Enrollment Settings and Changes

Enrollment Settings and Changes

Certain group settings can impact employee eligibility and the enrollment process. For most companies, enrollment and benefits change activity constitutes the biggest piece of the administration process. As such, we recommend you familiarize yourself with this section and pay particular attention to the information that must be included on an enrollment or change form in order to prevent potential claims problems caused by delayed enrollment or missing information.

So we can provide you with accurate billing statements and effectively administer the benefits under your health benefits plan, please submit timely and accurate information on any eligibility changes that may occur. These include but are not limited to the following:

• Employees and/or dependents being added to the plan

• Employees and/or dependents being deleted from the plan

• Group address change

• Employee address change

• Change in plans

• Change in Medicare eligibility

• Change in COBRA or State Continuation status for employees

• Employees turning age 65

• Change in ownership of the group

• Employee changes within the group in the event of an acquisition

• Change in the number of employees within the group that would affect the group’s eligibility for COBRA, State Continuation, or Medicare payor status

• Change in dependent student status

All changes must be received within 31 days of the event.

    • Related Articles

    • Changes in Ownership/Purchases/Acquisitions

      When an in-force group has been sold, the case should normally be terminated. However, there are a few instances when the new owner may want to continue to offer benefits to the employees. The following information will need to be completed and ...
    • Group Address Changes

      Submit a group address change in writing on company letterhead to billing@tbsmga.com. A group move to a new rating area may affect the billing and premiums for the employee and or dependents. Changes to your plans can be made at new business or at ...
    • Employee Name Changes

      Employee name changes can be submitted to TBS via email within 30 days of the name change. Proof of the name change must be provided. The marriage certificate can be used as proof as long as it shows the new legal name, if not, then a government ...
    • Global Renewal FAQ

      Broker Guide for Renewals Q: When are the renewals released? A: Aetna releases their renewals approximately 75 days prior to the group’s effective date. Q: Do they need to sign anything to renew? A: Yes, signed paperwork is required to renew the ...
    • OAMC Network

      OAMC plans for Alaska, Idaho, Montana, Missouri, South Dakota or Wyoming cannot be setup, given these states do not have enough OAMC network coverage. An Out-of-Area PPO plan will need be to be set up should an enrollment come in for one of these ...

    TBS Website

      Scale PEO website

        TBS Online Billing System