A member’s coverage is normally terminated on the last day of employment. It is important to terminate members on their last day worked, claims paid after a member’s termination will directly affect your plan’s claims experience and could affect renewal rates.
Tip!
- Please report any terminations to GroupSource (via WEBS™, email, fax, or mail) as soon as possible to prevent claims paid in error.
- If the termination of benefits is due to an approved Leave of Absence (ex. Maternity Leave), please enter a note in WEBS™ or send an email to your Billing Administrator. Benefits may be reinstated without Evidence of Insurability beyond 6 months in some cases.
- On WEBS™, change the employee’s status from Active to Terminated and enter the effective date. GroupSource will process the information within 24 hours.
- Advise the member (and spouse) of their right to apply to convert their Life Insurance coverage to an individual policy when coverage reduces or terminates. The member has 31 days to convert, so it is important you give the member the information in a timely manner. See “Purchasing Individual Life Insurance (Conversion)” or contact your Client Service Coordinator.
- If the member has Optional Critical Illness with Temple, inform the member that they need to port their benefits to an individual plan within 60 days of the termination date.
- Remind terminated members that they have 90 days from their termination date to submit any eligible claims incurred prior to their termination date, or as defined in your booklet.
- Retain the member’s original signed enrollment card for 6 months in the event that the member returns to work within 6 months, see “Reinstating a Member”.
Some members request coverage to the end of the month after the last day worked, or for a specific amount of time. Contact your Client Service Coordinator or Billing Administrator to request an extension of benefits before terminating benefits, see “Request for Extension of Benefits Beyond Termination”.