Rank of 0, regardless of the Display Order assigned.

Troubleshooting/FAQ

  1. How does Level Rank effect EOI? Level Rank is what the system uses to determine if the elected coverage level requires EOI. The system compares the Level Rank for the current coverage to the Level Rank of the elected coverage.
  2. My Waive Coverage does not have a Level Rank of 0, will that be a problem? It is recommended that for benefits that have Guarantee Issue/EOI that the Waive option have a Level Rank of 0. This is so that the Waive option will never be seen as an increase in coverage. For example of there are 50 coverage options, plus Waive and Waive has a Level Rank of 51 instead of 0, an employee moving to the Waive option from a coverage option with a Level Rank of 25, could be seen as an increase and therefore have an EOI action incorrectly associated with it.
  3. Why does the Waive option require EOI? See question #2 above.

 

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