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Exceptions Process

Health Benefit Representatives (HBRs)
Exceptions Process

To ensure consistency and adherence to both state and federal legislation, it is important that all transactions for new hire enrollments, adding or dropping dependents due to a qualifying life event, and the processing of terminations are completed in a timely manner. For more information, visit the Enrollment Rules webpage. 

The exceptions process allows HBRs to submit requests to make changes that are outside of the State Health Plan's rules and regulations due to: 

  • an administrative change to correct a member's health coverage that is not the fault of the member. For example, the member was provided with incorrect information by the employer and did not enroll within the required time period or the HBR made an error in processing the transaction. 

  • a member wishes to request a variance to an established rule due to extenuating circumstance. For example, the member missed the enrollment period because he/she was out of the country. 

The exceptions request process is not intended for arbitrary requests and will be handled on a case-by-case basis. The Plan will take into consideration the reason for the request, if the request is submitted within a reasonable amount of time, and whether or not granting an approval will be in conflict with state and federal laws.

How to Submit an Exception Request

An exception request form  is required to process your request. Completed forms should be sent to the HBR Inquiry box by using the secure file exchange "Leapfile." All of the transfers are confidential and encrypted. Click here  for instructions on how to securely upload your completed exception forms to the HBR Inquiry box. 

Whenever you need to request an exception, you will simply go to‚Äč and click on "secure upload" and check the HBR Inquiry box. You will be able to send your document along with any message or special instructions. The Plan will then receive a notice that we have a secure message waiting to be retrieved and be able to download your exception request with no risk to the employee's personal information.

For quick access to the secure website, you may find it helpful to save the Leapfile link as a favorite on your desktop.

Only completed forms will be processed. Forms missing required information will be returned.

Download the Exception Form

Important Policies

SHP Enrollment Exceptions and Appeals

SHP Policy on Arrears