Retroactive adjustments serve the purpose of backdating coverage to the date of a qualifying event (date of birth, marriage, new employment, loss of coverage, award of legal custody) and are a very important part of the enrollment or change process. Retroactive adjustments may require a check or money order from the employee, but not always. The only mandatory retroactive adjustments are for newborns added to an employee’s existing coverage. Most others are voluntary.
Submission of the retroactive adjustment form and payment (if deductions will change) to the State Employee Benefits Division is required within 60 days of the date of the qualifying event. We cannot process a retroactive adjustment if it is received beyond 60 days of the date of the qualifying event. It is best to submit the retroactive adjustment for a qualifying event with the enrollment worksheet.
Retroactive adjustments for newborns are mandatory. There are no exceptions. The retroactive adjustment and payment (if deductions will change) must be submitted with an enrollment worksheet.
In all cases, please contact the University Office of Employee Benefits to calculate the correct retroactive payment amount.
This type of retroactive adjustment is submitted within 60 days of the date you get your first pay stub when:
- the amount of a payroll deduction is wrong because of a keying error by the State Employee Benefits Division. For example, you selected prescription coverage on the worksheet at the Employee & Spouse coverage level, but it was keyed Employee Only. The retroactive adjustment to correct this error would be required within 60 days of the date you received the first paycheck with the incorrectdeduction. You pay the difference between rates back to the original effective date of enrollment. The retroactive adjustment must cover all affected pay periods.
- A deduction is missing from the list of payroll deductions on your pay stub. For example, you selected prescription coverage on the worksheet, but the State Employee Benefits Division did not key the enrollment for prescription coverage. The retroactive adjustment to correct this error would be required within 60 days of the date you received the first paycheck with the missing deduction. You must pay the full deduction back to the original effective date of enrollment. The retroactive adjustment must cover all affected pay periods.
The same 60-day deadline exists; however, it begins on the date the employee gets their first pay stub showing the missing or incorrect deduction.
A retroactive adjustment sent because of an incorrect or missing deduction will require a letter of explanation. Any retroactive adjustment and letter of explanation submitted to the State Employee Benefits Division for missing or incorrect deductions would require a review of the worksheet that was processed to guarantee a keying error occurred.
If a keying error is found, the letter of explanation allows the State Employee Benefits Division to correct the error on your enrollment record. The retroactive adjustment would then backdate coverage as if the error did not occur.
The State Employee Benefits Division cannot make enrollment changes if you did not complete the enrollment worksheet correctly. In this instance, you would have to wait until the next Open Enrollment period to make the desired changes.
In some instances, deductions may be missed or do not occur as a result of missed pay periods due to administrative errors during changes to appointments, or your earnings during a pay period are not sufficient to cover the amount of the deductions. In these instances, you will receive a letter from the State Employee Benefits Division indicating the missed pay period and instructing you to pay the total cost of the premiums (employee portion and state subsidy).
As soon as you receive this letter or notice that deductions did not appear on your Earnings Statement, you should contact the University Office of Employee Benefits (301-405-5654) to arrange for payment of the missed deduction(s). In most cases, you will only need to pay the employee portion of the premium. Do not ignore this letter or that the deduction did not appear on your Earnings Statement. Failure to pay by the deadline in the letter will result in termination of benefits. If termination occurs, you will not be eligible to re-enroll until the next Open Enrollment period.
Some “no-pay” situations will require a letter of explanation by you or your department representative before you are reinstated. The University Office of Employee Benefits will advise you if an explanation letter is necessary.