Benefits of Reviewing your Monthly Benefit Statement   

Monthly statements seem to flow through on almost a daily basis and with the move to electronic bills and pre-authorized payments we are all guilty of becoming a little lazy about actually looking at these statements to see where our money is going. Every month as a plan administrator you either receive an email notification letting you know your monthly benefits premium statement is available or you receive the statement in mail. To have payments made in time you may quickly look at the amount billed and send a payment for that amount, if you have pre-authorized payment set up you might not even open the statement at all! Personally, I rarely look at any of my monthly statements as in most cases I have set up pre-authorized payments. Simply reviewing your monthly statement can save you time, money, payroll discrepancies, and late applicant situations. 

 The monthly statements provide you with more than just the amount that is owing, here is a list of just some of the information provided on most monthly group benefit statements:

– Breakdown of premium charges per employee by benefit.

– Coverage changes, who the changes were for and what the change was.

– Retro active adjustments.

– Employee Salaries

– Level of coverage per employee, single/couple/family

 It’s important to review the statements in detail because there is some information only you as the employer will know and if any changes need to be made it is up to you to notify the carrier. Review the statement to see if:


– Are all employees listed actually still employed by the company and eligible for coverage? Yes, I have had situations where an ex employee has been left on the plan for years!


– Is there any employee missing from the statement?


– Are the reported salaries all correct? This could impact the amount of coverage an employee has for salary based benefits such as long term disability.


– Is the level of health and dental coverage for each employee correct? Life changes such as marriage, separation, birth of a child can effective the level of coverage. New eligible dependents need to be added to the plan within 31days of becoming an eligible dependent.


– Certain benefits reduce or terminate after a certain age, have you updated your payroll to reflect these changes?

When a request to add a new employee or dependent is received by the carrier after 31 days of them becoming eligible they could be treated as a late applicant. In the case of a late applicant the carrier could request the employee/dependent to submit medical evidence for approval of coverage. When medical evidence is requested the employee/dependent could face a lengthy process involving subsequent requests for additional medical information needed to determine insurability. Potentially the carrier could also decline coverage. The benefit statement can help you determine if any employees or dependents have been missed hopefully before 31 days of them becoming eligible.

A general rule is to have all coverage changes reported to the carrier within 31 days of the change. When changes are reported late you can run into late applicant situations and premium charges that can’t be recovered for ex employees. Making it a point to review your monthly statement can be a great tool to ensure that you are on top of administering the benefits for each employee.