Re-adding certs and the process of which we follow is determined by the manner of which the member was initially terminated. Terminated is a term sometimes wrongly used and we will endeavor to explain what can sometimes be meant by this term below.
In any case where a Member was terminated and needs to be added back to the plan as a new cert: This is the only scenario where the term “termination” should be used. A true termination triggers all the steps outlined below since the employee is done/finished with the company. In that case when and if they return the system should treat them as complete new hire (new cert #/no claim history)
1. Update the email address in the original Member Profile to include "-terminated" with the Effective Date of that change being their Termination Date. (important we use this format and not a +, in order to avoid erroneous emails being sent)
2. Add the Member as if they were a new-hire, and send their enrollment, treating them as a brand new employee. They will be treated as a new member in every sense, by the system.
3. Once they have enrolled, ensure to merge their contact record in Freshdesk with their old one so that all Customer Service history is maintained under one record
In any case where a Member was terminated and needs to be reinstated to the plan. This scenario should not be labelled termination only because it opens the room to confuse it with the above one and also because this is simply not a termination.
This scenario is a “layoff”. Under this scenario the possibility of an employee to return is left opened for up to six months. Layoffs are usually the result of a company busy season coming to an end (ie. less employees are needed) but the company leaves this option open so that when the employee returns they can “pick up” where they left their group benefits coverage.
In this case their claim history/certificate # should simply be reactivated as they are not necessarily gone forever but there is an expectation of their return. This also should prevent the waiting period to be applied by the system (which will be the case with a termination). With a termination the possibility to waive the waiting period should be an option for the employer to apply but not necessarily as a default. Now; a layoff has also some sort of “expiry date” in the sense that the option for them to be reinstated is only to be open for up to six months from the date the employee is laid off. After six months if the employee returns the layoff provision is not applicable any longer meaning the new cert. #/no claim history of a termination should apply.
1. Go to the Member Profile of the Terminated Member
2. Edit Profile
3. Change their status from Terminated to Active
4. Their usages and balances will be based on that year's claims and they will not have a new cert.