16 May Is Your Agency Doing “Adds and Terms?”
For the non-benefits folks, this procedure involves the client contacting the agency to make employee changes to the benefits coverage. The agency would then contact the carrier (typically through the carrier’s online portal) to make those changes. The change would involve an employee being added to the coverage or deleted as the employee is no longer with the firm.
Many might ask why the client doesn’t contact the carrier or change through the carrier portal. While many agencies don’t want to take on this procedure, the competition is doing it. Thus it is felt that for the agency to attract/retain the account, taking on this process is necessary.
Some thoughts on this issue:
- For the producers/sales staff: before you advise the client that you will take on this process, clear it with the benefits team to ensure they are okay with assuming this role. I have seen many agencies “forced” to take on this role or variations of this role without consulting with their internal team. I have seen one scenario with several agencies where the producer agreed to have the benefits team enter the client’s payroll system to secure the necessary information. I think this has DANGER written all over it, including some potential cyber ramifications.
- If the agency takes on this role, serious consideration should be given to establishing a common email address to which the clients would send their requests. I think it is best to avoid taking the information verbally as problems could take on a “He said, she said” scenario, and those can be difficult to win. An email address such as employeechanges@(agencyname).com should work.
- Consider developing a form that lists all of the required information and advise the client that requests can be made only through the form.
- Lastly, establish an agreement between the agency and those clients that clearly spells out the process and the detail needed to effect a transaction. Something such as:
[Client Name] requests [Agency Name] to process eligibility (enrollment additions, changes, and terminations) into the insurance carrier’s enrollment systems via the carrier’s online portal. [Client Name] will provide the necessary information in writing using the form provided by [Agency Name]. This completed form should be sent to [Specified Email Address]. [Agency Name] is not responsible if the necessary information is not provided.
While [Agency Name] agrees to process the eligibility, [Client Name] is responsible for monitoring the monthly invoices to ensure the changes are made and agrees to notify [Agency Name] immediately if changes are not processed. [Agency Name] will not be responsible for back premiums or claims associated with errors in enrollment not identified by [Client Name] in a timely fashion.
This is where I add my disclaimer that I am not an attorney and would suggest that your agency counsel be involved in developing this agreement.
You may be thinking, “What could go wrong?” I am aware of several scenarios where, for some unknown reason, a change in the client’s benefit plan was not made. In one case, the requested change was not made for seven months. A lot could go wrong in seven months. Fortunately, nothing did.