Wiki: IBEN

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. Plan_Code is a mandatory 16-character alphanumeric field you must either manually enter or use the LOV (F9).

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. Last_Remit_Date is an optional date field that is system updated, but may be user altered.

Description: This is the user-defined description of the benefit plan. Description is defaults 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. Participation_Rule is an optional fixed lexicon (X_PARTICIPATION_RULE).

Details#

Coverage: Coverage is a user-defined code uniquely identifying the coverage to the organization. Coverage_Code is a mandatory 16-character alphanumeric field you must either manually enter or use the LOV (F9).

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...). Coverage_Step_Code is a mandatory 16-character alphanumeric field you must manually enter.

Registration #: Plan registration number is an employee's individual registration number within the plan. Plan_Reg_Number is an optional 50-character alphanumeric field you may enter.

Status: Enrollment Status records whether the employee has ‘not yet enrolled in’, ‘enrolled in’ or ‘declined’ the plan. Enrollment_Status is an optional fixed lexicon (X_ENROLLMENT_STATUS).

In Process: Processing Stage indicates an update process of the system has or has not yet committed the record. Processing is an optional fixed lexicon (X_PROCESSING) that 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. Frequency_Code is a 16-character alphanumeric mandatory field you must either manually enter or use the LOV (F9).

Eligibility Start: This field displays the earliest date from which an employee may submit claims. Eligibility_Start_Date is an optional date field that is populated by the rules of the coverage but may be user altered.

Eligibility End: This field displays the last date that an employee may submit claims. Eligibility_End_Date is an optional date field that is populated by the rules of the coverage but may be user altered.

Premium Start: This is the date from which premium deductions start. Premium_Start_Date is an optional date field that is populated by the rules of the coverage but may be user altered.

Premium End: This is the date after which premium deductions end. Premium_End_Date is an optional date field that is populated by the rules of the coverage but may be user altered.

Percentage: This field provides the benefit percentage an employee receives in the event of a claim. Percentage is a 5-digit numeric optional field that you may manually enter.

BC: BC Code is a High Line provided code to define 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. BC_Code is a mandatory 16-character alphanumeric field you may either manually enter or use the LOV (F9).

Rule: Rule is a High Line provided 2-digit code to describe 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. BC_Rule_Code from the P2K_BE_BC_RULES table is a 2-character numeric mandatory field provided by High Line.

Seq #: Sequence specifies the order in which the Benefits or Payroll Calculation Program will calculate the benefits components. Component_Sequence defaults in once the BC has been selected.

Description: The component description is a brief explanation of the benefits component code highlighted. Description 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_Override is an optional 18-digit numeric field you may manually enter.

Amount $: This is the value of the person's coverage component amount. Amount is an 18-digit numeric optional field that is system populated.

Reductions#

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. Status_Code is a mandatory 16-character alphanumeric field you must manually enter or use the LOV (F9).

Description: This field supplies the user-defined description of the employment status. Description is an optional 50-character alphanumeric field that defaults from the Employment Status (IDES) form.

Up to Limit: This field indicates the highest age for which this reduction rule applies, if applicable. Up_To_Limit is a mandatory 18-digit numeric field you must manually enter.

Waiver Method: This field indicates who pays the premium amount when an employee is on a benefit waiver. Waiver_Method is an optional fixed lexicon (X_WAIVER_METHOD).

Coverage Percent: This field indicates by how much the coverage/benefit amount is reduced. Covg_Reduction_Percent is an optional 5-digit numeric field you may manually enter.

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. EE_Reduction_Percent is an optional 5-digit numeric field you may manually enter.

ER Percent: This field indicates by how much the employer contribution is reduced. ER_Reduction_Percent is an optional 5-digit numeric field you may manually enter.