Overview
Every Peace of Mind feature has an enrollment window for adding eligible Members.
If you add a Member after that enrollment window has closed, they're considered a late applicant. Late applicants may need to complete additional steps before coverage can begin, which can delay the enrollment process.
The good news? Most late applications can be avoided by adding Members to your Plan as soon as they qualify.
The details
What makes someone a late applicant?
A Member becomes a late applicant when they're enrolled after the enrollment window for the Peace of Mind feature has closed.
This can happen for a few different reasons, including:
- The Member wasn't added when they first became eligible
- The Member previously declined coverage and now wants to enroll
- A change in employment status affects the Member's eligibility
What happens next?
Members who are added during their enrollment window can typically begin coverage without additional medical review.
Members added after the enrollment window has closed may require medical underwriting before coverage can begin.
If the window has closed, a Member will likely need to complete a form with their medical information and their application will be reviewed by our Partner’s medical underwriting team before coverage can begin.
Our Partner will review the application and determine whether coverage is:
- Approved
- Approved with conditions, such as a different coverage amount or exclusions
- Declined
If underwriting is required, coverage won’t begin until the forms have been reviewed, approved, and an effective date has been confirmed.
The dates that matter
There are four key dates or time frames to understand when enrolling a Member in a Peace of Mind feature.
- Hire date: The Member’s first day of work.
- Waiting period: Some Peace of Mind features require that a Member complete a waiting period before they’re eligible for the benefit. The waiting period may be determined by our Partner, and/or Plan design.
- Eligibility date: This is the date the Member first becomes eligible to enroll in the feature. This can be the hire date, or the date the waiting period is completed.
- Enrollment window: This is the period of time you have to enroll a Member in the feature before they’re considered a late applicant. The period is calculated from the Eligibility date.
- Effective date: This is the date the Member’s coverage begins. If a Member is a late applicant and underwriting is required, the effective date won't be determined until the application has been reviewed and approved.
Anything else?
The easiest way to avoid late applicant situations is to add Members to the Plan as soon as they’re eligible for their Peace of Mind features.
If you’re unsure whether someone is still in their enrollment window, or have questions about their eligibility, reach out to our Customer Experience team. They’ll be happy to confirm any details and help avoid delays.