Changes made after Confirmation sent?

[Guest sidalee1]

I recently discovered that after an "enrollment window" closes either because the employee makes an election or defaults, a confirmation is sent to the employee telling them to look it over, etc. and stating that they have 15 business days to contact us regarding any errors. If the employee then calls us and says s/he wants to add a dependent, that dependent is enrolled retro to opening of the "enrollment window." Is this okay? I don't see that this is a "mistake" as much as it is an oversight, etc. on the part of the employee and therefore wouldn't open anything back up? There doesn't appear to be any exception in the 125 rules which would permit this, but I don't know whether I am missing something.

Thanks,

[J Simmons]

I think you would need clear evidence that the employee attempted to enroll the dependent in question during the enrollment window and reasonably thought all steps to enroll the employee were in fact taken. If it is an online enrollment process (which I suspect given the confirmations), then I think you'd want to see what traces, if any, there are in the online system that might show or point to the attempt by the employee to have enrolled the dependent. You could compare this against answers the employee gives in an interview about what steps were taken by the employee.

[GBurns]

An "enrollment window" exists as a convenience to an employer and is not law.

What matters is plan year start date.

Since most changes have to be made prospectively, an employee should be able to make any change before that date.

[J Simmons]

Is the enrollment window specified in the plan documents?

If so, there's a fiduciary duty to follow the written documents.

[Guest sidalee1]

By "enrollment window," I mean annual enrollment which varies each year, but typically runs from early November to early December, initial enrollment, which lasts for 31 days after hire date, and change in status events, again 31 days and yes these are all explained in the document. So, it appears as if my fears are correct - they shouldn't be allowing people to add dependents in the 15 day "confirmation" period?

[GBurns]

Isn't the purpose of the "confirmation" period to allow the employee to confirm choices AND to make any changes that they deem necessary ?

What does the SPD say about this "confirmation" period etc ?

[Guest sidalee1]

There is nothing in the SPD about the confirmation period - this has evolved as part of the administrative practice.

[J Simmons]

Most IT systems give an 'instant' confirmation to the employee so that the employee can verify and make changes during the open enrollment period. When I was in-house, the post-enrollment period confirmation was a few weeks before the new plan year begins, one last look. Not to allow employees to change their minds, but to provoke those whose confirmations did not jive with what they actually attempted to elect during open enrollment to come into the Benefits Office and have a Benefits Rep begin investigating the situation to see if there was situation as described in post #2 in this thread that could be sorted out before the elections went live on the first day of the new plan year.

[GBurns]

But most employees are not enrolled using such IT systems. In fact, it seems a large number are still enrolled manually.

I do not know what actual enrollment experience your opinions are based on, but I passed a 100 employers long long ago. With recurring annual enrollments as a multiplier I would say that I have years of extensice experience with many different benefits plans. This year is a low year, I am only at 6 so far. 2007 was around 20.

I cannot recall any plan that would not allow changes during the "confirmation" window. After all it is only for the convenience of the employer's admin function and not allowing changes could be seen as restricting an employee's right without pressure of law.