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BENEFIT ENROLLMENTS#

Benefit Enrollments (IBEN) indicate an employee's participation in a benefit plan, or confirm explicitly that coverage has been declined.

Maintain Benefit Enrollment data is stored on the P2K_BE_ENROLLMENTS, P2K_BE_ENROLLMENT_DETAILS and P2K_BE_ENROLLMENT_COMPONENTS tables.

Plan

Plan Code is a user-defined code uniquely identifying the plan to the organization.

Last Remit Date

This field displays the date this plan was last remitted to the insurance carrier (or reconciled for internal plans). Each time the remittance process is run, this date is updated by the system to reflect the last date processed. When a user runs remittances for a time period, the system checks there are no missing remittance periods since the last run. This field is system updated, but may be altered.

Description

This is the user-defined description of the benefit plan. This field is defaulted in when the plan is selected, however, you may select a description from the LOV (F9).

Participation Rule

This field indicates whether participation in a benefit plan or coverage is mandatory or optional. The participation rule on the plan definition is used as a default entry to the benefit schedule. Only the participation rule from the benefit schedule is enforced.

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Details tab#

Coverage

Coverage is a user-defined code uniquely identifying the coverage to the organization.

Coverage Step

Coverage Step code indicates the set of rates that apply to this enrollment. Codes may be numeric (e.g. 01, 02, 03...) or they may be alphanumeric (e.g. A, B, C, FS, MN, A1, B2...).

Registration #

Plan registration number is an employee's individual registration number within the plan.

Status

Enrollment Status records whether the employee has ‘not yet enrolled in’, ‘enrolled in’ or ‘declined’ the plan.

In Process

Processing Stage indicates an update process of the system has or has not yet committed the record. This field is system updated.

Evidence of Insurance

If this toggle is ON, there is a hard copy ‘Evidence of Insurance’ that has been received. If this toggle is OFF, there was no hard copy provided.

Frequency

This is the frequency of the benefit cycle for this coverage for the employee. This information only needs to be entered if the frequency is different than the one established on the benefit schedule.

Eligibility Start

This field displays the earliest date from which an employee may submit claims. This field is populated by the rules of the coverage but may be altered.

Eligibility End

This field displays the last date that an employee may submit claims. This field is populated by the rules of the coverage but may be altered.

Premium Start

This is the date from which premium deductions start. This field is populated by the rules of the coverage but may be altered.

Premium End

This is the date after which premium deductions end. This field is populated by the rules of the coverage but may be altered.

Percentage

This field provides the benefit percentage an employee receives in the event of a claim.

BC

BC Code defines the benefits component. All BC codes begin with the letter “B” followed by a 4-digit number. Definitions of each of the benefits components may be found in the Benefit Components section.

Rule

Rule describes the possible options available for each benefits component. The rules shown are applicable to the highlighted benefits component in the BC code field of the form.

Seq #

Sequence specifies the order in which the Benefits or Payroll Calculation Program will calculate the benefits components. This field defaults in once the BC has been selected.

Description

The component description is a brief explanation of the benefits component code highlighted. This field defaults in once the BC has been selected.

O/R AMOUNT $

This field provides the value of any override amount entered by the user.

Amount $

This is the value of the person's coverage component amount. This field is system populated.

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Reductions tab#

Reductions govern the way in which an employee will be processed when they are either in a special employment status that causes premiums to be waived, or they reach an age limit that triggers a reduction in benefit coverage.

Employment Status

The employment status of an employee may be pending approval, active, on a leave of some type, or terminated.

Description

This field supplies the user-defined description of the employment status. This field defaults from the Employment Status (IDES) form.

Up to Limit

This field indicates the highest age for which this reduction rule applies, if applicable.

Waiver Method

This field indicates who pays the premium amount when an employee is on a benefit waiver.

Coverage Percent

This field indicates by how much the coverage/benefit amount is reduced.

Premium Percent

This field indicates by how much the premium is reduced. Prem_Reduction_Percent is an optional 5-digit numeric field you may manually enter.

EE Percent

This field indicates by how much the employee deduction is reduced.

ER Percent

This field indicates by how much the employer contribution is reduced.

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Notes #

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