- When should the Health Insurance Application/Change
Form (ET-2301) and its advance carrier copy be submitted, and
to whom?
When applying for coverage, the application should be submitted
to ETF and the advance carrier copy to the plan as soon as possible
to ensure timely processing and issuance of insurance and pharmacy
cards.
- When an employee moves within the the same county can
they change their health plan? Do they need to notify ETF and
the plan of the change in address?
When a move occurs within the same county, no change in health
plans can be made, but both ETF and the health plan need to
be notified of the new address. To notify ETF and the health
plan of a new address, complete the descriptive data portions
of the Health Insurance Application/Change Form (ET-2301) and
submit. Only moves out of the county provide an opportunity
to change plans. In those instances the employee would need
to complete the enrollment sections of the Health Insurance
Application/Change Form (ET-2301) and submit within 30 days
after relocation.
- What is the importance of the 'Date Application Received
by Employer' field on the Health Insurance Application/Change
Form (ET-2301)?
The date the application is received by the employer assists
ETF in determining whether the application was received timely
(i.e., within 30 days of their hire date or prior to becoming
eligible for the employer share of premium). This date is especially
important on Dual Choice applications since the application
must be processed during the Dual Choice period.
- What form needs to be filed when an employee's spouse
dies?
When there was family coverage and there are remaining dependents,
the descriptive data sections (i.e., 'Deleting a dependent')
of the Health Insurance Application/Change Form (ET-2301) needs
to be completed and submitted. If the deceased spouse was the
only dependent, the enrollment sections of the Health Insurance
Application/Change Form (ET-2301) must be completed to switch
from family to single coverage.
- What is the purpose/use of the 'Event Date' field on
the Health Insurance Application/Change Form (ET-2301)?
The event date is the date of an eligibility-qualifying event
(divorce, marriage, return from leave when coverage has lapsed,
change from family to single coverage and vice versa) that requires
submission of an application. The date is used by ETF to verify
that the employee is eligible to either apply for coverage or
make a coverage change and sets the effective date of coverage
or coverage change.
- What exactly is meant by the 'Date Employment Began'
field on the Health Insurance Application/Change Form (ET-2301)?
Does it mean the date employment began, the date the employee
qualified for WRS coverage with us or with another employer, or
the date the employer share of premium begins?
'Date Employment Began' refers to the date the employee qualified
for WRS coverage at your organization.
- What happened to the Health Insurance Information Change
form (ET-2329) and what form is used in its place? What form is
used to when switching from family to single coverage or vice
versa?
The ET-2329 has been incorporated into the Health Insurance
Application/Change Form (ET-2301), which is now used both when
maintaining current coverage but changing personal information
of the subscriber or their dependent(s) such as name, address,
physician, etc., as well as when changing from single to family
coverage, or family to single coverage. Changing descriptive
data requires that the employee complete the descriptive data
sections of the Health Insurance Application/Change Form (ET-2301)
whereas changing from single to family or from family to single
coverage requires that the employee complete the enrollment
sections of the ET-2301 and that the employer complete a Change
Report (ET-2614).
- Should the completed Health Insurance Application/Change
Form (ET-2301) be mailed to ETF or are facsimiles accepted?
ETF will accept mailed or faxed applications, so it is an
employer choice. However, please do not submit both a faxed
application and a mailed original unless ETF requests the original.
Also, keep in mind that faxes can be difficult to read at times.
- Can a Health Insurance Application/Change Form (ET-2301)
be signed prior to the actual event that will create an enrollment
opportunity?
Typically the event should occur at the time the application
is completed and submitted. Signing and submitting a Health
Insurance Application prior to the event could cause unnecessary
problems if the event doesn't actually take place, for example.
However, there are instances where the application can be completed
and submitted to the employer prior to the actual qualifying
event. For example, an employer may include the Health Insurance
Application/Change Form with other 'new employee' materials
and the employee asked to complete it in advance of the employer
share of contribution commencing.
- When a baby is born a Health Insurance Application/Change
Form (ET-2301) is submitted to add the child to the family coverage.
The ET-2301 asks for the child's SSN but if the baby doesn't have
an SSN yet, what do you do?
A newborn's SSN is not required to obtain health coverage
for the child so that field on the form can be left blank. Please
submit the SSN once it has been issued.
- When an employee with family coverage has a baby, or
otherwise adds a dependent, what form needs to be completed?
Complete the proper sections of a Health Insurance Application/Change
Form (ET-2301) to add a dependent to existing family coverage.
- Can an employer require new employees to submit their
Health Insurance Application/Change Form (ET-2301) earlier than
the required 30 days of their eligibility to expedite processing
or to ensure that their payroll deductions get set up for their
first payroll check?
Yes, an employer may institute a policy requesting that applications
be submitted earlier. However, you cannot deny an employee health
insurance coverage if they fail to meet your internal deadline
but do submit the application within the required 30 days of
hire or prior to becoming eligible for the employer share of
premium.
- When hiring a new employee we enclose their Health Insurance
Application/Change Form (ET-2301) in their new employee packets.
How long do they have to return the completed application to us?
The employee must return the completed Health Insurance Application/Change
Form to their employer within 30 days of their date of hire,
which is defined as the day they provide compensated services
for the employer, or prior to the date the employee becomes
eligible for the employer contribution toward the premium (which
can be no later than 6 months from hire date). Coverage will
then be effective the first of the following month. An exception
occurs for teachers. Teachers typically sign their initial contracts
ahead of their actual first day of work. If a teacher submits
their Health Insurance Application/Change Form on or before
the first of the month in which they provide compensable services,
their effective date of health coverage will be the first of
that month (i.e., prior to their first day of compensable services).
- How critical is the SSN on a Health Insurance Application/Change
Form (ET-2301). We have an employee who doesn't want to provide
the SSN.
It is a critical element for the subscriber but not the dependents.
