What are Eligibility Groups in Maxwell?

The eligibility group an employee is in can determine what benefits are offered to them and when they are eligible for the benefit. Reasons why your portal may need eligibility groups are:

  • Benefit offerings - Separate eligibility groups are required if there are groups of employees that receive different benefit offerings.
    • Example: Executives get LTD Class 1 plan and All Other employees get the LTD Class 2 plan.
  • Different contribution strategies amongst employees - Separate eligibility groups are required if there are groups of employees that receive different contribution strategies.
    • Example: Medical is 100% employer paid for Executives but only 50% ER paid for All Other Employees.
  • New Hire Waiting Periods - eligibility groups are required if there are groups of employees that have different waiting periods before their plan becomes effective.
    • Example: Executives have a NHWP of Date of Hire + 0 days and All Other Employees have a NHWP of First of the Month following 30 days from hire.
  • Different Payroll Frequencies (Payroll Period) - Separate eligibility groups are required if there are groups of employees that have different payroll frequencies.
    • Example: Full-Time employees have a Semi-Monthly payroll period and Part-Time employees have a Bi-Weekly payroll period.
  • Different Payroll Schedules (Payroll Calendar) - Separate eligibility groups are required if there are groups of employees that have different payroll schedules.
    • Example: Full-Time employees have 26 pay dates and Part-Time employees have 20 pay dates.
  • Ineligible employees - certain groups of employees might not be eligible for any benefits and require a separate eligibility group.
    • Example: Ineligible Employees, Part-Time, Interns

Before you started using Maxwell, the Maxwell Team set up these groups after obtaining information from you about how you categorize or group your employees. You can find them under People > Eligibility Groups.

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You may have different eligibility groups set up in Maxwell. Eligibility groups were customized by you and the Maxwell Team for your needs specifically. And don’t worry, the name of eligibility groups are not visible to employees, only to Administrators.

How eligibility groups are used

You will always have at least one eligibility group in Maxwell

  • For example, you may just have one eligibility group called "All Employees".

If you have differences between subsets of your employees, such as different eligibility for products, you may have more than one eligibility group.

  • For example, you may offer your in-state employees different medical plans than your out-of-state employees.  
NOTE: Standard Administrators can only view the eligibility groups that a Master Administrator has granted them access to. Reach out to our Support Team if you need access to an eligibility group. For more information, read about Administrator permissions.

Moving an employee to a different eligibility group

There may be occasions where you need to move an employee to a different eligibility group.

  • For example, you may have an employee who is in the “Out of State” group, but they’ve moved in-state to work at your company’s headquarters, so they need to be moved to the “In State” group.

You'll want to make sure the employee’s eligibility group is updated because that change will update the set of products and rates they’re eligible for. Updating the eligibility group ensures the right information shows when that employee has the ability to shop.  Follow these instructions if you need to move an employee to a different eligibility group.

Please note: Eligibility groups were customized by the Maxwell Team after you submitted information on how you wanted your employees to be grouped. It was set up for your needs specifically. Based on overall user experience and system performance, Maxwell supports a maximum of 25 eligibility groups for an employer.  If you have questions about your eligibility group setup, please reach out to your implementation consultant, or contact support@maxwellhealth.com.

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