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Avoid Claim & Billing Issues by Submitting an Annual Census

submit an annual census

It’s important that public sector organizations with life and/or disability coverage send an annual census to their insurance carrier at least once a year. Employers want their enrollment records to match the carrier’s records, ensuring that no one falls through the cracks. What if an employee was going to go out on disability, only to find out the insurance carrier doesn't have them on the insurance policy? What if an employee died, but left no life insurance benefit to their family because the carrier didn’t have them listed as covered? A census can also help employers avoid claim and billing issues and receive their renewal information in a timely manner.

Renewal

An insurance underwriter uses the census information (demographics) to determine the renewal rates. If your coverage is salary-based, make sure that salaries are kept updated as well.

If you have a multi-year rate guarantee, it is still recommended that you submit an annual census. Groups often make changes to their plans such as a change in the benefit amount or other plan provisions. Maintaining accurate information on an on-going basis will help the underwriter easily calculate any rate impact your change has during your rate guarantee period.

 

Premium Billing

The census information you provide to your insurance carrier is used to calculate your premiums (how many eligible employees, coverages each person elects, etc.) Census information is in a constant flux with new hires and terminations happening regularly. If the information is not updated, you could be paying premiums on employees who are no longer active (retired, terminated, etc.).

  •  For list-billed groups, the premium statement should reflect those employees eligible for coverage and the correct benefit amounts. It’s important to keep this information up-to-date (including current salaries) so it accurately reflects what you owe.
  • For self-billed groups, an annual census will help the insurance carrier validate those enrolled in the plan and analyze the premiums being paid. It can help to identify over/underpayments and make the proper adjustments.
  • If your coverages are salary-based, your census should include updated salaries.
  • If you have a multi-year rate guarantee, a census is still recommended so that records match and premiums are submitted accurately.

 

Claim Verification

To keep claim paperwork moving through the approval process, make sure that current salary information is on file with the carrier. If the information on file doesn’t match the claim paperwork, this may cause delays in processing and payment. Read more about the disability claims process.

 

Best Time to Submit a Census

The best time to submit a census depends upon your type of organization.

  • Cities and counties should submit a census shortly after the beginning of each calendar or fiscal year.
  • Groups with an annual enrollment period should provide a census after the close of their annual enrollment period.
  • School districts should give information to the carrier after their salary changes and enrollment information is known for the new school year (August-November each year).

 

Census Information

You can submit your census information to your insurance carrier in Excel format. Include the following information:

  1. Employee full name
  2. Social security number
  3. Gender
  4. Date of birth
  5. Date of hire
  6. Hours worked per time period (specify day, week, month, or year)
  7. Occupation/insurance classification
  8. Annual salary (not pro-rated) if any coverage is based on salary, limited to a multiple of salary or cannot exceed a percentage of earnings
  9. Effective date of last change (salary or class change)
  10. Basic life, employee supplemental life, and spouse life volumes, if applicable
  11. Indication of dependent life coverage, if applicable
  12. Indication of long-term disability coverage, if applicable
  13. Indication of short-term disability coverage, if applicable

For more information on this topic, contact your National Insurance Services Representative.

 

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National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.

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Erin Woulfe

Erin Woulfe

Erin Woulfe likes to write about things that matter. Keeping her finger on the pulse of what’s happening in the public sector world, she blogs about the latest legislative news and employee benefit trends that affect our school, city and county clients. She’s been with NIS since 2002. “I love connecting to our clients and providing them with the tools they need in order to administrate their plan,” says Erin. “Whether that be materials to educate their employees on certain benefits, how to effectively communicate change within an organization, or providing tips and how-to’s to help them make their job easier.”