How to Close a Benefit Plan

You cannot delete a benefit plan after it has been added. A benefit plan must remain in the database for the historical record and to process any claims that fall within the plan's effective dates.

If the benefit plan should no longer be used to process claims for services after a certain date, you edit the plan and close it, making it no longer valid, by entering the date after which it will no longer be effective in the Plan End Date field.

This change begins the Mass Dis-Enroll and Enroll process, which determines the benefit plan(s) to be closed and identifies all the members affected by the change in the benefit plan. For each member identified, the system looks for the enrollment span(s) affected and either adds an end date to the enrollment span or cancels the enrollment span as defined by the business rules in place.

You cannot edit the following information after the benefit plan has been added:

• LOB
• Benefit Plan ID

If any of this information is incorrect, you must edit this benefit plan and change the date in the Plan End Date field to the date it should be invalid and save your changes. Then you must add a new benefit plan with the correct information.

If the date you are entering in the Plan End Date field is in the past, then claims that have been processed using this benefit plan may need to be adjusted. You must carefully consider all the processing steps that must be completed if you are closing a plan retroactively.

If a component of benefit plan has been incorrectly entered, you can choose one of the following options:

• Delete a benefit plan component
• Void some of the components

Optionally, you can

• View or add notes. To view or add notes for this record, on the action bar, click Notes.
• View audit details. To retrieve audit information, close any open panels and, on the action bar, click Audit Log. To view the details for a particular record, click Audit.

To close a benefit plan

1. On the Benefits menu, click Benefit Plan Navigator.
2. In the Navigator panel, click the appropriate plan ID.
3. On the main Plan Navigator page, in the Plan End Date field, enter the date after which the plan is no longer effective.
4. In the Plan Navigator action bar, click Save.

See Also

Plan Navigator - Main Page

What Is Plan Navigator?

About Benefit Plans

Version as of 5/16/14.