National HealthClaim is in the process of migrating all our accounts from Version 2 to Version 3.
Not sure what version you are on?
When you are using ClaimSnap, the version is listed at the bottom of your Settings page.
When you are using the online portal, here are the differences:
Please select what version you are currently on to get the right information:
When you are adding a new employee on the system, there is a step that allows you to enter in a Hire Date.
This is important as it determines how the waiting period and pro-rating is calculated, if you have those features enabled. To view or edit these features, click here to learn how.
Definitions:
Waiting period: The number of days an employee has to wait, after they are hired, before their benefits begin. The system allows an entry of 30, 60, 90, 180, 365 days.
Note: Only once the waiting period has elapsed will employees get a welcome email from National HealthClaim.
Pro-rating: If this feature is on, an employee does not get a full year's limit if they are added mid-year to the account. For example, if an employee is eligible for benefits starting July, they will receive 6/12th (50%) of their limit. This is assuming the standard Benefit Year of January - December.
As a plan administrator, you do not have to calculate these restrictions. The system will handle it automatically, based on the Hire Date you enter when adding the employee.
Note: Waiting period is calculated on a daily basis. Pro-rating is calculated on a monthly basis.
See below example for details:
Sample Calculation
New employee John Smith at Company A
Benefit Year: January 01 - December 31
Waiting Period: 30 days
Pro-rating: Yes
Benefit Category: Part-time Employee with $500 limit
Hire Date: March 01
Results:
Waiting period is calculated on a daily basis. March has 31 days in the calendar month. After a 30-day waiting period, the benefits for John start on March 31.
However, pro-rating is calculated on a monthly basis. Although John is on as of the last day of March, he is technically still within the month. So John is granted 9/12 (75%) of his limit. He has a limit of $375 to use, until his benefits reset on December 31.
If, as a plan administrator, you intend for John to have 8/12 (0.66%) of his limit instead, then you can enter in the Hire Date of March 02, to ensure this happens. So after 30 days, John will land in the April calendar month, and have a limit of $330.
Note: If you leave Hire Date blank when adding an employee, BOTH the waiting period and pro-rating are waived for that individual.
That is a detailed look at waiting period and benefit categories.
Hope that helps!
Summary
This article covers hire date, waiting period, and pro-rating in detail.
When adding an employee to the plan, our system requires a Hire Date. This date is used in combination with Waiting Period and Pro-rating to determine the Employee’s Benefit Start Date and limits for the first year of coverage.
By default we enter in the start date of the plan as the employee's Hire Date, but you should override this date with the employee’s real Hire Date if there is one available.
Get Started
- Waiting Period and Pro-rating Explained
- How It Works
- Review Limits or Make Further Edits After Adding An Employee
Waiting Period and Pro-rating Explained
The Waiting Period is the number of months an employee has to wait after they are hired before their benefits begin. The system allows an entry of 0-6 months.
Please note, only once the waiting period has elapsed will the employee get a welcome email from National HealthClaim.
If Pro-rating is ticked on, an employee’s available credits are adjusted based on the months remaining in the benefit year. If unchecked, an employee receives their full yearly limit.
Pro-rating is also determined monthly, not daily.
For example, if an employee is eligible for benefits starting on the last day of July, they will receive 6/12th (50%) of their limit which includes July's month of limit. This is assuming the standard Benefit Year of January - December.
How It Works
The system calculates the employee's benefit start date and limit once you, as Plan Administrator, do the following:
1. Enter in the employee’s Hire Date. If you do not have this information available, you may keep the default date entered in the system. Calculations will be based on that default date.
2. Select a Waiting Period for the employee.
3. If you are pro-rating the employee’s limit, click the Pro-rating checkbox.
4. Hit “Save.”
Now, based on your selection, a confirmation dialogue will appear with the benefit start date calculation.
In this step, you are able to override the system calculated date by clicking a check mark, and entering in your own desired start date for the employee.
This date is important because it determines the start of their benefits. Only eligible expenses incurred on or after this date are reimbursable. Employees can only submit eligible expenses incurred on or after this date.
5. Click "Finish Employee Add" to finish.
Review Limits or Make Further Edits After Adding An Employee
1. To review what limit the system calculated for the employee, or to make edits to Pro-rating and/or Waiting period after adding an employee, click on their name under the 'Employees' tab.
2. Click on their "Benefit Limits" tab.
Here you can review all the information (including their assigned limits).
Please note, certain fields are only editable within the employee’s first year of coverage as they no longer apply after that. For example, you can only pro-rate the employee’s first year of coverage as after that they are annually granted their full year coverage.
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