#1:Can I enroll an employee in the group health plan outside the open enrollment period? The open enrollment period is an opportunity for employees who have previously waived coverage to join the group health plan. If an employee requests to join the group health plan outside the open enrollment period or new hire eligibility period, they must have a qualifying event and supportive documentation to be enrolled.

Under HIPAA Special Enrollment rules, employees and/or dependents may enroll in the Plan as a Special Enrollee under the following circumstances:

• MARITAL STATUS CHANGE: Marriage; Death of spouse; Divorce or annulment; Legal separation
• NUMBER OF DEPENDENTS CHANGE: Birth; Adoption or placement for adoption; Death of dependent child; Newly eligible dependents due to plan design change
• LOSS OF COVERAGE: If the employee loses other coverage (e.g., spouse’s health plan coverage terminates, or Medicare or Medicaid eligibility ends)
• DEPENDENT STATUS CHANGE: Dependent no longer satisfies rule for eligibility as a dependent due to attainment of age 26
• EMPLOYMENT STATUS: Start or end of employment; Start of or return from leave of absence; Change from part-time to full-time status, or vice versa; Strike or lockout
• JUDGMENT, DECREE OR ORDER REQUIRING COVERAGE: Qualified Medical Child Support Orders (QMCSO)
• CHANGE IN RESIDENCE: May qualify if there is a loss of eligibility for a region-specific plan, such as an HMO

Reminder: It is the group’s responsibility to determine and maintain proof of eligibility and to notify HNE within 31 days of these events.

#2: What is a waiting period? A waiting period, also known as an elimination period, is the period between when an employee is hired and when he or she is eligible for group health insurance or other benefits. The company sets this period, which (beginning January 1, 2014) can be no longer than 90 days. This period is set at the time an employer applies for group health insurance on the group application. The Enrollment Department monitors this period before newly hired employees become eligible for the group health plan. The group must notify HNE if they wish to change the waiting period.

#3: Our members received summary of benefits and coverage (SBC) statements before our group made a plan change upon the group’s renewal date. Will HNE mail out updated SBCs for our new group health plan selection? The federal guidelines for health insurance carriers are to mail an SBC to members 30 days prior to the renewal date or the first day of open enrollment. If the employer elects or adds a new group health plan option after that date, it is the employer’s responsibility to provide employees with updated SBCs. HNE will provide an electronic copy of the SBC via email.

#4: I noticed that HNE offers direct COBRA billing; does this mean HNE administers our COBRA? No, HNE does not offer COBRA administration. We offer an option to bill COBRA beneficiaries directly once they have elected COBRA and the employer has requested to reinstate them. The employer must provide a signed COBRA election form and a first-month COBRA premium payment to HNE in order to reinstate the beneficiary. After the initial reinstatement, HNE will bill the member directly.

To direct bill a COBRA beneficiary, the group must select the individual billing option; otherwise the group is billed for COBRA participants reinstated for COBRA benefits.

Please contact your account representative if you have additional questions regarding COBRA billing, or to confirm your current COBRA billing option.

#5: How do I access HNE Direct to do enrollment transactions for my employees? Our HNE Direct is a user-friendly tool for employers. For access, please complete these steps:

1. Go to our website: www.HNE.com
2. Click HNE Direct (bottom right)
3. Click the for Employers tab
4. Click Login Screen
5. Click Need to Register (bottom right)
6. Click Employer
7. Enter your Group number
8. Click Next
9. Continue through the Registration Process

You should receive an onscreen message with your Login ID. Once your account has been confirmed by HNE, you will receive a confirmation email with a link to create your password. Use the Login ID and password (case sensitive) to log in to HNE Direct.

Please note: Only the group contact person listed for this group is eligible for HNE Direct access. If someone other than the group contact person attempts to log in, HNE requires authorization from the group contact before granting access.