Employee Status and Plan Changes
From WEA Trust Insurance Coordinators Handbook
Next section: Adoption/Legal Wards
From time to time, employees will experience one of the changes listed on the next page and will want to modify their coverage under the various plans your district offers. It is important that you report all such changes to us as soon as you know about them. Don’t ask or rely on the employee to report the change.
How do I report changes?
Some changes require that an employee complete an Enrollment Form. Other changes require that you complete a Transmittal Report. We’ve created a chart that identifies what forms, if any, need to be completed for each change.
When an Enrollment Form is necessary, please have the employee complete the form. Check to see that the employee has completed the Enrollment Form accurately, entered the date the event occurred, and signed and dated the form.
If only a Transmittal Report is required, please be sure to include all pertinent information (such as subscriber name and number and effective date of change).
Send the Enrollment Form and/or the Transmittal Report to the Trust as soon as they’re completed. Please keep in mind if you are reporting terminations, we need to receive the information within 30 days.
If the change requires underwriting (evidence of insurability), submit the Enrollment Form and completed Evidence of Insurability form at the same time. (Please refer to Late Enrollment for information on changes that require evidence of insurability.) Remember to notify applicants that coverage will not be in effect until we have notified them that they are eligible for coverage. Please don’t make payments or apply credits for changes until they appear on the invoice. It may take a month for them to appear on the invoice.
At the beginning of each new school year, we receive a vast amount of information from school districts. Due to the increase in paperwork during this time period, it takes longer to process additions, deletions, and changes. To help alleviate a delay in processing, please forward information to our office as soon as you are aware of it. This advance notice will help us to provide you with the best service possible.
Please refer to the procedures outlined on the following pages when your employees experience any of the changes listed in the table below. If an employee has a change that is not listed and you need assistance, please call us.
|
Type of change
|
Enrollment |
Transmittal |
Other Documents/Comments
|
| Address changes |
No
|
No
|
May call us with information. |
| Adoption |
Yes
|
No
|
Date placed for adoption. |
| Alternate Benefit Program |
Yes
|
No
|
N/A
|
| Beneficiary Changes—Life |
Yes
|
No
|
Will accept a letter with information. |
| Benefit Level—Additional Purchase Life Plan |
Yes
|
No
|
Life Evidence of Insurability form. |
| Benefit Level—STD |
Yes
|
No
|
STD Evidence of Insurability form for higher benefit. |
| Death |
No
|
Yes
|
May call us with information. |
| Dependent Child Changes |
No
|
No
|
You or the subscriber may call us with this information. |
| Disability |
No
|
Yes
|
You or the subscriber may call us to request the initial disability forms for claims. |
| Divorce |
No*
|
No
|
You or the subscriber may call us with this information. |
| Domestic Partner** |
Yes
|
No
|
Domestic Partner Designee form must be completed in its entirety. |
| Layoff |
No
|
Yes
|
N/A |
| Leave of Absence |
No
|
Yes
|
N/A |
| Legal Ward |
Yes
|
No
|
Copies of legal court documents. |
| Loss of Coverage |
Yes
|
No
|
A Loss of Health Coverage and/or Dental Proof of Loss form must be completed by the employer sponsoring the prior coverage or the prior insurance carrier. |
| Marriage |
Yes
|
No
|
N/A |
| Medicare Eligibility |
No
|
Yes
|
Please send uas a copy of the Medicare card. |
| Name Change |
Yes
|
No
|
N/A |
| Occupation Change |
Yes
|
Yes
|
An Enrollment Form is necessary if the change in occupation creates eligibility for plans. |
| Reduction or Increase In Hours Worked |
No
|
Yes
|
Include new hours and effective date on Transmittal Report. |
| Resignation, Nonrenewal, or Discharged Employees |
No
|
Yes
|
N/A |
| Retirement |
No
|
Yes
|
If the employee was not covered by the WEA Trust prior to retirement, an Enrollment Form is required within 30 days of retirement. |
| Salary Level Changes |
No
|
Yes
|
N/A |
| Transfer of Coverage |
Yes
|
Yes
|
N/A |
| Waiver of Premium/Changes |
No
|
Yes
|
N/A |
* Unless there is a name change, then an Enrollment Form should be completed.
** Applies only to groups with the Domestic Partner Optional Beneift Provision.
