How Do Eligibility Rules Work in the Portal?
Eligibility rules define which employees and dependents qualify for coverage under your Self Fund Health plan. These rules are set at the group level and control who appears as eligible when managing census data.
👉 Full details here:
That guide explains how to:
- Review the eligibility rules configured for your group
- Understand which employees (full-time, part-time, waiting period, etc.) qualify for coverage
- Confirm how dependents (spouse, children) are treated under your plan
- Update or request changes to your eligibility rules if your company policies change
Why it matters: Clear eligibility rules ensure accurate enrollment, correct billing, and compliance with your plan design—helping avoid costly errors or delays in coverage.