Many carriers have special handling for cases where members were removed from coverage and then re-added. This can happen after a mistake is corrected, a member is rehired, or a formerly active member opts back into coverage via open enrollment or qualifying life event. To be sure that all carriers have enough information to process rehires/reinstatements accurately, requests must follow these guidelines:
  • For all reinstated and rehired members, coverages in the snapshot should include the new effective start date of their most recent coverages, and not the start date of any previously terminated coverages. This applies even if the members are intended to be enrolled without any gap between old coverage and new, and even if the new coverage is meant to correct a mistaken termination. For example, a member whose coverage was mistakenly terminated as of June 30th must have the reinstated coverage sent beginning July 1. Sending an earlier start date may cause requests to be rejected by the carrier.
  • For rehired members only, the first request meant to re-enroll the member must include an event reason of rehire. The event date must also be equal to the member’s rehire date. For that first request and all future requests, rehired members must always have both a hire_date and a rehire_date. The hire_date should reflect the member’s original hire date, while the rehire_date should reflect their new, most recent hire date.

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Examples

Reinstate a member's coverage

Reinstate terminated coverage for a terminated employee

Rehire an employee

Add a rehired employee back to employment and active coverage