electronic web-based enrollment user’s manual v 2 · 2020-02-25 · electronic web-based...

Electronic Web-based Enrollment User’s Manual v 2.0

Electronic Enrollment User Manual

Table of Contents

Section 1.0 – Electronic Enrollment Home – Page 2 • How to sign into Electronic Enrollment

Section 2.0 – Add A Subscriber – Page 3 -12 • Add an employee and their dependent(s) Section 3.0 – Manage Dependents – Page 13 - 21 • Add a dependent (spouse, child) to an existing subscriber’s account. (13 – 19) • Terminate (disenroll) a dependent from a subscriber’s account (20 – 21) Section 4.0 – Transfer/Disenroll Subscriber – Page 22 - 31 • Terminate (disenroll) a subscriber (22 – 26) • Transfer an employee from one Blue Cross plan to another (27 – 31) Section 5.0 – Recall/Rehire Subscribers– Page 32 - 35 • Use this function when recalling/rehiring a former employee • Use to add a former employee to COBRA Section 6.0 – Edit Member PCP – Page 36 - 42 • Change an employee’s or dependent’s Primary Care Physician Section 7.0 - Edit Member Demographics – Page 43 - 47 • Change an employee’s address or other demographic information Section 8.0 – Group Activity Report – Page 48 - 49 • Review activity on your account Section 9.0 – Submitted Transactions – Page 50 - 51 • Review submitted transactions • Voiding incorrect transactions Section 10.0 – Download Subscriber Rosters – Page 52 - 53 • Download spreadsheets for enrollee’s awaiting approval, denied, active, or future

enrollees Appendix – page 54 - 57


Electronic Enrollment Home Page How to Sign In to Electronic Enrollment

Section 1.0

1. Visit BCBSRI.com.

2. To go to the Employer’s area of BCBSRI.com, please enter your BCBSRI user name and password and click Sign In.

Note: As a security precaution, the system will lock your account after five failed sign in attempts. If this occurs, or if you have forgotten your password, please contact our Call Center at (401) 751-1673 or 1-800-343-5743 during normal operating hours: 8:15 a.m. to 4:30 p.m. EST Monday - Friday and 9 a.m.- 12 p.m. EST on Saturday.

3. On the Employer home page, click Electronic Enrollment (Figure 1).

Figure 1


4. The Electronic Enrollment application will open in a new window. Available features are listed in the left navigation menu (Figure 2).

Note: The system will time out after 20 minutes of inactivity. You’ll need to log in again to continue the enrollment process. Figure 2

Add a Subscriber How to Add an Employee and Dependents

Section 2.0 1. Click the Add Subscriber link in the left navigation menu.

Any dependents (employee’s spouse and children) should be added while adding a new subscriber.

2. Choose the Qualifying Event and input the employee information in the fields provided, using the TAB key to navigate through the fields. Required fields are noted in red - all others are optional (Figure 3).

Note: All transactions are submitted for processing daily at 8 p.m., Monday – Friday. After processing, changes are viewable the following business day.


Figure 3

Note: A description of these fields is located in the appendix on pages 54 – 55.


Tips: Use the calendar drop-down menu to select the Event Date (Figure 4). Note: Event Date is the actual date of hire for an employee, not the effective date of health insurance coverage. Figure 4 Calendar Drop-down Menu

.


3. Once the employee information is added, if there are no dependents, click N and then Complete. If the employee has dependents, click Y and a drop-down box will open with room to add up to five dependents. Additional drop-down boxes are available if there are more than five dependents (Figure 5). Note: Dependents should be added when adding the employee.

Figure 5

4. Once you have finished entering information for the employee and any dependents,

click complete. You will then be directed to the Select Employer Plan page (Figure 6).


Figure 6

Select the appropriate product information, and then click Submit. Note: Only employer plans that are currently being offered to the subscriber will be shown.


Selecting a BlueCHiP plan will cause the Select PCP for Subscriber and Dependent page to display (Figure 7). For family or two-person plans, a primary care physician (PCP) must be selected for the subscriber and each individual dependent. If you did not select a BlueCHiP plan, you will be brought directly to the Thank You page (Figure 11, Page 12) after clicking Submit. Figure 7


Search for PCP If the PCP’s name or provider ID is unknown, click Select PCP to search for a provider. Complete the necessary fields, (highlighted in red) and then click Search (Figure 8). If you know the provider ID number type it, preceding it by enough zeros to make a 6-digit number. For example, if the provider ID number is “1370,” enter “001370.” Figure 8

Note: You do not need to choose a language or specialty to search for a PCP.


Click the View Details link next to a provider’s name to view more information or select that provider as a PCP (Figure 9). Figure 9


Figure 10

A button to select the provider as a PCP will appear when you view Provider Details (Figure 10). 5. Once you have selected a PCP for each member, click Complete. A Thank You page

will appear (Figure 11). Note: Please review the Thank You page (Figure 11) to verify accuracy. If you notice an error, you may void the transaction (see pages 50-51). To print a copy of the Thank You page, use one of the print-friendly buttons located at the top and bottom of the page. Clicking this button will open the print dialog box.


Figure 11


Manage Dependents How to Add a Dependent to a Subscriber’s Contract

Section 3.0 1. Select Manage Dependents from the left navigation menu. The Search for a

Subscriber screen appears. Figure 11a

2. Dependents must be added via the main subscriber record. To search for the

subscriber record, input the last name or the first few letters of the last name, and click Search. All subscribers matching the search criteria will be shown (Figure 12).


Figure 12

3. Click Manage Dependents to view the subscriber and his or her dependents

(Figure 13).


Figure 13

4. To add a dependent, click Add another family member. You will be prompted to

enter the qualifying event and date (Figures 14 & 15). Figure 14


Figure 15

5. For transactions performed during the anniversary period, (open enrollment) select

the following qualifying event: Add Dependent on Employer Anniversary. Input a date within the anniversary period as the qualifying event date. For non-anniversary transactions, select the appropriate qualifying event and the date the event occurred. Click Submit to continue.

Note: See page 56 for more information on Qualifying Events.


6. The Enter Dependent Information screen will be displayed (Figure 16). Input the required information (red fields). Click Submit to continue. If there are other dependents, click Add another dependent.

Figure 16


7. Click Submit and you will be brought back to the Employee and Dependent Summary page (Figure 17).

8. Click Complete to finish adding the dependent. Figure 17


Note: Please review the Thank You page (Figure 17a) to verify accuracy. If you notice an error, you may void the transaction (see pages 50-51). To print a copy of the Thank You page, use one of the print-friendly buttons located at the top and bottom of the page. Clicking this button will open the print dialog box. Figure 17a


To terminate a dependent from a subscriber’s contract: 1. Select Manage Dependents from the left navigation menu. The Search for a

Subscriber screen appears (Figure 11a, page 13). 2. Search for the subscriber of a dependent to be terminated by inputting the

subscriber’s last name or the first few letters of the last name, and click Search. All subscribers matching search criteria will be shown (Figure 12, page 14).

3. Click Manage Dependents to the right of the subscriber’s name (Figure 12, page 14)

to view the subscriber and his or her dependents (Figure 18). Figure 18

4. Click Disenroll to the right of the appropriate dependent’s name (Figure 18). A

Confirm Disenrollment screen will appear (Figure 19). Note: For the Change option, please see pages 43 – 47 How to make General Changes to a Subscriber’s and/or Dependent’s Information.


Figure 19

5. Select the reason and enter the date of disenrollment. Click Confirm Disenrollment.

You will receive the Employee and Dependent Summary page (Figure 17, page 18) Click Complete to finish the Transaction.

Note: Please review the Thank You page (Figure 17a) to verify accuracy. If you notice an error, you may void the transaction (see pages 50-51). To print a copy of the Thank You page, use one of the print-friendly buttons located at the top and bottom of the page. Clicking this button will open the print dialog box.


Transfer/Disenroll Subscriber How to Terminate a Subscriber

Section 4.0 1. Select Transfer/Disenroll Subscriber from the left navigation menu. 2. To search for a subscriber, input the last name or the first few letters of the last name.

(Figure 20). All subscribers matching search criteria will be shown (Figure 21). Note: Disenrolling the subscriber will terminate coverage for the entire family. Figure 20


Figure 21

Note: If the subscriber’s name is displayed in red or green, there is already a transaction in process for that subscriber. 3. To terminate coverage for a subscriber, click Disenroll next to that employee’s name.


4. On the Confirm Disenrollment page, provide a disenrollment reason and date, and

click Confirm Disenrollment to complete the transaction (Figure 22). Mandatory fields are shown in red.

Figure 22


5. The system will ask if “you really want to disenroll this member.” Click

OK to continue or Cancel to go back (Figure 23). Figure 23


Note: Please review the Disenrollment Confirmation page (Figure 24) to verify accuracy. If you notice an error, you may void the transaction (see pages 50-51). To print a copy of the confirmation page, use one of the print-friendly buttons located at the top and bottom of the page. Clicking this button will open the print dialog box. Figure 24


To change which contract the subscriber is enrolled in: 1. Select Transfer/Disenroll Subscriber from the left navigation menu. The Search

for A Subscriber page will appear. 2. To search for a subscriber, input the last name or the first few letters of the last name,

and then click Search. All subscribers matching search criteria will be shown (Figure 25).

Figure 25


3. Click the Transfer, which is located to the right of the subscriber’s name. The

Subscriber Transfer page will appear (Figure 26). Figure 26

4. Select the Qualifying Event (Figure 27). If a contract change is being performed

during the anniversary month (open enrollment), use either of the following qualifying events: • Employee Change in Benefit Package within Group (anniversary) • Transfer from One Affiliated Group to Another Affiliated Group (non-Plan 65 at

anniversary). • For non-anniversary events, choose the appropriate event from the other options

listed. Note: See page 57 for Qualifying Event definitions. You may enter a reason for the change in the box marked Reason to Change SubGroup. However, it is not a mandatory field.


Figure 27

Figure 28

5. Input the date of the qualifying event in the Transfer Date field (Figure 28). For

anniversary transactions, enter a date within the open enrollment period. For non-anniversary transactions, enter the date of the qualifying event. Click Select when finished. You will be brought to the Select Employer Plan screen (Figure 29).


Figure 29

6. See pages 7 through 11 to complete the process.


Note: Please review the Thank You page (Figure 30) to verify accuracy. If you notice an error, you may void the transaction (see pages 50-51). To print a copy of the Thank You page, use one of the print-friendly buttons located at the top and bottom of the page. Clicking this button will open the print dialog box. Figure 30


Recall/Rehire Subscribers Section 5.0

Recall/Rehire is used to:

• Add a former employee and his/her dependents. • Add a former employee to COBRA.

Note: This selection should only be used when an employee is recalled/rehired within one year and previously had BCBSRI coverage. 1. Select Recall/Rehire Subscribers from the left navigation menu. The Search for a

Subscriber page will appear (Figure 31).

Figure 31

2. To search for a subscriber, input the last name or the first few letters of the last name, and then click Search. All the subscribers’ matching the search criteria will be shown (Figure 32).


Figure 32

3. Click on the subscriber’s name and you will be brought to the Add A Subscriber page (Figure 33). All the information that was previously entered for the employee you are Recalling/Rehiring will be pre-filled for you, including any dependent information. Required fields are shown in red.


Figure 33

Note: For more information on Qualifying Events, see page 55.


4. Use the following qualifying event for recall/rehires: • Recall/Rehire.

For COBRA, select the qualifying event: • Add Former Employee and/or Dependent(s) eligible under COBRA.

5. Enter the event date using the calendar drop-down menu. Click Complete when

finished. You will receive the Select Employer Plan screen (Figure 34). Figure 34

6. See pages 7 through 11 to complete the transaction.

Note: Please review the Thank You page (Figures 17a, page 19) to verify accuracy. If you notice an error, you may void the transaction (see pages 50-51). To print a copy of the Thank You page, use one of the print-friendly buttons located at the top and bottom of the page. Clicking this button will open the print dialog box.


Edit Member PCP How to Change a Member’s PCP

Section 6.0 1. Select Edit Member PCP from the left navigation menu. The Search for A

Subscriber page will appear (Figure 35). Figure 35

2. To search for a subscriber or their dependent(s), input the last name or the first few

letters of the last name, and then click Search. All subscribers matching search criteria will appear (Figure 36).


Figure 36

3. Click the Change PCP link to the right of the appropriate subscriber (Figure 36). The

subscriber and dependents will be listed, along with their current PCP. Click the Search for PCP link located to the right of the appropriate subscriber or dependent (Figure 37).

Figure 37


4. A Provider Search screen will be displayed (Figure 38). Input as much of your search criteria as available, and click the Search button. Required fields are in red.

Figure 38

Note: You do not need to choose a language or specialty to search for a PCP.


A list of available PCPs will be displayed (Figure 39). Figure 39


5. Select a PCP by clicking on the physician’s name (Figure 39). The PCP’s information will be displayed. Click Select This PCP to assign this physician to the member (Figure 40).

Figure 40


You will be directed to the Physician Selection screen (Figure 41). Figure 41

The new physician name is shown. If you wish to assign this PCP to all family members, you can click Select Employee’s PCP for All. When done, click Complete.


Edit Member Demographics How to Make General Changes to Subscriber and/or Dependent Information

Section 7.0 1. Select Edit Member Demographics from the left navigation menu. The Search for

a Subscriber page will appear (Figure 43). Figure 43


2. To search for a subscriber, input the last name or the first few letters of the last name, and then click Search. All matching search criteria will be shown (Figure 44).

Figure 44

3. Click the Edit Demographics link to the right of the subscriber’s name (Figure 44)

to view the Subscriber and Dependent Summary (Figure 45). Note: Some information, such as address, can only be edited under the employee. In addition, you must submit a paper request to Membership Administration Services for some types of corrections, including employee or dependent’s gender.


Figure 45

4. If you click on the family member’s name it will display the Subscriber Details page.

No changes can be made on this screen (Figure 46). Figure 46


5. Click the Change link (Figure 45) next to the desired member to edit his or her demographic information. Mandatory fields are in red (Figure 47).

Figure 47


6. Click Submit Changes and you will be brought back to the Employee and Dependent Summary page (Figure 45). You must click Complete to finish the transaction.



Group Activity Report Section 8.0 1. Select Group Activity Report from the left navigation menu.

The Group Activity Report shows all electronic enrollment transactions on your account for the date range you select (Figure 49).

Figure 49

2. Input the dates you would like to review and click Search.


The Group Activity Detail page will appear (Figure 50). Figure 50

Note: This report is not printable.


Submitted Transactions

How to Review Processed Transactions or Void a Processed Transaction Section 9.0 1. Select Submitted Transactions from the left navigation menu. 2. The Enrollment Transaction Search screen will appear (Figure 51). Fill in any

information necessary to limit your search, and click Search. A list of all transactions matching your criteria will be displayed (Figure 52).

Figure 51


Figure 52

The void button will be displayed for any transactions entered that day. Note: Transactions can only be voided the day they are entered. To make corrections after processing Monday through Friday, you must submit a paper request to Membership Administrative Services.


Download Subscriber Rosters Section 10.0 1. Select Download Subscriber Rosters from the left navigation menu. 2. The Download Roster screen will appear (Figure 53). Click on the type of roster you

would like to download. Figure 53

3. The system will generate the roster in a spreadsheet format. Click Save to save the

roster. Click the back button to return to the Download Roster selection screen. Note: The number next to the Download Roster options reflect the Employees that you are allowed to see based upon the access level for your user ID.


Figure 53a

Note: Depending on your computer’s operating system and Web browser version, a File Download dialog box (Figure 53a) may appear. Click Open to open the file in your Web browser and view the roster.


Appendix Add A Subscriber field descriptions: FIELD ENTRY DESCRIPTION Qualifying Event Click on the drop-down menu and select and

enter the appropriate qualifying event. See page 55-57 for Qualifying Event definitions.

Event Date Input the date of the qualifying event. Note: Event Date is the actual date of hire or other event, not the effective date of coverage.

Social Security # Input the employee’s social security number. Employee ID Input employee’s ID if available Prefix Click on the drop-down box and, select and

enter the appropriate prefix, if applicable. First Name Enter the employee’s first name. MI Input the employee’s middle initial. Last Name Input the employee’s last name. Suffix Click on the drop-down box and enter the

appropriate suffix, if applicable Gender Click on the drop-down box and select and

enter the appropriate category. Date of Birth Input employee’s date of birth. (mm/dd/yyyy) Marital Status Input employee’s marital status Address Input employee’s street address, including

apartment number, if any. Secondary Address Input employee’s second address, including

apartment number, if applicable. City Input the name of the city.

State Click on the drop-down box and select and enter the appropriate state abbreviation.

Zip Code Input five-digit ZIP code. Home Phone Input the employee’s home telephone number,

starting with the area code. Business Phone Input employee’s business telephone number,

starting with the area code. E-mail Address Input employee’s e-mail address. Hire Date Input employee’s date of hire. Language Input subscriber’s primary language.


Qualifying Events for Adding an Employee and Dependents, and Recall/Rehire

New Hire Use to add a new employee ReCall/Rehire Use to recall/rehire an employee. Note: If

recalled/rehired within one year and the employee had BCBSRI coverage, the add should be done using the recall/rehire selection on the left navigation menu. All previous information for that employee is pre-filled.

Transfer from Other Coverage Add an employee who is transferring from another insurance coverage

Add Employee on Employer Anniversary Date

Use to add an employee on the group anniversary date.

Add Retiree or Spouse of Retiree to Plan 65 Group

Use to add a retired employee or his or her spouse to Plan 65. Note: This function could be done using the Recall/Rehire selection on the left navigation menu. All previous information for that employee is pre-filled (cannot use for dependents).

Add Former Employee and/or Dependents(s) eligible under COBRA

Use to add a former employee and his or her dependents to COBRA. Note: This function could be done using the recall/rehire selection on the left navigation menu. All previous information for that employee is pre-filled (cannot use for dependents).

Addition of Employee Changing from Part-Time to Full-Tine Status

Use when an employee is changing from part-time to full-time (waiting period applies).


Qualifying Events for Managing Dependents

New Born Use when adding a newborn baby. Note: For existing family accounts, date of birth will be the newborn’s effective date. For contract changes (individual to family), the effective date will be the first of the month following date of birth.

Spouse Transfer Use when adding a spouse who has transferred from non-BCBSRI insurance. Note: Subscriber must be listed as “married” to use this Qualifying Event.

Adoption of a Child Use when adding an adopted child. Addition of a Handicapped Child over 19 Use when adding a handicapped child over

19. Addition of a Student Child over age 19 Use when adding a student over age 19 Spouse Returning from Military Leave Use when a spouse has returned from

military service. Dependent Transfer Use when adding a dependent who has

transferred from another insurance. Add Dependent on Employer Anniversary Use when adding dependents during open

enrollment period.


Qualifying Events for Subscriber Transfer

Transfer from One Affiliated Group to Another Affiliated Group (non-Plan 65)

Use when an employee moves from one affiliate to another non-anniversary.

Employee Transferring to Plan 65 Use when an employee transfers to Plan 65 Employee Change in Benefit Package (Non Anniversary)

Use for non-anniversary changes to an employee’s benefit package.

Change Department If you have department numbers set up, use this event for employee changes within those departments.

Employee Change in Benefit Packages within Group (Anniversary)

Use when an employee changes his or her benefit package during open enrollment

Employee Change in Benefit Package Due to Moving Out of A CHiP Area (Non Anniversary)

Use when an employee must change his or her benefit package due to a move from a BlueCHiP network area.

Transfer from One Affiliated Group to Another Affiliated Group (non-Plan 65 at Anniversary)

Use when an employee changes groups during open enrollment.

electronic web-based enrollment user’s manual v 2 · 2020-02-25 · electronic web-based...

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