This page (revision-37) was last changed on 26-Nov-2021 10:22 by rforbes

This page was created on 26-Nov-2021 10:22 by JEscott

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Version Date Modified Size Author Changes ... Change note
37 26-Nov-2021 10:22 20 KB rforbes to previous BSS_EVIDENCE_REQ(System_Preference) ==> BSS EVIDENCE REQ(System_Preference)
36 26-Nov-2021 10:22 20 KB jmyers to previous | to last BSS D REASON REQ ==> BSS D REASON REQ(System_Preference)
35 26-Nov-2021 10:22 20 KB jmyers to previous | to last BSS_EVIDENCE_REQ ==> BSS_EVIDENCE_REQ(System_Preference)
34 26-Nov-2021 10:22 20 KB jmyers to previous | to last
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Page References

Incoming links Outgoing links
OPEN ENROLLMENT SET UP
OPEN ENROLLMENT SET UP

Version management

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[{TableOfContents }]
!!!OPEN ENROLLMENT SET UP
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!Step 1: IBPT – Define Benefit Plan Types
!!Step 1: IBPT – Define Benefit Plan Types
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;[Plan Type|PLAN_TYPE_CODE]:This field holds the defined plan type code that uniquely identify the plan type. The Plan Type will be displayed in the [WEBOEE] form so it should be reflective of the plans within the type.
;[Sequence|CALCULATION_SEQUENCE]:The Calculation Sequence field determines the order in which this plan type will be processed by payroll. This sequence is also used by the BSS module to determine the order the plan types are displayed to the employee in the election form ([WEBOEE]). If a sequence is not defined, the plan types will display in alphabetical order. Calculation_Sequence is a 5-digit numeric field provided by High Line but may be user altered.
;[Recipient Type|RECIPIENT_TYPE]:This can be used to define a recipient type if all of the plans linked to the plan type allow the same type of recipient to be enrolled. If an employee is only allowed to elect themselves in the plan, ‘Not Applicable’ should be used. If the plans allow for different participant types a recipient type can be defined at the coverage level. This field is used by the BSS module only. Recipient_Type is a fixed lexicon ([X_PLAN_RECIPIENT_TYPE])
;[Plan Type|PLAN_TYPE_CODE]:This field uniquely identifies the plan type. The Plan Type will be displayed in the [WEBOEE] form so it should be reflective of the plans within the type.
;[Sequence|CALCULATION_SEQUENCE]:The Calculation Sequence field determines the order in which this plan type will be processed by payroll. This sequence is also used by the BSS module to determine the order the plan types are displayed to the employee in the election form ([WEBOEE]). If a sequence is not defined, the plan types will display in alphabetical order. This sequence is automatically provided, but may be altered.
;[Recipient Type|RECIPIENT_TYPE]:This field is used by the BSS module only. This can be used to define a recipient type if all of the plans linked to the plan type allow the same type of recipient to be enrolled. If an employee is only allowed to elect themselves in the plan, ‘Not Applicable’ should be used. If the plans allow for different participant types a recipient type can be defined at the coverage level. The type of recipient defined will filter the list of benefit recipients available to the employee for that plan during the election period. The filtration is done by comparing the recipient type lexicon values to the stored values of the [relation lexicon|X_RELATION] in [IECT]. The system will check for a recipient type at the coverage first, if none are found it will then check the plan type to see if one has been defined at that level. If the system cannot locate a recipient type for either the coverage or plan type, all of the employee’s contacts defined in [IECT] will be listed for the employee to elect. The page [Benefit Recipient Matrix for Open Enrollment|BENEFIT RECIPIENT MATRIX FOR OPEN ENROLLMENT] shows which relation values fall under each of the recipient types.
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!!Step 2: IMLN- Maintain Lexicons
A common requirement of benefit elections is that an employee is eligible to a set of plans that are offered from different carriers and are mutually exclusive of one another (the employee is only allowed to elect one plan from the set). The application is able to handle this requirement by grouping these plans into a “[Plan Election Set|PLAN_ELECTION_SET]”. A plan set code is used to group these plans together. The plan set code is user defined in a lexicon called [X_PLAN_ELECTION_SET] in [IMLN]. The plan set code should be reflective of the type of plans included in the set. The plan set code is then added to [IBPN] to each of the plans to be included in the set.
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Before employees can submit their elections, they may be prompted for a decline reason for the elections they declined. This decline reason is based on the lexicon [X_BE_DECLINE_REASON]. This is a user defined lexicon which clients should populate with suitable decline reasons, unless the client will not be requiring decline reasons in which case the lexicon does not need to be updated.
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!Step 2: IMLN- Maintain Lexicons
A common requirement of benefit elections is that an employee is eligible to a set of plans that are offered from different carriers and are mutually exclusive of one another (the employee is only allowed to elect one plan out the set). We are now able to handle this requirement by grouping these plans into a “[Plan Election Set|PLAN_ELECTION_SET]”. A plan set code is used to group these plans together. The plan set code is user defined in a lexicon called [X_PLAN_ELECTION_SET] in [IMLN]. The plan set code should be reflective of the type of plans included in the set. The plan set code is then added to [IBPN] to each of the plans to be included in the set.
!!Step 3: IMST – Define Client Site Information
By default decline reasons are required; however, if it is a client’s policy not to require reasons for declines, the site preference [BSS D REASON REQ|BSS D REASON REQ(System_Preference)] must be defined in [IMST] with a value of N.
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Before employees can submit their elections, they are prompted for a decline reason for the elections they declined. This decline reason is based on the lexicon [X_BE_DECLINE_REASON]. This is a user defined lexicon which clients must populate with suitable decline reasons.
The site preference [BSS EVIDENCE REQ(System_Preference)] may be defined with a value of Y to force an employee to provide Evidence/Documentation during the Open Enrollment before they can submit their elections. If this is defined with a Y a validation message will be displayed to the employee. If a value of N is provided, the employee will still be prompted to submit evidence however they will still able to submit their elections if no evidence is uploaded.
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!Step 3: IMST – Define Client Site Information
By default decline reasons are required; however, if it is a client’s policy not to require reasons for declines, the site preference [BSS D REASON REQ] must be defined in [IMST] with a value of N.
!Step 4: IPPGU / IPPGC – Define US/CDN Pay Categories
!!Step 4: IPPGU / IPPGC – Define US/CDN Pay Categories
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!Step 5: IPPF – Define Processing Frequencies
The new pay category must be added to all of the pay frequencies that are used by the benefit plans associated to the Events for Open Enrollment. The Times Per Year field for this category must be populated with the number of times per year that the benefit plan is to be processed by payroll. This number will be used in conjunction with the rate basis for the category in the EE and ER calculations.
!!Step 5: IPPF – Define Processing Frequencies
The new pay category must be added to all of the pay frequencies that are used by the benefit plans associated to the Events for Open Enrollment. In [IPPF], the [Times Per Year|TIMES_PER_YEAR] field for this category must be populated with the number of times per year that the benefit plan is to be processed by payroll. This number will be used in conjunction with the rate basis for the category in the EE and ER calculations.
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!Step 6: IBPN – Define Benefit Plans/Coverages
!!Step 6: IBPN – Define Benefit Plans/Coverages
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;Plan Details
;[Description|DESCRIPTION]:The description of the benefit plan should be descriptive of the plan as this will be displayed to the employees.
;[Plan Election Set |PLAN_ELECTION_SET]:Specify a plan set code if the benefit plan is part of a Plan Election Set. The plans within the Plan Election Set must be part of the same plan type. Since Plan Election Sets are used when plans are mutually exclusive of one another, they can only be implemented if the client already restricts the employees to only enroll into one plan. If employees are currently enrolled in multiple plans that are to be included in the same plan election set, the enrollments for these plans must be first declined before the plans can be tied to a plan election set, otherwise there will be errors when the OE period is generated. This field is tied to the lexicon [X_PLAN_ELECTION_SET].
;[Open Enroll Allowed |OPEN_ENROLLMENT_ALLOWED]:If the benefit plan is to be included in the Open Enrollment process then the Open Enroll Allowed field must be populated with either ‘Always Open’ or ‘OE Periods Only’. 'Always Open' will ensure that the benefit plan is always open to employees to elect into. 'OE Periods Only' ensures that the benefit plan is only open during the OE Period. If the benefit plan is never to be used by the Open Enrollment process then select ‘Never Open’. This field is tied to the lexicon [X_BE_OE_ALLOWED].
;[Approval Required|APPROVAL_REQUIRED]:Approval logic is required for Open Enrollments and can be enabled at the plan level. All employee Open Enrollments must be first approved before they can be processed into enrollments in [IBEN]. The approval is made at the employee Open Enrollment level, not at a benefit election level meaning that the Administrator will not be approving each election change but the employee’s overall participation in the Open Enrollment.\\ \\However, should there be the need to have the approval process be different for certain plans within the Open Enrollment, the Administrator can tailor the approval process using where clauses that take this field into account. For example, the client may decide that a specific plan requires approval for changes only.\\ \\This field is also taken into account by [IBEL] when elections are made outside of the Open Enrollment process.\\ \\Clients can choose:\\No Approval Required - This is used in [IBEL] to indicate an election into the plan does not need approval.\\Approval Required – Approval is required for Open Enrollments with new elections, existing elections with changes and declined election\\Apr Req for Chgs Only – Approval is only required for changes made to elections.\\ \\If no plans in the employee’s open enrollment require approval, then no specific approval process will be called. However, since the enrollment must still be approved in order for it to be processed, a generic approval process will display.
;[Display Sequence|DISPLAY_SEQUENCE]:A display sequence is used to determine the order the benefit plans are listed in the [WEBOEE] form in Self Service.
;[Grandfathered|GRANDFATHERED]:This will indicate if the benefit plan has been ‘grandfathered’. This field is currently only supported in Open Enrollments, it is not currently respected in [IBEL]. Employees who are currently enrolled in a grandfathered plan will have the ability to change coverage within the plan, as long as the plan is set up for Open Enrollment. Employees not enrolled in a grandfathered plan will not see the plan in their election options.
;[Do Not Split Enrollment When No Change| ]:When toggled, this indicates to [UBPOE] to not create an effective record in [IBEN] when the employee does not make any changes to their enrollment of the plan/coverage. If an employee makes a change or if there are rate changes, the system will create a new effective record.\\ \\If an employee only makes a change to their elected recipients, regardless of this toggle being toggled on or off, the system will not create a new effective record in [IBEN]. This is due to the Recipient table (BBR) not being configured in the database to support date effective changes.
;[Required Documents|ELECTION_INTRO_TEXT]:Any documents that are required to be uploaded by the employee during the Open Enrollment must be listed here. This field will be visible in the third tab in [WEBOEE] to indicate to the employee what documents are needed for each plan. If none of the coverages in the plan require documentation, this field should be left blank.
\\
;Coverages
;[Recipient Type|RECIPIENT_TYPE]:This field is used for Open Enrollments and determines the type of recipient eligible for the coverage. If the coverage is only available to the employee, ‘Not Applicable’ must be selected. The type of recipient defined at the coverage will filter the list of benefit recipients available to the employee for that plan during the election period. The filtration is done by comparing the recipient type lexicon values to the stored values of the [relation lexicon|X_RELATION] in [IECT]. The system will check for a recipient type at the coverage first, if none are found it will then check the plan type to see if one has been defined at that level. If the system cannot locate a recipient type for either the coverage or plan type, all of the employee’s contacts defined in [IECT] will be listed for the employee to elect. The page [Benefit Recipient Matrix for Open Enrollment|BENEFIT RECIPIENT MATRIX FOR OPEN ENROLLMENT] shows which relation values fall under each of the recipient types.
;[Display Sequence|DISPLAY_SEQUENCE]:This will determine the order the coverages are listed within the plans in [WEBOEE].
;[Waiting Period|WAITING_PERIOD]:If there is a waiting period before an employee is eligible for the plan, specify the number of days.
;[Minimum hrs/wk|MINIMUM_HOURS_PER_WEEK]:Used when an employee must work a minimum number of hours per week to qualify for the plan.
;[Max # Recipients|NUMBER_RECIPIENTS]:If the coverage is only available to a specific number of recipients, define the maximum number allowed.
;[Max Child Age|MAXIMUM_CHILD_AGE]:If the coverage is open to children and there is an age restriction, state what the maximum child age is. The election process will verify the recipient’s age based on their birth date defined in [IECT].
;[Max Student Age|MAXIMUM_STUDENT_AGE]:If the coverage is open to students and there is an age restriction, state what the maximum student age is. The election process will verify the recipient’s age based on their birth date defined in [IECT]. This will only be in effect for those recipients who are defined as Students in [IECT].
;[Max. Disabled Age|MAXIMUM_DISABLED_AGE]:If the coverage is open to dependents and there is an age restriction in place for disabled members, this field is used to store the maximum age allowed for disabled members. If there is no age restriction, 999 may be entered as the age. The election process will verify the recipient’s age based on their birth date defined in [IECT]. The disabled recipient must have the Disabled Indicator toggled ON in [IECT].
;[Evidence Required|EVIDENCE_REQUIRED]:If evidence is required before an employee can be enrolled into a plan, then this should be toggled ON.
;[Estimated Costs|ESTIMATED_COSTS]:If the EE and ER costs are based on estimated earnings the Estimated Costs toggle should be checked ON. With this ON there will be a notation displayed for the coverage’s cost in [WEBOEE].
;[Pre Tax|PRE_TAX]:With this toggle checked ON, this will identify to the employee in [WEBOEE] if the coverage is Pre Tax or Not.
;[Exclude From OE|EXCLUDE_FROM_OPEN_ENROLLMENT]:A coverage may be excluded from an Open Enrollment by checking this toggle ON.
\\Coverage Details
;[Description|DESCRIPTION]:The description of the coverage is displayed in the [WEBOEE]. Ensure the description is descriptive of the coverage and is not too long.
;[OE Questions| ]:This field allows the Benefit Administrator to select an assessment from [IBAS]. Assessments may now be linked to a coverage allowing questions to be asked and responded to during on Open Enrollment period. If an employee elects a coverage with an assessment, an assessment event will be scheduled automatically. If there are mandatory answers within the assessment the employee will not be able to submit until the mandatory questions have been answered.
\\
;Components
;[OE Enter Elections|ENTER_ELECTION]: This is only used in BSS for Open Enrollments. This toggle must be checked if an employee must submit information before electing a coverage, such as a Deduction amount for a Flex Spending account. This will prompt the employee for the necessary information. Again, if the BC is not visible in [IBEN] then the BC will not be visible in [WEBOEE]. This field is not to be used to allow employee’s to override a system calculated amount. Its intent is to only allow employees elect a dollar amount of their choosing.\\The Allow Value Override toggle must also be checked in order for the BC to display in [WEBOEE].
;[Allow Value Override|ALLOW_VALUE_OVERRIDE|Allow Value Override]: In order for the Employee and Employer Costs to display in [WEBOEE] and [IBPOE], this toggle must be checked ON for [BC-B0840] and [BC-B1040].
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!Step 7: IBSC – Define Benefit Schedule
!!Step 7: IBSC – Define Benefit Schedule
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\\ \\New to the [IBSC] are the [Waiting Period (Days)|WAITING_PERIOD] and [Minimum Hrs/Week|MINIMUM_HOURS_PER_WEEK] fields. Any data supplied here will override what has been defined for the coverage.
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New to the [IBSC] are the [Waiting Period (Days)|WAITING_PERIOD] and [Minimum Hrs/Week|MINIMUM_HOURS_PER_WEEK] fields. Any data supplied here will override what has been defined for the coverage.
!Step 8: IDGR – Define Groups
!!Step 8: IDGR – Define Groups
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!Step 9: IBET – Define Benefit Event Types
!!Step 9: IBET – Define Benefit Event Types
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Clients are required to define event types that will suit their needs, this is done in the [IBET] form. Common event types are Mass Open Enrollment, Birth of Child, Marriage, Adoption, Divorce, New Hire, Termination etc..
Clients are required to define event types that will suit their needs, this is done in the [IBET] form. Common event types are Mass Open Enrollment, Birth of Child, Marriage, Adoption, Divorce, New Hire, Termination etc.
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;[Event Type |BE_EVENT_TYPE_CODE]:This is the Event Type code used to classify events, whether those are life events, work events, mass open enrollment or ad hoc events. These are user defined.
;[Open Enroll Type |OPEN_ENROLLMENT_TYPE]:This determines if the event is a life/work event, a mass open enrollment, an ad hoc event or an event that is Always Open.
;[Description |DESCRIPTION]:This provides a brief description of the event. This description will be carried over to [IBOE] when an OE period is created. If a description is provided in [UBOE] it will override the description in [IBOE]. This is also what is displayed to the employees in [WEBEV] for the life/work events.
;[Days Open |DAYS_OPEN]:This states how long the enrollment is to be left open. This is used to calculate the Open Enrollment End Date for life / work events.
;[Proof Required|PROOF_REQUIRED]:If employees are required to submit proof that the event took place, this toggle should be turned ON. For example, some carriers require a birth certificate or a marriage license.
;[Allow Auto Open Enrollment|ALLOW_AUTO_OPEN_ENROLLMENT]:This toggle allows an open enrollment period to be automatically generated if a life/work event is recorded in [WEBEV] / [IBEV]. This is only used for life/work events. If the toggle is not checked for any plans associated to the event, an Open Enrollment will not be created and the Administrator is responsible to create the Open Enrollment period for the employee.
;[Standing|STANDING]:This allows the BE Administrator to define which events are available to use and which ones are no longer in commission. The lexicon options are Active, Frozen and Obsolete.
;[Event Type URL|BE_EVENT_TYPE_URL]: This field allows clients to include a URL for employees to gain more information on the event.
;[Event Type Text|BE_EVENT_TYPE_TEXT]:This field allows for more information to be posted on the actual event type. This will also respect basic HTML tags. Again, this will be carried over to [IBOE].
\\
;Plans Affected
;[Plan Election Set |PLAN_ELECTION_SET]:If there are Plan Election Sets that are to be included in the event, users can specify the Plan Election Set instead of listing each plan individually. This will group the plans within the plan set together.
;[Plan|PLAN_CODE]:Plans that are not part of a Plan Election Set but should be included in the enrollment should be listed individually.
;[Description|DESCRIPTION]:This is the benefit plan description which will default in once the plan has been selected.
;[Election Required |ELECTION_REQUIRED]:This is used to force the employee to elect a coverage from a plan. This toggle will default as checked ON if the plan’s participation rule is ‘Required’. For Plan Election Sets, if one plan in the set has ‘Required’ defined as the participation rule, then the toggle will be checked ON. This can be used to override the Participation rule for Open Enrollments by selecting or unselecting the toggle.
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!Step 10: IMFD – Maintain Form Definitions
In order for the employees’ election choices to be automatically saved when entered in [WEBOEE] the Auto Commit preference must be added to the [WEBOEE] screen. The value for the preference must be Y.
!!Step 10: IMFD – Maintain Form Definitions
In order for the employees’ election choices to be automatically saved when entered in [WEBOEE] the Auto Commit preference must be added to [WEBOEE] in [IMFD]. The value for the preference must be Y.
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!Step 11: IMRO – Define Roles
!!Step 11: IMRO – Define Roles
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![Notes|Edit:Internal.OPEN+ENROLLMENT+SET+UP]
[{InsertPage page='Internal.OPEN+ENROLLMENT+SET+UP' default='Click to create a new notes page'}]
This page (revision-37) was last changed on 26-Nov-2021 10:22 by rforbesTop