Managing Eligibility Override

Learn how to perform this action in the HRMS.

Steps

  1. Sign onto HRMS using your single sign-on ID and password.
  2. Click on ‘Benefits Administration’ tab.
  3. Click on ‘Enrollment’.
  4. Enter ‘Name/Person Number

Note: Complete at least one field with double asterisk (**).

  1. Enter ‘Effective As-of Date’.

Note: This should be the same as the date on which the life event occurred for an employee.

  1. Click on ‘Search’.
  2. Under Search Results, click on ‘Name’ hyperlink of the employee.
  3. Benefits Service Centre will display.

Note: You will see Participant Benefits Summary, Life Events Summary divided into Life Events and Potential Life Events.  

  1. Click on ‘Task’ pane.
  2. Select ‘Person Life Events’ from the Benefits Enrollments list.

Note: Detected and occurred dates should be the same.

  1. Click on ‘Potential Life Events’ tab.

Note: Will default to Life Events tab. 

  1. Change Occurred, Notified and Unprocessed dates under the New Hire Life Event  to the next day.
  2. Add the ‘Enrollment Override’ Life Event by clicking the “+” sign on the Potential Life Events tab.

 Note: The ‘Occurred, Notified and Unprocessed Date’ of the Enrollment Override life event must be the day of the original new hire life event date.

  1. Process the Life Event by clicking on ‘Tasks,’ and then ‘Process Life Event’ under the Benefits Enrollment task.
  2. Click on ‘Evaluate Life Events’.

 Note: Only process the Enrolment Override life event

  1. Close out of all the remaining tabs by clicking the ‘x’ and then click ‘Refresh’ when back at the Benefit Service Centre.
  2. Click on ‘Tasks’ on right side, under the Benefits Override task, and click on ‘Eligibility Override.’

Note: This task will be used to override plan eligibility.  

  1. Under the Plan and Option section, go to the Plans in Program section.
  2. Select and expand the benefits program in which plan eligibility needs to be updated or changed.
  3. Check or uncheck the box the in the ‘Eligible’ column to reflect the required changes to benefit eligibility based on ‘Covered’ or ‘Waived’ option.
  4. Enter ‘Through Date’ future-dated for 6 months from date of hire.
  5. Select a reason for the plan eligibility override from the ‘Reason’ drop-down.

 Note: Reasons will be used to understand why the eligibility override was completed. 

  1. Click ‘Save.’
  2. Close out of all the remaining tabs by clicking the ‘x’ and then click ‘Refresh’ when back at the Benefit Service Centre.
  3. Click on ‘Tasks’ on right side, under the Benefits Enrollment task, and click on ‘Enrollments.’
  4. Click on Task pane and click on ‘Manage Action Items’. 
  5. Go to Certification Date field and update with the same date as the Enrollment Life Event date
  6. Select ‘Person Life Events’ from the Benefits Enrollments list.

Note: Detected and occurred dates should be the same.

  1. Under Life Events, highlight the life event that needs to be closed by clicking on it.
  2. Click on ‘Action’ and use the drop-down menu and choose ‘Close’ in order to close Enrolment Override Life Event. The ‘Occurred Date’ should be the same date that the ‘Enrollment Override’ Life Event was added.
  3. Click ‘Save’.
  4. Process the New Hire Life Event by clicking on ‘Tasks,’ and then ‘Process Life Event’ under the Benefits Enrollment task.
  5. Click on ‘Evaluate Life Events’.

 Note: Only process the New Hire Life Event.

  1. Click on ‘Tasks’ on right side, under the Benefits Enrollment task, and click on ‘Enrollments’.
  2. Enroll employee into their benefits as per their new benefit eligibility criteria.
  3. Click ‘Save.’

 Note: Enrollments will be saved.

  1. Click on ‘Manage Enrollment Activities’ on the Enrollments tab.
  2. Click ‘Yes’ in order to continue.
  3. Under ‘Enrollment Activities,’ ensure that all designated dependents have been selected and all Certifications and Action Items have been completed.
  4. Click ‘Save’.