Educating employees on the Importance of guaranteed or modified issue on eligible benefits
Often during open enrollment, employees are requesting benefit coverage for the first time. Normally, the employee must fill out an evidence of insurability form (medical questionnaire). The request must go through medical underwriting to be approved. The employee takes a risk that the coverage may not be approved due to medical history. Each carrier differs on their underwriting requirements, and so does each underwriter. Some are very strict where others are more lenient. Employees do not always realize the medical history that can interfere with their request being approved. Sometimes taking medications to control high blood pressure can end up in a declination for coverage. A declination stays on file in the MIB (Medical Information Bureau) for life and shows the employee was declined for coverage.
When employees are first hired and offered benefits (initial enrollment), the employee can elect many benefits with guaranteed or modified issue. Guaranteed issue means there is no evidence of insurability forms to complete and no medical questions. This means regardless of ANY medical history, the employee or dependent will be approved if taken at that time. Modified Issue means there are limited medical questions. As long as the employee or dependent can answer these questions with a “Noâ€, the employee or dependent will be approved for coverage.
There is a desperate need for employees to be educated on the importance of benefits when first eligible and the guaranteed or modified issue that is associated with it. Too many times employees are declined and say they were not made aware of guaranteed or modified issue for that benefit when first eligible.
Many employees do not have an understanding of the initial opportunity they have. I believe employees would apply for more benefits when first eligible if they were made aware of the importance of Guaranteed or Modified Issue, even if it was a low coverage amount they elected.
Houze & Associates provides a benefits website that outlines the coverage amounts and guarantee issue levels, available not only during open enrollment, but all year long. We also provide a call center for all employees (new or existing) that have specific benefit questions or need general information about enrollment, claims processing and administration.
