Insurance: what is the Renewal Process and How to set it up?

Introduction

Insurance benefits usually open once a year for all eligible employees, allowing them to make a selection or a change (if they are already participating in the benefit). This period is usually widely communicated within the company and clients make sure that everyone is aware when they can or can't apply for a benefit. We call this an Annual Renewal Window and have built a Renewal process in SmartPay that allows us to confirm that everyone is eligible before reporting their selection to the client and provider.

This guide will be focused on understanding what this process involves, how we communicate it with members and how to set it up.

Setting the Renewal process up

To set up the renewals, navigate to SmartPay -> Administer -> find your scheme -> Manage -> click on the Products tab -> find the Insurance product you'd like to set renewals for -> click on Manage where you will find the Renewal Process option. Click on the blue link Edit and you'll find the following options:

First, select the renewal type. Currently 2 types of insurance renewals are supported:

• Auto-renewal - when selections (applications) are self-renewing, meaning that once an employee applies, unless they cancel their selection, it will be automatically renewed. (This is the default option in the setup).
• Voluntary renewal - when selections (applications) are not self-renewing. Only selections of employees who apply for the benefit during the window are renewed (the process is again automatic).

Then choose a start date for the renewal window and a renewal date. Once set, the window will open on the selected Renewal Window Start Date and will run until the day before the selected Renewal Date. Please note that once you setup the renewal dates you also need to open an actual window with the same dates, so that employees can apply (setup the window from the Home tab in SmartPay -> Window Scheduler on the bottom of the page)

Finally, to complete the setup, select the action the system should take if the user fails an affordability or eligibility check. You can choose between the below three options:

• Reject - reject the selection
• Step down to combined affordability - amend the selection to the highest amount the employee can afford 
• Step down to fully funded - check if there is fully funded option (if the employer offers cover of the selections for their employees) and if there is one, enrol the user into that option

(Note - when someone falls any of the checks, we send them an email to notify them about the action we've taken. Find more information on Comms at the bottom of this article)

Now we can deep dive into the two types of renewals. For the purpose of the guide let's assume the products are Gross. However, keep in mind that they can be run as Net as well.

Auto-renewal process

The window opens on the Renewal Window Start Date. The system checks employees' eligibility for the current selection based on the new rates. This leads to the following 3 scenarios:

1. If the employee isn't eligible for their current cover, their subscription is canceled and they receive an email which informs them that their selection is stopped and they need to access the platform and make another selection.

2. If the employee can afford the newly submitted amount, then they have no obligation to make a change unless they want to. 

3. If the employee can't afford the newly submitted amount, then their subscription is canceled, they receive an email to inform them that they need to make a new selection.

In cases 1 and 3, the employee will see the Apply Now box on the benefit (this is the same one employees see if they don't have a selection and are eligible for the benefit).

(Please refer to the Comms section to see the content of the emails employees receive in these scenarios.)

In case 2 members see the renewal window info message, their current subscription and the Amend and Cancel buttons. 

Members are able to access the benefit and amend/cancel/apply for the benefit as many times as they want while the window is opened (until the Renewal date). The options they are eligible for vary based on salary, segmentation or the step limits on the benefit. Only the final selection an employee makes before the Renewal date is taken into account at the end of the process. 

On the Renewal date the window is closed and the system runs another round of checks on everyone's final selections. While the products stop everyone from applying if they can't afford or are not eligible for their selection, the system does this to ensure there were no last minute salary or entitlement changes.

If an affordability/eligibility check fails the application is processed based on the selected action in the product setup as described above. The product priority set in SmartPay (SmartPay -> Administer -> Products tab, the list of products) determines the order in which the checks are run and ultimately determines which applications will get rejected if needed.

A full flow diagram for the Auto-renewal process can be found here.

Voluntary renewal

As with the Auto-renewal, the Voluntary renewal process starts by opening the window on the Renewal Window Start Date.

Employees who didn't have an active selection before the window opened will see the standard application box:

Employees who had an active selection before the window opened will see the annual window message and the Reapply button:

Once the employee has applied/reapplied, they will see a new message on top, and the Amend and Cancel buttons below:

The above message informs the employee that their selection will be included in the renewal process. On the pre-set Renewal Date the system will pick up all eligible selections and run the eligibility and affordability checks to ensure everyone is eligible for their selected cover. From there on, the same logic as of the Auto-renewal is followed.

A full diagram process flow can be found here.

Comms

There are 4 different emails employees may receive.

1. Employee fails eligibility check on the Window Start Date: 

2. Employee fails affordability check on the Window Start Date: 

3. Employee fails affordability/eligibility checks on the Renewal Date and their selection have been rejected (when the option Reject is set on the setup):

4. Member fails the affordability/eligibility checks on the Renewal Date and their applications have been amended (when the option Step down to combined affordability/Step down to fully funded is set on the setup):