Enrollment/Missed PIE/Exception Requests
In order to protect the integrity of the UC Group Insurance Regulations as well as ensure that employees take full advantage of our rich benefits here at UC, we are providing to you the following guidelines for the preferred enrollment methods and the process required should someone fail to enroll during their PIE. We think you’ll agree—it’s as easy as one, two, three!
ONE
Provide (issue/email) the PIE Calculation to the newly eligible employee. You can find the PIE Calculator on the DBR Menu. You can also issue the PIE Calculation if you happen to know the date of acquisition of the newly eligible family member (marriage, birth, adoption). We recommend that you keep a signed receipt/copy on file or a notation that PIE Calculation was emailed to the employee. This would help to absolve the department of any potential future liabilities (e.g., employee was not advised of PIE, subsequently received medical services, and there isn’t any UC-sponsored insurance in place to cover them’department could be deemed liable to cover the cost for those services).
The calculated PIE provides the employee:
- A detailed description of what the PIE actually is,
- The timeframe during which enrollment must be completed (online enrollment vs paper enrollment is explained) and,
- Alternative enrollment options if the PIE is missed (default plans, 90-delayed effective date for medical plan (only), Open Enrollment, etc.).
This simple step may very well avoid any exceptional circumstances down the road.
TWO
Always, always, always encourage the use of online enrollment whenever possible. It is a proven fact that online enrollment significantly reduces the potential for error because the employee is actually entering/confirming the data in real time. Online enrollment can also help to expedite eligibility with the insurance carrier’s.
The department’s OLPPS Preparer must (as early-on as possible):
- Enter the newly eligible appointment on to the local database
- Assign/re-assign the appropriate BELI/BELI Effective Date
- Provide the “Benefits of Belonging” packet to all newly-eligible employees as soon as possible
- Issue/email PIE Calculation to the employee.
- Notify Payroll if “coverage end dates” (OLPPS/IINS) are still populated due to prior separation.
- If prior “coverage end dates” have not yet come to pass (coverage is still active), paper enrollment may be necessary.
As soon as this is done the employee will be able to successfully go online At Your Service and log in to “My Accounts” or “New Employees” and enter their enrollments.
- Encourage them to enroll early--don’t wait until the last day of the PIE.
- Remind them to follow all prompts until their “confirmation number/acknowledgement” is obtained--this may be instrumental should it be needed for #3, below.
- Pssst--remember--the initial (first-time) password is the new employee’s date of birth (MMDDYYYY).
THREE
If PIE is missed (or Open Enrollment action not reflected properly), and the department feels that there is a valid reason which might warrant an exception to UC Group Insurance Regulations, we ask that you, the DBR, coordinate all requests for exception. We find it crucial that you be involved and we will refer employees back to their respective DBR to initiate the following process.
Address an email to Linda Yee, , which includes the following:
- Employee’s name/ID number
- What plans/family members the request pertains to
- Why the request is necessary/what happened
- Any details pertinent to the missed PIE which might influence determination/resolution of the request
Follow-up immediately by sending the correctly completed enrollment form:
- UCSF HR/Benefits Box 0918,
- Include any supporting documentation
- Attach a hardcopy of the original email message as its cover. This special handling assures that it reaches the party for whom it is intended.
Once all of the above have been received in this office and a determination has been made, you (the DBR) will be notified of the resolution.