Employee Changes
PW_M010477
Processing employee changes
Every request for change (including adding or deleting dependents) should include the employee’s social security number. If a new application is necessary, the Employer/Group section of the application form should always be completed. This section is intended to assist the employer in identifying requirements and the billing impact associated with frequently requested employee changes.
This section includes:
When an employee changes coverage
Submit a new application showing any changes requested. In most cases, changes will become effective on the first billing due date after we receive the request, subject to any required underwriting approval.
When an employee drops coverage
Check the Adjustment Box on the group billing statement, list the effective date, and use reason code “3” for Dropping Benefits.
When an employee leaves the group
Check the Adjustment Box on the group billing statement, list the last day worked as the effective date and use reason code “1” for Left Employment. Notify the employee of his/her conversion right.
Check the Adjustment Box on the group billing statement, list the date of death as the effective date, and use reason code “4” for Deceased. If the employee had covered dependents at the time of death, notify the dependents of their life insurance conversion right.
When an employee reaches the end of the continuation of coverage period
When an employee reaches the end of the continuation of coverage period, report the employee as terminated by checking the Adjustment Box on the group billing statement. List the effective date and the appropriate reason code for the termination.
When an employee’s insurance amount changes due to a change in salary or class
When an employee’s life insurance or short term disability insurance amount changes due to a change in salary, class or occupation, the change should be reported by checking the Adjustment Box on the group billing statement. List the effective date, the appropriate reason code, and the information that is changing.
When an employee wants to change a beneficiary
If an employee wishes to change their beneficiary designation, they should complete an Anthem Life Beneficiary Designation Form. Check to make certain that the form is signed and dated. The employer should keep that form or a copy of the form in the employee’s personnel file.
If the insurance program includes group term life insurance for dependents, an employee who is planning to marry should apply to add the spouse or any new dependent children to their coverage. The employee should complete and sign the application form within 31 days of the marriage date. If the application for dependent life coverage is received more than 31 days after the marriage date, the spouse and/or any dependents must submit evidence of insurability unless the dependent life coverage is non-contributory (employer pays the entire premium).
When an employee adds dependent coverage
If an employee wishes to add dependent coverage, the employee must submit an application form requesting that change, listing all eligible dependents.
Application for dependent coverage should be made within 31 days after the employee acquires eligible dependents by marriage or a child’s birth or adoption. Otherwise, coverage will be subject to evidence of insurability. For Agency Adoptions, the adoption date is the date of adoptive placement as specified in the placement agreement.
For Independent Adoptions, the adoption date is the later of the date the child is placed in the physical custody of the employee or the date the petition is filed for adoption with the probate court.
When an employee loses spouse/dependent(s) because of death
A death claim should be filed immediately. If the employee does not have any other eligible dependents at the time of the dependent’s death, the employee should cancel dependent coverage by submitting an application form requesting that change. The change will be reflected on the next billing date after we receive the request for cancellation.
When an employee loses spouse/dependent(s) because of divorce
If an employee has covered dependents, please notify Anthem Life immediately in the event of a divorce. Upon divorce, the former spouse is no longer eligible for coverage. If the employee does not have any other eligible dependents to be covered, the employee should cancel dependent coverage by submitting an application form requesting that change. The change will be reflected on the next billing date after we receive the request for cancellation.
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