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MASS OPEN ENROLLMENT PROCESS FLOW#

The following is an overview of the Mass Open Enrollment process.

Step 1: Run UBOE to Generate Mass Open Enrollment Records#

UBOE is used only to create mass open enrollments.

Parameters
Entity	Specify which entity the open enrollment period will be for.
Event Type	A mass open enrollment event type must be chosen to create the open enrollment period. The benefit plans associated to that event type will be picked up and included in the open enrollment.
Election Open Date & Election Close Date	These fields determine the open enrollment period.
Coverage Effective	This is a mandatory field used to determine what the Coverage Effective date will be for the enrollment records.
Eligibility Effective	If supplied, this will be used to state the Eligibility Effective date for the enrollment records. If it is not provided, the date will be calculated by the BC rules for the elected coverages.
Premium Effective	If supplied, this will be used to state the Premium Effective date for the enrollment records. If it is not provided, the date will be calculated by the BC rules for the elected coverages.
Description	If supplied, the description of the Event Type will be overwritten in IBOE.
Exception Level	This will determine the level of trace the report is run at.
User Comment	This allows a comment to be added to the report.

Functionality#

• UBOE is used only to create mass open enrollments.
• Due to the nature of the UBOE, it cannot be run while a pay is in progress.
• The current enrollments are not affected by the open enrollment process and will only be updated with a new effective coverage record once the employee’s new elections have been processed.
• Each time UBOE is run, a single open enrollment control record is created and can be seen in IBOE. This control record gives Benefit Administrators control over the election activity.
• A header record is created for each employee involved in the open enrollment. These header records are linked to the open enrollment control record and can be seen in VBOEE.
• An Election Option record is created for each coverage option an employee has. These Election Option records are linked to the employee’s header record. A single Election Decision record is created for each election an employee is allowed to make (one per plan). These Election Decision records are linked to the employee’s header record.
• The employee’s eligibility will depend on the benefit schedule and the plan definition.

Step 2: Review the Open Enrollment record in IBOE. #

The open enrollment control record generated by UBOE is visible in IBOE.

The control record describes the open enrollment period and acts as a header for all of the employees involved. This control record has an “OE Status” field that gives Benefit Administrators control over the election activity. The status can be Open, Suspended, or Closed. Under no circumstance are elections allowed before the Election Open date or after the Election Close date.

This screen will display all current and historical open enrollment periods in the system. The Benefit Administrator can use this screen to keep track of the Open Enrollment period. Here they can extend or reduce the Open Enrollment period. The Event Type and Open Enrollment Type values cannot be changed.

The Event Type, Event Type Description, Open Enrollment Status, Event type URL and Event Type Text values have all defaulted in from IBET.

The 'Individual OE For' field indicates which employee is associated to the event and thus spawned an open enrollment period. This is only displayed for ad Hoc and Life/Work Events.

Under the Employees tab is a list of employees who are participating in the enrollment showing the overall status of their enrollments. The first total indicates how many plans and plan sets the employee is eligible for, the second total, ‘To Be Decided’, indicates how many elections the employee has not made a decision on and the last total, ‘Declined’, indicates how many elections the employee has declined.

The Employee Open Enrollment Stage can be changed to suspend or close their open enrollment.

The Open Enrollment Details tab indicates the plans and plan election sets involved in the open enrollment period. The Election Required toggle can be checked on or off overriding the setup defined in IBET.

If an employee or plan was missed for the open enrollment they can be manually added here in IBOE.

If the open enrollment period needs to be removed, the Benefit Administrator can simply delete the open enrollment control record in IBOE. This will trigger a cascade delete of the employee election records. If an employee’s election has already been processed, then the new record in IBEN must be removed first.

Step 3: Employees Review Their Elections via WEBOEE. #

WEBOEE is a scroll view of the employee’s elections. Using this form the employee may review their benefit election options in the Open Enrollment. The employee may make changes to their current enrollments, elect new coverages, update or remove recipients and upload documentation.

Below is a screen print of WEBOEE.

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MASS OE PROCESS FLOW_08.JPG The top of the form displays the Employee’s Open Enrollment Record Status and the OE Start and End dates. An introductory paragraph is shown followed by several numbered paragraphs that step the employee through the election process. The content of these paragraphs may be tailored and may contain HTML tags. These paragraphs are the Election Intro Text found on the Plan Type in IBPT.

Only plans that are part of the Open Enrollment process will appear.

If elections related to the open enrollment have already been submitted by the employee, only plans that have been re-opened by the Benefit Administrator can be changed.

If there are no open enrollments for an employee, a message will be presented indicating there is no information to display. There is a function preference called SS_EMPTY_FRM_MSG which when set to ‘Y’ will display the message defined in ‘<FORM_NAME>_EMPTY’, where FORM_NAME is the name of the form that has no data to display, i.e.: WEBOEE. These messages can be tailored in IMMS using translations, the message codes are: WEBOEE_Empty. At any time during the open enrollment process, the employee can print off a summary of the open enrollment elections. The print icon is displayed at the top of the form.

Step 4: View elections by Employee via VBOEE#

At any time during the Open Enrollment period the Benefit Administrator can view the elections by employee via the VBOEE screen.

This screen is a View Only screen and displays a history of Open Enrollments, Events and Uploaded Documents.

Step 5: Review and Approve Elections via IBPOE#

Once the employees have submitted their elections, the Benefit Administrator would then review and approve the employee's benefit elections using IBPOE.

IBPOE is a process screen that allows the Benefit Administrator to

• submit on behalf of the employee
• validate the elections
• cancel the employee’s open enrollment
• approve the employee's open enrollment
• process the employee's open enrollment (create enrollment records in IBEN)
• and if necessary, re-open the open enrollment if changes are required by the employee.

The Open Enrollment Activities By Stage By Role page shows what activities can take place in each stage by each of the roles.

Step 6: Process the Open Enrollment Elections#

The Benefit Administrator may process the employees’ elections using either IBPOE or UBPOE.

Step 7: Close Open Enrollment Period#

After the elections have been processed, the Benefit Administrator must close the Open Enrollment period via IBOE.

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Notes #

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Current Elections#

Step 1: Update Demographic Profile#

The employee is prompted to update their personal and demographic information prior to proceeding with their elections. There are links provided to WEEPP and WEECN for the employees so that they do not have to leave the enrollment form.

Step 2: Review Open Enrollment Plan List#

A list of benefit plans that are a part of the open enrollment that the employee is eligible for is displayed. The sequence of the plans is based from the sequence defined in IBPT. If no sequence was defined, they will be listed in alphabetical order.

Step 3: Record a Qualifying Life or Work Event#

The employees will be prompted to enter any qualifying life or work events. A link is provided to WEBEV for the employee.

Step 4: Choose a Basis for Costs#

The employee is prompted to choose how they want to view the costs. The Employer and Employee costs may be displayed annually, monthly, or by pay period. If the employee chooses a different view, such as monthly, a preference will be set for the employee for the current and any future open enrollments.

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Enter Election Changes#

Step 1: Review Plan Options and Make Election Decisions#

Plan Type

• Plan details are organized by plan type to make it easier for employees to understand their options, however employees make their elections one plan at a time.
• The Election Intro Text, if provided in IBPT, will display above the list of plans within the plan type.
• If a URL was provided in IBPT, it will be displayed here.

Plan Details

• Each plan must be elected separately.
• Plans of the same type that are mutually exclusive may be grouped in a Plan Election Set. Only one coverage option may be elected from a Plan Election Set.
• If BC codes were configured in IBPN to allow data to be entered (Enter Election) these will display above the plan details.
• The coverage costs may depend on this data.

Coverage Options

• All coverages that the employee can elect are shown in a list containing Plan Description, Policy #, Coverage Description, Pre-tax indication, Employee Cost (Your Cost) and Employer costs.
• The last column is reserved for the employee’s election choice. One and only one coverage line must have this toggled on.
• The employee’s current enrollment information always appears above the list of election options for the plan.
• If the employee is not yet enrolled in a plan, the Current Coverage will remain blank.

Costs

• The costs are shown in the basis chosen by the employee, by year/month/period.
• Cost sharing rules may vary by plan and/or coverage. Clients may secure either of these columns if they do not wish to show this information.
• To determine the EE and ER costs, the system will first calculate the annual amount using the rate basis defined for the coverage and will then calculate the monthly amount. To determine the period costs, the system will pick up the Frequency from the Coverage and then will look through the Frequency detail for the first Pay Category that has the Pay Category Type of ‘Open Enrollment’. Once it has found a record with this type the system will use the number found in the 'Times Per Year' field in its calculations.
• If the system cannot locate a Frequency detail record with a Pay Category of the type ”Open Enrollment” the system will use a default Times Per Year amount of 1.
• Coverage rates may be stepped by certain criteria. In most cases this criteria can be automatically derived, however, it sometimes must be specified by the employee as part of the additional data.
• All costs are calculated “as of” the coverage effective date, not the current date.
• Costs that are estimates are flagged with a check mark in the 'Est. Costs' column. This is derived from the

Estimated Costs toggle in IBPN.

• In order for the EE and ER Costs to display the toggle ‘Allow Value Override’ must be toggled ON for BC0840 and BC1040 in IBPN. If B0020 and B0070 are defined with the ‘Hire Date’ rule, the UBOE program will use the coverage component rules from the IBPN 'coverage' effective record where the Hire Date falls within the coverage effective start and end dates. Therefore, it is suggested to ensure all effective records are updated with the ‘Allow Value Override’ toggle.

Election Decision

• The employee makes an election choice by clicking the coverage they want.
• When one coverage option line is toggled on, all other lines are automatically toggled off.
• If the plan participation is optional, an additional “Coverage Declined” line will be shown at the bottom of the list to give the employee the ability to opt out of the plan. On the third tab the employee will be prompted for the reason for the decline for any plans / plan election sets that they have declined in the second tab.
• In all cases where there is a choice, a “Coverage To Be Decided” line will appear at the bottom of the list to give the employee time to think about the coverage they want.
• The “Coverage To Be Decided” line will not appear if the plan participation is required and there is only one coverage level to choose from.
• Validation must be performed in order for the correct Election Decision to display after election changes are made. Validation may be done manually by pressing the Validate Button in WEBOEE and in IBPOE. Validation will also be done automatically during the submit process when the Submit button is pressed. If changes are made by the Administrator in IBPOE, they should press the Validate button to ensure the correct Election Decision is displayed and read by any reports that may be run to capture changes.
• If the chosen coverage has an OE Question Code (ie Assessment Code) associated to it, the OE Questions button will be highlighted. The employee will be required to answer the questions in order for the validation process to pass. If the employee needs to change their answers to the questions, they may press the re-open button and then press the OE Question button to retake the assessment.
• The choice toggle determines the Election Decision for the plan as follows:

Election Decision
To Be Decided	In WEBOEE, the toggle is on the “To Be Decided” line. In IBPOE, no coverage is selected.
Elected, No Change	The toggle is on the line that matches the current enrollment. The recipients, elected coverage and entered election amount match the current enrollment record.
Elected, With Changes	Toggle is on a coverage that does not match the current enrollment. This includes changes to recipients, coverage, or entered election amount.
Declined	Toggle is on the “Coverage Declined” line.
Newly Elected	Toggle is on a coverage that the employee is not currently enrolled in.

Benefit Recipients

• Above the list of coverages is an LOV where employees can select the participants they wish to enroll into the coverage.
• Participants may be beneficiaries, children, dependents, or a spouse/others.
• The list of recipients available to an employee is derived from the relation type defined in IECT for each of their contacts and the recipient type defined in IBPN for each of the plan’s coverages. Please see the Benefit Recipient Matrix for a matrix displaying which relation types are allowed per recipient type.
• Participant changes are effective on the effective date of the coverage and do not impact current payrolls.
• Participants must have a Contact Role of ‘Dependent’ selected in IECT in order to display as eligible benefit recipients.

Step 2: Validate Election Decisions#

Employees are prompted to press a validate button to ensure their election choices are valid. Extensive validation is done to ensure the elections meet any conditions which were defined in IBPN.

For example, the validation ensures the correct number of recipients has been defined, the correct recipient type has been selected, the child/student age is within the restriction provided in IBPN etc..

After the validation has completed, a pop up message will display indicating to the employee if their elections have passed or failed the validation process.

If there are any errors, they will be displayed under each plan that caused an issue during validation. These notes will clearly indicate to the employee what is wrong with their election. The notes indicated are derived from message codes in IMMS. For a complete list of messages used in the Open Enrollment facility please see the Open Enrollment Messages section.

Upload Required Documents#

Step 1: The Elections Listed Below Require Documentation#

This step displays a list of plans and coverages which the employee has elected that have been defined as requiring documentation in IBPN.

The Required Documents field from IBPN will be displayed for each plan/coverage to indicate to the employee what documents need to be uploaded.

Step 2: Please Upload the Documentation Described Above for Each of the Elected Plans#

Three media fields have been provided to allow the employee to upload documents if required. The three provided media are Birth Certificate, Marriage License and Health Questionnaire.

As stated earlier, the prompts for these can be translated to meet your business needs and additional media may be added to the form if necessary.

Review Costs and Submit Elections#

Step 1: Summary of Total Cost#

A summary of costs is displayed to let the employee see the impact of their elections.

Totals are displayed for the employee’s pre tax cost, employee’s post tax cost and the employer cost. The Grand

Total line is controlled by the system message BEPS_00007. This message may be translated to include HTML tags.

Costs will be derived through the same benefit calculation rules that are used in the Payroll module.

Costs will be shown by Pay Period, by Month or by Year, based on what the employee has chosen on the first tab.

Step 2: Summary of Elected Benefit Recipients #

The employee’s elected benefit recipients will display for each elected plan and coverage.

Step 3: Select Reason for Decline for Declined Plans#

A summary of the plans the employee has declined is displayed.

The employee is prompted to enter a ‘Reason for Decline’ for each of the plans they have declined, unless the site preference “BSS D REASON REQ” was defined with a value on N in IMST.

Step 4: Submit Elections for Approval#

When an employee has completed all of their elections, they will submit them for approval.

If there are no errors, a confirmation dialog will appear to ensure that the employee understands that their decisions will be binding.

If there are errors the employee will be directed back to tab 2 to correct the validation errors.

If the employee accepts the conditions, the election stage will change to Submitted and it will be up to the Benefit Administrator to review the employee’s choices. The employee will not be able to make any further changes to their elections, unless the Benefit Administrator intervenes.

Once the employee has clicked OK to the confirmation dialog and successfully submits their benefit elections, a message will appear stating the employee has successfully submitted their elections.

If approval processes were defined in IDAP and if Approval logic was initiated in IBPN for the plan the elections will be sent through an approval process. Upon approval, the election will be ready to be processed. When an employee submits their elections, the toggle, EMPLOYEE_SIGN_OFF, is checked on. This toggle is not seen in any form; it is strictly in the database and may be used for workflow purposes. When the employee’s open enrollment is re-opened, the toggle is unchecked.

The elections will not be brought through to IBEN at this point. They must first be processed by the Benefit Administrator.

Step 5: View elections by Employee via VBOEE#

At any time during the Open Enrollment period the Benefit Administrator can view the elections by employee via the VBOEE screen.

This screen is a View Only screen and contains three tabs; Open Enrollments, Event History and Uploaded Documents.

The Benefit Administrator would use this form to view an employee’s elections. This form indicates the stage of the Open Enrollment and Election. Also listed are the totals as seen in IBOE, the total number of plans/plan sets, total number of elections yet to be decided and total number of elections declined.

The detail section shows the plans and their coverages and the employee’s decision, if made.

If there are Questions (assessments) associated to the elected coverage, the questions and the employee’s responses will be visible in the OE Questions tab. The elected coverage must be in focus for the questions and answers to be shown.

Step 6: Process Employee Benefit Elections #

Once the employees have submitted their elections, the Benefit Administrator would then validate and process the employees’ elections via IBPOE or WABPOE. The Benefit Administrator can process the elections as they are submitted or can wait and process them all at once via the UBPOE (next step).

IBPOE is a process screen that allows the Benefit Administrator to

• submit on behalf of the employee
• validate the elections
• cancel the employee’s open enrollment
• process the elections
• and if necessary, re-open the open enrollment if changes are required by the employee.

WABPOE is a self service version of the IBPOE screen. The WABPOE has the same functionality as the IBPOE, as well as the ability for the administrator to take the assessment on behalf of the employee.

If Approval logic is defined for the open enrollments, here is where the Benefit Administrator would be required to make the approval.

Extensive validation is done when the administrator presses the Validate button. If any errors are encountered, they will be displayed in the Validation Warnings tab for each of the elections.

The IBPOE will display whether Open Enrollment status is open, suspended or closed.

The Employee’s Open Enrollment Stage is displayed indicating the stage of the enrollment record as it goes through a series of stages from the time it is created until it has been processed. The various stages are Open, Suspended, Submitted, Approved, Processed, Not Approved, Cancelled and Closed.

The administrator can re-open the employee’s open enrollment if changes are required. When the Re-Open button is pressed the administrator will be prompted with a dialog that states, “Press OK to re-open all of the plans for the employee’s current open enrollment. Press ‘Cancel’ to manually re-open individual plans”. If ‘Cancel’ is selected, the Re-Open Elections button located in the Plans area of the screen will become enabled and the administrator can then manually re-open plans on an individual basis. If only one plan was re-opened when the employee goes into WEBOEE to make a new choice for that plan, the other plans will be displayed as well but will not be editable. By re-opening the employee’s Open Enrollment, any assessments that were completed will be re-opened as well.

There is also a ‘Re-Open OE Questions’ button which allows the Benefit Administrator to re-open the assessment for an employee, if they have already completed the questions. A similar button is available in the WEBOEE screen as well.

The administrator has the ability to cancel and decline employee elections. Beneath the Plans area there are a Cancel Elections button and a Decline Elections button. Cancelling an election will stop the election from being processed. When a plan has been declined, the Decline button will change to ‘Un Decline Election’ to allow the Administrator to undo a decline. Once a decline has been undone the decision will change to ‘To Be Decided’.

If there are Questions (assessments) associated to the elected coverage, the questions and the employee’s responses will be visible in the OE Questions tab. The elected coverage must be in focus for the questions and answers to be shown in the Questions tab.

The elections can only be processed once the EE Open Enroll stage is in a status of ‘Approved’.

The elections cannot be processed if there is a pay for the employee that is in a stage of Calculated/Paid (ie: if UPCALC has been run but UPCLOZ has not). If a pay is in progress, the Process button will be unavailable. The UBPOE will also display a message within the report.

The following table shows what activities can take place in each stage by each of the roles:

Employee Open Enroll Stage	Election Decision	EE Actions	BEN Actions Open Enrollment	BEN Actions Election Options	APR Actions
Open	To Be Decided Elected,With Changes Elected, No Change Declined	Leave and Return Make Decisions, Leave and Return Make Decisions and Submit For Approval	Submit OE Validate Cancel OE Close OE (IBOE)	Make Corrections Decline Elections Cancel Elections	View Only
Suspended	Elected, With Changes Elected, No Change Declined	View Only	Re-Open OE Cancel OE Close OE (IBOE)	View Only	View Only
Submitted	Elected, With Changes Elected, No Change Declined	View Only	Re-Open OE Make corrections Validate Approve and Route Approve (Final) Do Not Approve Cancel OE Close OE (IBOE)	Make Corrections Decline Elections Cancel Elections	Re-Open OE Make Corrections Approve and Route Approve (Final) Do not approve
Approved	Elected, With Changes Elected, No Change Declined	View Only	Re-Open OE Process OE Cancel OE Close OE (IBOE)	View Only	View Only
Not Approved	Elected, With Changes Elected, No Change Declined	View Only	Re-Open OE Close OE (IBOE)	View Only	View Only
Cancelled	Elected, With Changes Elected, No Change Declined	View Only	Re-Open OE Close OE (IBOE)	View Only	View Only

Step 7: Run UBPOE to mass process the Open Enrollment Elections#

If preferred, the Benefit Administrator can run UBPOE to batch process the elections.

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Notes #

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