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Advisors, employers and benefits administrators want to provide a benefits package that will attract talent and provide a financial safety net to employees. They also want employees to have the coverage they signed up for when they file a claim. But it can be challenging for an employer self-administering its own benefits plan, particularly enrolling employees and tracking eligibility criteria throughout the year. Has an employee ever filed a claim only to learn they’re not covered because of an eligibility issue? Maybe their schedule changed and they didn’t work enough hours to qualify for coverage, but premiums kept coming out of their paycheck?

Employers should remember that if the answer is yes, they are not alone. As an insurance provider, we see common administrative pitfalls that employers have faced, causing surprises for their employees at claims time. No one wants this to happen, especially when the employee is already going through life changes due to injury, illness, a new baby, or the death of a loved one.

We mapped out common triggers for problems, such as missing documentation or changes in eligibility, and created tips to help employers avoid these mistakes, which are included below. Many revolve around evidence of insurability (EOI) or staying on top of eligibility criteria. In our poll, we found that 78 percent of employers said it is challenging to stay on top of eligibility requirements throughout the year, and 53 percent have seen an employee experience an unexpected lack of coverage upon filing a claim.

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