Termination rules and how they are applied

Termination Rules are used by the Employee Enrollment Updates action to determine when an individual is no longer eligible for a benefit plan. The termination rules are applied in alphabetical order by benefit group when an individual is found to be no longer eligible for the benefit. If a termination rule cannot be found and there is one that does not specify a benefit group then that one is applied.

Employee Termination rules are also used for COBRA Benefit Enrollment. If an employee is terminated and the Employee Benefit has not stopped, the COBRA Enrollment uses termination rules to calculate the Employee Benefit stop date. COBRA Benefits cannot be enrolled in prior to that stop date. If no termination rules are found, COBRA Benefits cannot be enrolled in until the Employee Benefit is stopped.

Example

In this example, both employees A and B were hired as Full Time and enrolled in a benefit plan based on their Plan Eligibility and Entry Rules. However, Employee A became ineligible for one benefit plan and eligible for another when they went from Full Time to Part Time. It was the Active PT Termination Rule that determined that change in benefit plan. Employee B terminated employment and thus had all benefits stopped as per the Not Active Termination Rule.

To determine eligibility, Mass Create Eligibility uses Plan Eligibility and Entry Rules. To stop eligibility and enrollments, Employee Enrollment Updates uses Termination Rules.

Employee Status Benefit Group To determine eligibility
Employee A Hire Active FT

Mass Create Eligibility uses:

  • Plan Eligibility

  • Entry Rule
Employee B Hire Active FT

Mass Create Eligibility uses:

  • Plan Eligibility

  • Entry Rule
Employee A Work assignment change Active PT

Employee Enrollment Updates uses:

Termination Rule
Employee B Terminated Not Active

Employee Enrollment Updates uses:

Termination Rule