I speak with prospective clients who often say that their Open Enrollment went well, but they have these nagging invoice issues. If you notice that benefit amounts are incorrect on your invoices or employee deductions don't match the carrier invoice, an Evidence of Insurability (EOI) issue might be the cause.
Insurance carriers may require Evidence of Insurability (EOI), sometimes called a Statement of Health, to determine an employee's eligibility for benefits exceeding the guaranteed issue amount. For example, if the guaranteed issue life insurance limit is $250,000, and John Smith applies for $300,000, the additional $50,000 requires EOI. This applies to disability, critical illness, hospital, or cancer policies.
To prevent unintended billing errors, two crucial factors must be addressed throughout the plan year: accurate and intuitive technology for employee enrollment and a documented EOI follow-up process.
Ensure your benefits administration technology aligns with EOI rules:
Develop and execute an EOI strategy to manage pending EOIs effectively:
EOIs may seem straightforward, but carrier-specific processes require a clear understanding. Brokers should outline this plan during or after Open Enrollment to avoid confusion in communication strategies and timeline expectations throughout the plan year.
**Pro Tip:** When marketing your plans, inquire about carriers' EOI processes, technology specifications, and communication methods. Obtain a schedule and samples for efficient employee communication before selecting your vendor partner.