02/21/2008
InnovaSM and EngageSM administrative rules clarified
The following information clarifies administrative changes regarding InnovaSM and EngageSM medical plans (also covers EncoreSM, RadianceSM and ExpressionsSM dental plans):
- Eligibility Guidelines: All newly enrolled members will become effective the first of the month following date of hire and upon satisfaction of any additional time for an employee new-hire probationary period requirements (except newborns and adopted children). Example: If an employee is hired March 1, 2008 (or any other date through March 31, 2008) and the group has a first of the month following date of hire probationary period, April 1, 2008 would be their enrollment effective date. Similarly, if an employee is hired on March 3, 2008, and the group has a 30-day probationary period, the employee would be eligible for enrollment effective May 1, 2008. They satisfy the 30 days on April 2, 2008, then we look forward to the first of the following month for the effective date.
- Waivers: For new groups, employees who decline coverage when they are initially eligible will be required to complete a Waiver form. If they are declining coverage due to having other coverage, we require that the name of the other carrier and the employee's policy number be provided on the form.
- Member Cards: Once members are enrolled, we will automatically send a quick start guide and member cards to the address provided in the member's record. These two items are sent out separately and at slightly different times.
To read other information about enrollment, billing, and appeals procedures, the Group Administrator's Manual for Innova and Engage is available on the Employer Web site. If you have questions, please talk to your Regence Sales contact.
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