(Implementer) How do Evidence of Insurability (EOI) work on GoCo?

Do employees have to fill out an Evidence of Insurability form? GoCo can help with that workflow!

As an implementer in GoCo you have a few options on how you want EOI notifications to work. You'll find these options under the Benefit Processors tab when building a line that may require an EOI form (Voluntary Life, Voluntary STD, Voluntary LTD, etc.).

There are three categories you need to specify:

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1. Benefit Processors

Decide who is responsible for processing the benefit enrollments for the policy with the carrier. This is typically the implementer or broker, but GoCo lets you choose a few options from a dropdown.

2. Who submits the EOI to the carrier?*

Most commonly and to be HIPAA compliant, employees should be submitting their own forms to the carrier. This is recommended because the forms include a lot of personal questions they may not want their employer, or even their broker, to see.

If you do set this to the employee, you must also include submission instructions. Where do they mail / email the completed form to? You can type in whatever you'd like.

Here's what submission instructions typically look like to get you started:

Print, fill out and send completed form to:

Acme Insurance Co.

P.O. Box 123

New York, NY, 10001

The carrier will approve or reject your request.

If you want to set the submitter to the admin or broker you can do so from the drop-down. If you do this, they will get a separate notification on the Benefit Sync Dashboard to submit the EOI. They should Sync the task when they have submitted it:

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3. Who enters whether the EOI was approved or rejected on GoCo?*

Once the EOI is submitted to the carrier (by the employee, admin, broker, etc.), the carrier will make a decision on if they want to approve the benefit coverage or not. The carrier will communicate an approval or rejection to the company contact, who should then update GoCo.

This setting allows the admin (company contact with carrier) access to the approval/rejection page. This is located on the Company Benefits > Forms tab and should be updated when the carrier sends communication about any decisions:

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Misc. questions you may have:

  • Q: Will employees always have to fill out an EOI?
    • A: This is up to you and the settings you choose in GoCo! It depends on the Guaranteed Issue and Coverage Change Rules section. Refer to this article for more details.

  • Q: Where do I find EOI submission instructions from the carrier?
    • A: You can usually find the submission instructions on the EOI form you get from the carrier

If you have any questions on how variations of above will work, please email us at help@goco.io!