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Sun Life + Maxwell Frequently Asked Questions

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Allie Schermerhorn

 

Here are some frequently asked questions when it comes to your Sun Life benefits on your Maxwell portal. The following FAQs should answer your most common questions.

Find more general Maxwell FAQs here.

Electronic Data Interchange (EDI) Feeds: 

How does the Sun Life EDI connection work with my Maxwell technology? 

Your Sun Life EDI connection will be live within 10 business days of your implementation being complete. We will automatically take care of getting your employee’s latest enrollment information over to Sun Life. Ongoing, the feed will send weekly on Monday mornings and include changes to employee’s Sun Life elections (i.e. new hire, terminations, qualifying life events) that have occurred in the portal since the last file was sent. Any changes made in the portal on Monday will be sent in the following week’s file. Changes sent on the feed typically take 24-72 hours to fully process in Sun Life.

For information on EDI for non Sun Life benefits, click here.

Can the EDI feed(s) be set up to send COBRA enrollments to Sun Life and our other carriers? 

EDI feeds from Maxwell do NOT send COBRA enrollments to any carriers.

  • EDI feeds will send enrollments and terminations to specific carriers; however, these feeds will not include COBRA enrollments.
  • Integrations are available to have COBRA eligibility sent to COBRA administrators that can accept a standard EDI file.
  • In some cases, TPAs can set up EDI feeds to send COBRA enrollment information to Sun Life and/or other carriers on your behalf.

For more information see COBRA.

Evidence of Insurability (EOI) + Sun Life: 

As an Administrator, what do I need to care for regarding EOI for my employees? 

No administrator approval is needed at any point during the EOI application process for Sun Life benefits in your Maxwell portal. Once an employee completes their EOI application and is approved, this will automatically be updated in the Maxwell portal. You can check on the status of an employee’s EOI approval via the Sun Life Connect portal. The Pending Elections Report can be run in the Maxwell portal to see employees with pending volumes of coverage.

How will my employees be notified they need to complete EOI for a plan they’ve elected?  

If an employee enrolls in a product over the Guaranteed Issue (GI) they will receive an email from Maxwell within 2 business days advising them to complete their EOI application. The email will contain instructions to help employees log in to Sun Life Connect and complete their EOI application. This will include their group number and the URL of the website where they should log in. They will also need their Social Security Number, which will not be provided in the email.

How will a dependent be notified if they need to complete the EOI application?

When the employee is notified that they can complete their application, they will also be required to complete any necessary dependent applications at that time.

How quickly will a decision be made after an EOI application is completed by the employee and/or dependents?

This will vary. Some approvals and denials are very quick (happening within minutes), while others require Underwriting review and as such, take longer (usually 1-5 business days unless additional information is required from the employee). However, within 2-3 business days of the decision being made, the election will be updated in the Maxwell portal.

How will a Client’s HR administrator and/or employee be alerted when a decision is made?

This will not change from the current Sun Life process: the administrator will be alerted via an email from the Medical Underwriting team, and the member will be alerted via mail and email (as long as the member has indicated to be notified by email in SunLife Connect).

Note: Any non-Sun Life benefits that require EOI will need a more manual administration effort. Our About Evidence of Insurability article will walk you through this process. 

Accessing Benefits 

How can my employees access their Sun Life benefits? 

Employees should download the Sun Life mobile app to access their dental and vision ID cards as well as search for what providers are in network. 

Sun Life Connect

What should we be using Sun Life Connect for?  

  • Viewing and printing your bills
  • Paying bills online and setting up automatic payments
  • Easily accessing and download forms
  • Viewing claims status and claims payment details
  • Checking status of EOI 

Can I access Sun Life Connect through Maxwell?  

Admins logged into Maxwell can quickly access Sun Life connect by clicking on either the Sun Life Resources tab or on any of the Sun Life Connect Links listed in various areas of the portal.

Below are a few examples of where you can access Sun Life Connect from within Maxwell:

Sun Life Resources Tab

SLResourcesTab.png

Reports

SLReportsBanner.png

Pending EOI Banner

When an employee has requested coverage that requires Evidence of Insurability (EOI), you can see if the status is still pending directly on the benefit from their profile. You can also log in to Sun Life Connect to see more details.

SLBannerEOI.png

 

I managed Sun Life benefits in Sun Life Connect prior to using Maxwell. My access seems different when I log in to Sun Life Connect now. Has something changed?

Many of the actions you were taking in Sun Life Connect to manage employees and their benefits, will now be performed in your Maxwell portal. Your access in Sun Life Connect has been modified to reflect that. 

  • Manage employees is not available from the main menu
  • Upload census will no longer show as an option under Bills. 
    • You can utilize reporting in Maxwell to see a census of your employees, their coverage, and dependents.
    • The Bulk Upload tool can be utilized to add multiple new hires to your Maxwell portal at once.
  • You can View & print bills on Sun Life Connect, but member/payroll deductions will be available in Maxwell

Sun Life Billing & Support 

When and how will we receive our Sun Life bill? 

Your first bill will be available when you receive your Case Install Email (this will come a few weeks after your open enrollment has ended). Depending on the benefits you are offering, you will receive your bill at different times:

  • Dental, Vision, Basic Life & AD&D, STD, and LTD are all billed in “Advance” 
  • Supplemental benefits (Accident, Critical Illness, Cancer Indemnity, and Hospital Indemnity “Gap”) are billed in “Arrears” and will come later  
  • Voluntary Life & AD&D, Voluntary STD, and Voluntary LTD can be either billed in Advance or Arrears (based on what was selected on the Employer Information Form)

Your Sun Life billing questions or discrepancies should be directed to Sun Life CSS via phone at 800-247-6875 or email at clientservices@sunlife.com.

Who should I reach out to if I have questions regarding my Sun Life benefits or Maxwell portal? 

Depending on your need, you'll want to direct your questions to the experts: 

  • Sun Life Client Service - for assistance with plan administration capabilities for all your Sun Life benefits. You'll want to use Sun Life Connect to:
    • View and print your bills
    • Pay bills online and set up automatic payments
    • Easily access and download forms
    • View claims status and claims payment details
    • View status of Evidence of Insurability (EOI) applications
  • Maxwell Technology Support - for assistance with managing employee information and benefits or technical support questions while using Maxwell. You'll use Maxwell to: 
    • Add new hires and get them enrolled in benefits
    • Submit life events and update an employee's coverage
    • Run an annual open enrollment for employees
    • Edit employee information
    • View employee benefit deductions and run reports

Sun Life’s Key Contacts resource outlines this is greater detail. 

COBRA

Can employees (or eligible dependents) enroll in COBRA coverage through the Maxwell portal?

Employees will not log into Maxwell Health to make their COBRA elections. Maxwell does not act as a COBRA administrator, but you can use Maxwell to manage qualifying events that cause an active employee to be eligible for COBRA coverage. To learn more about how to mark an employee COBRA eligible during a COBRA qualifying event, please refer to the “Managing COBRA Events in Maxwell” Resource Center article.

While Maxwell does not act as a COBRA administrator, we do offer integrations with COBRA administrators, through our Marketplace for an additional cost.   We also have the ability to connect with any COBRA vendor that can accept our standard EDI eligibility file.

Reminder: This information should be sent to Sun Life and/or other carriers via your COBRA administrator, or by you if you are administering your own COBRA

  • Please send all Sun Life COBRA eligibility updates to customeradvocacy@sunlife.com with the following details:
    • Policy Name
    • Policy Number
    • Employee’s Name
    • Employee’s Last 4 of SSN or Member ID
    • Coverages extended with COBRA
    • COBRA effective date
    • COBRA reason

Can the EDI feed(s) be set up to send COBRA enrollments to Sun Life and our other carriers?

EDI feeds do NOT send COBRA enrollments to any carriers.

  • EDI feeds will send enrollments and terminations to specific carriers; however, these feeds will not include COBRA enrollments
  • Integrations are available to have COBRA eligibility sent to COBRA administrators that can accept a standard EDI file
  • In some cases, TPAs can set up EDI feeds to send COBRA enrollment information to Sun Life and/or other carriers on your behalf

The EDI feed between Maxwell and Sun Life will not contain any COBRA related information

    • This information should be sent to Sun Life and/or other carriers via your COBRA administrator, or by you if you are administering your own COBRA
    • If you are self-administering COBRA, please send all Sun Life COBRA eligibility updates to customeradvocacy@sunlife.com with the following details:
      • Policy Name
      • Policy Number
      • Employee’s Name
      • Employee’s Last 4 of SSN or Member ID
      • Coverages extended with COBRA
      • COBRA effective date
      • COBRA reason
      • COBRA cancel date

Massachusetts Paid Family Medical Leave

How do I manage eligibility for Massachusetts Paid Family Medical Leave in our Maxwell portal?

You should indicate eligibility for this coverage when you are adding an employee as a New Hire to your Maxwell portal. You should see a dropdown field to indicate eligibility:

MA_PMFL_Elig_Indicator.png

  • You can always update this eligibility throughout the year by updating this field on your employee's profile.
  • If an employee is not benefits eligible (i.e. Part Time), but is eligible for Massachusetts Paid Family Medical Leave (MA PFML)  coverage, you are responsible for confirming their eligibility directly via email to customeradvocacy@sunlife.com. Please include in your email the following information:
    • First Name
    • Last Name
    • Date of Birth (DOB)
    • Date of Hire (DOH)
    • Gender
    • Annual Salary
    • Benefits Covered (MA PFML only in this instance)
    • Date of Change of Status and any other benefit termination dates (if no longer eligible for any other benefits)
  • Your Sun Life EDX connection will send eligibility for MA PFML, alongside your other benefit enrollments, weekly on Mondays.
  • For more information on Massachusetts Paid Family Medical Leave coverage with Sun Life, please check out the following resources (and pass along the Members video to your employees):
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