If schools, cities and counties want to avoid claim and billing issues on life and disability insurance and receive their renewal information timely, it is imperative to submit a census at least once each year. Why? If your enrollment records don’t match the insurance carrier records, people may fall through the cracks. Imagine an employee going out on disability claim only to find that the insurance company doesn’t even have them on the policy! Or an employee dies and there is no life insurance benefit for their loved ones!
Claim Verification
In addition to making sure that the insurance company is insuring the correct people, it’s also important to have the most up-to-date salary information on file. If the information on file doesn’t match the claim paperwork submitted, it must be researched and verified before moving on to the next step. This may cause a delay in your employee receiving their claim payments.
Premium Billing
Your insurance premiums are calculated utilizing your census information (how many employees are eligible for coverage, what coverage each individual elects, etc.). New hires and terminations can occur frequently so your census information is in constant fluctuation.
If you are list-billed, the premium statement should reflect the employees eligible for coverage and their current salaries (if the coverage is salary-based). If you forget to let the insurance company know that you hired two new employees and you had five employees retire, then your bill won’t be an accurate representation of what you owe.
If you are self-billed, submitting an annual census helps the insurance company validate those enrolled in the plan and analyze the premiums being paid. This can help them identify premium payment discrepancies, such as over- or underpayments, so adjustments can be made.
Renewal Time
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.
When Should I Submit a Census?
The ideal time to submit a census for school districts is shortly after the enrollment and salary changes are known for the new school year (August - November each year). Cities and counties should provide their census shortly after the beginning of each calendar or fiscal year. Groups that have an annual enrollment period should submit their census after the close of the annual enrollment period which will provide the insurance company with updated information resulting from that enrollment.
What Information Should be Included in the Census?
Censuses can be submitted easily to your insurance company in Excel format and include the following information:
- Employee full name
- Social security number
- Gender
- Date of birth
- Date of hire
- Hours worked per time period (specify day, week, month or year)
- Occupation/insurance classification
- 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
- Effective date of last change (salary or class change)
- Basic life, employee supplemental life and spouse life volumes, if applicable
- Indication of dependent life coverage, if applicable
- Indication of long-term disability coverage, if applicable
- Indication of short-term disability coverage, if applicable
For more information on this topic, contact your National Insurance Services Representative.
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.