From the Compliance Manager: Best Practices for Timely Claim Filing

November 25, 2019

As we come to the end of 2019 and close out another busy year in the Health and Benefits space, Chard Snyder would like to thank you for the trust you have placed in us as a third party administrator. We would also like to take this opportunity to share with you the following best practices around claim filing that we feel could enhance your employees’ experience.

During the third quarter, Chard Snyder processed a large volume of plan participant appeals regarding timely claim filing. Through investigation of each one of these appeals, a common theme surfaced that the employee was either never made aware or not sufficiently reminded of their filing deadlines and other terms of their benefits. We acknowledge how difficult it can be to determine what is and is not covered, and what may or may not be a qualifying event. You can help by reinforcing the following practices when communicating with plan participants:

• Clearly explain details of contribution options
• Make sure to distribute the Summary Plan Description (SPD) to employees once they are enrolled in the benefit
• Cover these conditions in an exit interview for terminating employees

HR departments can communicate conditions of the benefit electronically as well as through printed materials, but it is legally required to notify a participant of their rights and conditions of their benefit in writing.  A verbal reminder is not sufficient.

Michelle Fowler, Compliance Manager