Group Life Minimum Hours Worked Eligibility Question

insurehound

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I had a question from one of my Groups regarding the minimum amount of hours needed to be eligible for Group Life Insurance.

Many of the contracts I read usually stipulate that an employee needs to work a minimum of 20 hours a week in order to be eligible for Group Life.

What happens if you have a salaried employee that may work 5 hours one week and 40 hours the next week? Maybe their paid to complete an assigned job or task which can vary from week to week.

If there is a claim, how does the insurance company measure this? Do they pull payroll or is it just an employer statement that needs to be signed? Is it like Group Health where the amount of pay needs to be over what minimum wage equals for 20 hours?

And of course, what a headache to keep enrolling and deleting each employee on a weekly basis depending on their hours.

I have downloaded several claim forms and each company is different. Some ask for payroll, others don't. I am in the process of contacting claims managers to clarify this question. I have called my sales reps which don't seem to really know the answer or want to find out.

I have also reviewed the contracts which do not elaborate on the exact method of calculation used.

I could see an insurance company finding a way to say, "oh, I'm sorry, Joe Smith didn't work 20 hours during the week of May 1, 2011 so we can't pay the claim".
 
Could happen ...but doubt it.....small face amounts....the many living still on the books offsets a claim....if they do pull this lose a chance of losing a big block of biz......
 
I would imagine it is an average hours over a set period of time. Ive never seen the insurance company question this though. The employer states that the employee is full time and averages 20 plus hours and the claim is paid.
 
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