ESTABLISH BENEFIT SCHEDULES#

Benefit Schedules (IBSC) define the plan and coverage options available to an entity, unit, group or individual, and are based on the employment status.

Establish Benefits Schedules data is stored on the P2K_BE_BENEFIT_SCHEDULES table.

Entity

Entity identifies the organization to which the schedule is applied.

Unit

Unit identifies the organization to which the schedule is applied.

Group

Group identifies the organization to which the schedule is applied.

Plan

This identifies the benefit plan to which the schedule belongs.

Person

This field displays the name of the employee to whom the schedule is applied. Use this field if an employee is to receive a different policy than others in his/her group. If used, the Entity, Unit and Group fields should be blank.

Election Default Covg

This field identifies the specific coverage the system will use as the default in IBEL when electing a coverage for an employee.

Allow Default Override

This toggle is used by the Open Enrollment (OE). When an open enrollment is created, the plans are restricting the coverage available to the EE to be only the coverage listed in Election Default Coverage.
- If a Default Coverage is defined and the ALLOW_DEFAULT_OVERRIDE toggle is ON all the coverages will be included when generating an OE.
- If the toggle is OFF and a default coverage is defined, then only this coverage will be included when generating an OE.

Costing Default Covg

This field is used only for the Forecasting and Costing module.

Frequency

This field identifies the overriding frequency for the coverage. This field only needs to be entered if the frequency is different than the one established on the coverage.

Status

This indicates the employment status of qualified employees on the schedule.

Start Date

This is the date from which the schedule is applicable.

End Date

The benefit plan will not show in IBEL if this date is less than the As of Date.

Participation

Participation Rule 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.

Waiting Period (Days)

This is used to indicate in days the waiting period before an employee is eligible for the plan. This field is only used in Benefit Self Service for Open Enrollments.

Minimum Hrs/Week

This field is a 5 digit numerical field used when an employee must work a minimum number of hours per week to qualify for the plan. This field is only used in Benefit Self Service for Open Enrollments.

Plan Dependencies#

During the Open Enrollment process (i.e. on WEBOEE/WEBOEE_FLEX), Coverage choices made in Primary Plans will change the selections available in Secondary Plans. The choices made will be validated and warnings issued if Employee has not made required selections.

Primary Coverage

For the Primary plan, this is the coverage that has a dependency to another plan/coverage

Optional

This is a toggle used to determine if the employee has to select the Secondary Plan or not.
- If the toggle is ON, then the employee does NOT have to select the Secondary Plan, however, if they do, they must choose from the Coverage options noted in the Dependencies table.
- If the toggle is OFF, then the employee MUST choose from the Secondary Plans/Coverages noted.

Secondary Plan

This field determines if there is a Secondary Plan associated to the Primary plan. If this field contains a Benefit Plan, then the employee must select this plan when they have chosen the Primary Plan/Coverage.

Allowed Second. Coverage

This field determines if there is a Secondary Plan coverage associated to the Primary plan. If this field is blank, then the employee can choose ANY coverage for that Secondary Plan. If this field contains a Coverage, then this is the ONLY existing row for that Secondary Plan, then this is the ONLY allowed coverage for the Secondary Plan.

Default

This field determines what coverage is used for the Secondary Plan when the 'Allowed Secondary Coverage' field is populated.
- If the toggle is ON, then the system will default the coverage (i.e. if the user does nothing, they will get this coverage)
- If “Default” is OFF, then the user must actively choose this coverage – i.e. must make a positive choice even though this is the only option.

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Notes #

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