Costpoint Essentials Online Help

Enrollment Rules Tab

Use the Enrollment/Coverage Rules tab to define additional rules for this benefit plan.

Enrollment Timing

Use this group box to define the open enrollment period and which events allow for different times of enrollment. This group box is for information only.

Field Description
Any time

Select this checkbox if there is no time restriction on enrollment for this benefit plan. If you select this checkbox, the remaining checkboxes and fields in this group box are disabled.

On hire

Select this checkbox if an employee should be enrolled in this plan upon being hired. Your entry in the Grace Period Days field defines the grace period for enrolling after the hire date.

On qualifying life event

Select this checkbox if the enrollment can be changed because of a qualifying life event.

Open Enrollment Period

Select this checkbox to if you want to define a period during which employees may enroll for this benefit. If you selected this checkbox, both the Open Enroll Date and Grace Period Days fields are active and required.

Note: You must select either the Any Time checkbox or one of the On Hire, On Qualifying Life Event, and/or Open Enrollment Period checkboxes.
Open Enroll Date

Enter the date, in MM/DD format, on which open enrollment in this benefit plan begins. This field is required only if you selected the Open Enrollment Period checkbox.

Grace Period Days

If you selected the Open Enrollment Period checkbox, you must enter the number of days an employee has beyond the open enrollment date to enroll in this benefit plan. If you selected the On Hire checkbox, you must enter the number of days an employee has to enroll.

Enrollment Requirements

Field Description
Evidence of insurability (EOI) required

Select this checkbox if Evidence of Insurability is needed for the benefit plan.

If you select this checkbox, use the EOI Rules tab to specify the following:

  • Conditions which will require the employee or his/her spouse to provide Evidence of Insurability
  • Steps that should occur if the employee or spouse is denied coverage or is pending coverage

If you select this checkbox for a benefit plan, you will not be able to assign the plan to an employee in the Manage Employee Benefit Elections table. Instead, you will have to enter a record into the Manage Employee Evidence of Insurability (EOI) screen which determines if the employee’s calculated coverage amount requires evidence of insurability (EOI) and, if so, you will be able to approve or deny the coverage amount.

Note: If this checkbox is selected but the coverage option is NO CVG (no coverage), it should be assigned to the employee on the Manage Employee Benefit Elections screen. NO CVG coverage option cannot be assigned in Manage Employee Evidence of Insurability (EOI) screen.

In cases of denial or pending coverage, the Substitution Rules you specify on the EOI Rules tab of the Manage Benefit Plans screen will be used to determine the coverage amount, if any, for which the employee is eligible.

This checkbox is only available if the System Benefit Type is one of the following:

  • Life Insurance
  • AD&D Insurance
  • Long Term Disability
  • Short Term Disability
  • Supplemental Life Insurance
  • Supplemental AD&D Insurance
  • Spouse Life Insurance
  • Spouse AD&D Insurance
Beneficiaries required

Select this checkbox if you selected Beneficiaries Required on the Manage System Benefit Types for this system benefit type and you require beneficiaries to be assigned to the plan. This checkbox is for information only.

Require primary care physician name and ID

If you select this checkbox, employees will be required to specify the Primary Care Physician (PCP) name and number when the benefit plan is elected in Employee Self Service or when the benefit plan is assigned to the employee in Costpoint.

New Hire and Rehire Coverage Start Dates

Field Description
Rehires eligible on rehire date

Select this checkbox if a rehired employee's benefit start date should be his rehire date. If you do not select this checkbox, a rehired employee’s benefit start date will be based on your selections in the Eligibility Rules group box.

Waiting Period Months

Enter the number of months new employees must wait to become eligible for this plan. This setting impacts the following screens:

  • Manage Employee Benefit Elections: When assigning this benefit plan to a new employee, the coverage start date cannot fall within the waiting period. If the First of month after waiting period checkbox is selected, the coverage start date must be on or after the first day of the month following the waiting period. For example, if an employee is hired on 11/15/2024, with a 3-month waiting period, and the First of month after waiting period checkbox is not selected, coverage can begin on 02/15/2025. If the checkbox is selected, coverage can start on 03/01/2025.
  • ESS Life Events/New Hires: If an employee selects the benefit plan during the life event benefit election process in Costpoint ESS, the coverage start date will be three months after the hire date. If the First of month after waiting period checkbox is selected, the start date will be the first day of the month following the waiting period. For instance, if an employee is hired on 11/15/2024, with a 3-month waiting period, and the First of month after waiting period checkbox is not selected, coverage starts on 02/15/2025. If the checkbox is selected, coverage starts on 03/01/2025.

If the employee is a rehire and the Rehires eligible on rehire date checkbox is selected, this setting is ignored, and the coverage start date will be the rehire date.

First of month after waiting period

Select this checkbox if this benefit is not available until the first of the month after the end of the waiting period. If you do not select this checkbox, this benefit is available immediately upon completion of the waiting period.

This checkbox is only available if the Waiting Period Months field is populated.