Employers: Eligibility Changes

Employers should transmit employee eligibility updates to SHBP as often as possible, and no later than 30 days of any eligibility changes. All eligibility records transmitted by Employers are considered accurate as it is an Employers responsibility to determine the eligibility status of its employees. Failure to transmit records in a timely manner will result in inaccurate billing. For other information and timeframes for transmitting employee records, please review the Plan Documents.

SHBP Approved Record Types

The list below includes the approved Record Types accepted by SHBP to transmit employee eligibility records from Boards of Education and other Employer Locations not participating in SAO Peoplesoft. The State Accounting Office transmits employee eligibility records on similar approved Record Types to SHBP with slightly different names and action codes on behalf of State Agencies and Employer Locations Participating in SAO Peoplesoft.

Employers should choose the Record Type based on the applicable employee eligibility transaction.

Record Type Applicable Employee Transactions to the Record Type
NEMP
  • New Hire
  • Transfer-In
  • Rehire
  • Retiree Returning to Employment (Indicate “Y” in the SHBP Eligible Field for Retirees Returning to a benefits eligible position; Indicate “N” in the SHBP Eligible Field for Retirees Returning to a benefits ineligible position)
  • Employee who does not currently have an employee record in the SHBP Enrollment Portal. See MISC Record Type below for employees who currently have an employee record in the SHBP Enrollment Portal
TERM*
  • Terminated Employee
  • Transfer-Out
  • Retiree Returning to Retirement
RETR*
  • Retired (Employee Terminating Employment Due to Retirement)
MISC*
  • Newly Eligible Employee who has an employee record in the SHBP Enrollment Portal that requires an update from “N” to “Y” for their SHBP Eligibility status
  • Newly Ineligible Employee who has an employee record in the SHBP Enrollment Portal that requires an update from “Y” to “N” for their SHBP Eligibility status
  • Miscellaneous updates to an employee’s record currently in the SHBP Enrollment Portal including: Name, Social Security Number, Date of Birth, Gender, Address, City, State, Zip Code, Phone Number, or Salary.

NOTE: At least three of the following four (4) items must match current data in the SHBP Enrollment Portal or the MISC Record will produce an error: First Name, Last Name, Date of Birth, Gender. For certain changes, the Employer Services Specialist will request additional documentation.
DCSD* Deceased Employee.
KLOD* Employee who is killed in the Line of Duty.
LOFF* Employee who is laid off making them ineligible for SHBP coverage.
RHRS* Employee whose hours are reduced making them ineligible for SHBP coverage.

*Assumes Employer has previously transmitted a successful employee eligibility record to the SHBP Enrollment Portal.