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Membership Processing ExampleAn employee has an actively-at-work date of May 13 and they want coverage to start on that date. The BA has until June 27 to enter the change. If the employee selected June 1 as their start date, the BA would have until July 16 to enter the change.On May 29, an employee makes the initial election and on June 1 they make a change while still within their enrollment window. Even though these transactions may not post on the June bill, it is important to check in bswift for the update. The update must be made by the applicable membership processing guidelines for the selected effective date.What are the processing guidelines for dropping coverage for non-payment of premium?If an employer is cancelling coverage for an employee due to non-payment, the cancellation will be effective in the month in which the termination is processed in the bswift Enrollment Portal or the automated eligibility processing file is received by bswift. For example, if the cancellation is received in April, it will be effective April 1 regardless of the date requested on the form.If you are terminating coverage due to non-payment of premiums, the effective date of the change must be the first of the following month of the non-payment notice. For example, if an employee stopped making payments and their last payment made was Feb. 15, their first day of no coverage would be March 1. For those using the bswift Enrollment Portal, BAs will record this in the special enrollment section of the employee%u2019s record.What happens if an employee voluntarily drops (declines) coverage?An employee cannot elect to drop coverage retroactively; a future cancellation date is required. The employee%u2019s signature date will be used to determine the cancellation date. For example, if the form is signed in August for a Sept. 1 cancellation date, the cancellation will be effective Sept. 1.If the form is signed in September for a Sept. 1 cancellation date, the cancellation will be effective Oct. 1. Entering a termination date outside of guidelines will not be accepted. If you feel you submitted a timely cancellation, the employer may request an exception for a retroactive termination through the bswift Exception and Appeals portal within the membership processing guidelines. Note: If coverage is voluntarily dropped during the plan year, the individual will not be eligible to re-enroll in TRS-ActiveCare until the next enrollment period, unless there is a special enrollment event.What if additional information is needed to complete processing?If bswift receives an incomplete enrollment via the bswift Enrollment Portal, the bswift BA Advocate will contact the BA by phone or email. If the information is not readily available or is not provided to the BA Advocate within three business days, the BA will receive a request for additional information.Request for Exceptions*The following request for exceptions process is separate and apart from an employee%u2019s filing an appeal about a denial of eligibility addressed in TRS Rule, Section 41.51, Texas Administrative Code.Exceptions may be granted for extraordinary circumstances constituting %u201cgood cause.%u201d Exceptions are not a guarantee of coverage reinstatement, billing credit or enrollment. The definition of %u201cgood cause%u201d means that a person%u2019s failure to act was not because of a lack of diligence to reasonably take prompt and timely action. BAs should ask employees to review the first statement they receive after enrolling in coverage to ensure their plan selection and payroll deductions are correct. If the employee waits to request an exception, or the BA does not report the request for an exception in a timely manner, the exception request will not be granted.If an employee or BA submits an exception and it does not meet the guidelines outlined above, it will be denied. Please do not submit an exception if it does not meet these guidelines. Employees and BAs from participating employers will be held accountable for their decisions and must abide by TRS Rules and the TRS-ActiveCare membership processing guidelines.*Find %u201cSteps to Report an Exception%u201d in the BA Manager Guide within bswift.Note: If the BA is unsure if a reason meets %u201cgood cause,%u201d they should reach out to their BA Advocate.40 www.bcbstx.com/trsactivecareba