How to Apply Evidence of Insurability

How to Apply Evidence of Insurability

Purpose

This guide explains what Evidence of Insurability is, what settings are available to customize Evidence of Insurability to plans, as well as what the Admin process is to update Evidence of Insurability on an employee level.

Evidence of Insurability (EOI) Explained

Evidence of Insurability (EOI) is a requirement for certain plan types, typically only where an employee is able to elect their own coverage level. The plan will generally have a “guaranteed issue amount” that an employee will be entitled to without an EOI, but if they wish to go beyond that limit the Benefit Provider may require them to complete a document, or have a physician complete it on the employee’s behalf, etc. Your plan info may vary greatly from the specifics outlined below, so be sure to review plan documentation to confirm any of your company’s specific requirements.

Updating Evidence of Insurability

When an employee elects their coverage amount, it will show in the Benefit Plan (but only calculate deductions based off of the Guaranteed Issue Amount). You can use the Override EOI button to update the amount and provide a reason (i.e., if the employee had been approved for that coverage level in a previous benefit admin system) without providing any EOI, but if it has already been provided you can use the Upload Document Button, and the requested amount will be approved.


Evidence of Insurability Settings

If a Benefit Plan requires Evidence of Insurability, the settings will be located in Hamburger Menu > Settings Tab > Profiles/Policies > Benefits > Plans and then they are customized within each specific plan. Green Leaf is happy to customize this information on the administrative side, so you should not update any of these settings without confirming with your Broker and your Benefit Technology Specialist. 


 

  • Require Evidence... - This field is what sets the Guarantee Issue Amount.
  • Enable EOI by Enrollment Type - If you only want to collect for Life Events but not for new hire / open enrollment, for example.
  • Require Custom Form.... - If your carrier has a standardized application that they use for Evidence of Insurability, we can add it here.
  • No need to provide... - If we enable any of the different rules we can use this to not require EOI for employees that have previously provided it and are keeping the same coverage level.
  • Always require if previously waived - If an employee previously waived coverage, we can require that they have to submit an EOI regardless of coverage level.
  • Hide Document Upload... - This can be used to keep employees from uploading, forcing manager to when approving.
  • Allow requests over the limit - This allows employees to request higher than the Guarantee Issue Amount, but limits them to the GIA until EOI is provided.
  • Enable EOI Tiers - If employees qualify for certain coverages based on length of service, we can set those here.
  • Units may be Overwritten By - We can set up a group of managers / benefits admins for your company that are able to enter the new Coverage Amounts once EOI is obtained.
  • Need to be Reviewed By - Can be set if there should be an additional level of review.
  • EOI Expires - Can be set if EOI needs to be collected annually, every 5 years, etc.

 


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