Benefits processors are responsible for managing all Evidence of Insurability (E of I) or evidence of good health decisions that cannot be automatically processed by iBenefits. To work with E of I decisions, select E of I Decisions from the iBenefits Processor menu or through the Participants menu:
The E of I decisions screen is searchable, as shown in the example below:
As a benefits processor you should resolve E of I-related issued on a regular basis. This means looking for E of I decisions whose decision status is in the “All Errors”. To find a subset of E of I decisions, select one of the other options in the Decision Status dropdown:
To review an individual decision, click the “Details” button to see the decision details screen.
iBenefits will automatically process approvals and denials when the document (either AE or NE) the E of I application is associated with is still active. You will see the decision reflected on the Edit Life page of the document.
- Approvals: When Minnesota Life approves an application, they are approving the coverage multiplier requested. So, the “Coverage Amount” listed in the Detail, is actually referring to the coverage multiplier and not an actual coverage amount limit. In the event there has been a salary increase since the E of I application was submitted, a higher coverage amount will be calculated based on the coverage multiplier.
- NOTE: There may be situations where the employee subsequently dropped the requested Life coverage before the approval came back. Be sure you do not add coverage based on an approval when the employee subsequently dropped the Life coverage.
- Denials: When an application is denied, the coverage (either OL or DL) will not be Posted to BPP. There are a few other situations that can result from a denied application
- In rare cases Minnesota Life may approve a lower multiplier or coverage level if the participant reapplies at a lower level. If they would like to try this, you can lower their coverage level and set the E of I required flag back to Required.
- When OL is denied and there is a pending DL Plan A application, the spouse can no longer have Plan A since the employee cannot have OL. You may ask the participant if they would rather switch the spouse to Plan B (if the participant is enrolled in BL) or drop the DL coverage.
If a decision cannot be automatically processed, what you will do depends on why iBenefits could not complete the processing automatically.
Some common scenarios are explored in the list below:
- Other Non Approval – Minnesota Life has contacted the participant to supply further documentation with their application before a decision can be made. iBenefits will receive another notification when a decision is reached on the application. Clear the error. No further action is required.
- E of I Not Pending – The participant may have reduced their life insurance coverage amount to a level that does not require E of I. Alternately the coverage may have been dropped entirely. Clear the error. No further action is required.
- Coverage Amount Mismatch – The amount approved by the carrier is different than what was requested on the document. This may mean reducing the employee’s coverage request on the document. Alternately, the employee may need to submit a new E of I request for a higher amount. You should follow up with the participant to ensure he/she gets the correct coverage.
- Conflicting E of I Decisions – More than one E of I decision was received for a participant, some research will be needed to determine which decision to take action on.
- Invalid Document Status – The iBenefits document the E of I request is related to is in a status where it cannot post automatically to BPP. If the decision was an approval, a manual BPP update needs to be made. First verify that the employee did not subsequently drop coverage on another iBenefits document (use the UIN link then the Documents button to get a list of documents for an employee), then verify the multiplier that was requested by checking the associated iBenefits document.
- Invalid UIN/No iBenefits Document – The data received from the carrier does not match any information in iBenefits. The System Benefits Administration office should handle these decisions.
When you’ve completed your review of the E of I decision and made any required changes to the participant’s iBenefits document and/or BPP, click the “Clear Error” button on the Decision Details page (as shown above) to mark the decision as “Manual Update Complete”.