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Dear Benefits Administrators,
This is our second message to provide some extra guidance about enrollment topics we typically receive questions about at the start of the new school year. Today’s message is regarding the date of eligibility and how it applies to when coverage becomes effective for subscribers.
When does coverage begin?
The date a school employee becomes eligible for the employer contribution toward SEBB benefits is not always the same as the date their coverage begins.
The Benefits 24/7 system uses the Date of Eligibility (which is input by the BA) to determine when coverage is effective. Benefits 24/7 does not ask for, and the BA does not enter, the date when coverage begins. For most months of the school year, coverage begins the first of the month following the date of eligibility. There is, however, an exception with the month of September (start of the school year).
Newly eligible school employees hired on or before the first day of school
If a newly eligible school employee’s first day of work is between September 1 and the first day of school, the employee’s date of eligibility is the first day worked and the coverage effective date is also the first day worked. In order for Benefits 24/7 to apply this rule, the BA needs to correctly indicate if the employee's first day of work is on or before the first day of school.
Newly eligible school employees hired after the first day of school
If a newly eligible school employee’s first day of work is after the first day of school the employee’s date of eligibility is the first day worked. Coverage effective date is the first day of the following month.
Important: "First day of work is on or before the first day of school” checkbox
When adding a newly eligible school employee in Benefits 24/7 during the month of September, you will see the “Subscriber's first day of work is on or before the first day of school” checkbox. Benefits 24/7 does not know what the first day of school is for your district, so the system must ask this question in order to correctly calculate when coverage should begin.
This checkbox should only be selected when the employee’s first day of work is between September 1 and the first day of school, resulting in the employee’s coverage effective date being the same as their date of eligibility.
Do not select this checkbox if the employee’s first day of work is after the first day of school. For example, if a September 25 date of eligibility is entered, and the checkbox is checked, then coverage will be effective September 25 (even if that is after the first day of school).
Selecting this checkbox incorrectly will result in the wrong coverage effective date being applied and require manual corrections.
Examples
Please review this list of examples for additional guidance associated with this topic.
Want to learn more?
For additional information about eligibility and other SEBB benefits topics, register for our August 7 Benefits Webinar. During the webinar, we’ll review key eligibility rules, recent updates, and answer common questions to help you confidently administer SEBB benefits.
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