Wiki: OPEN ENROLLMENT SET UP

OPEN ENROLLMENT SET UP
Step 1: IBPT – Define Benefit Plan Types
Step 2: IMLN- Maintain Lexicons
Step 3: IMST – Define Client Site Information
Step 4: IPPGU / IPPGC – Define US/CDN Pay Categories
Step 5: IPPF – Define Processing Frequencies
Step 6: IBPN – Define Benefit Plans/Coverages
Step 7: IBSC – Define Benefit Schedule
Step 8: IDGR – Define Groups
Step 9: IBET – Define Benefit Event Types
Step 10: IMFD – Maintain Form Definitions
Step 11: IMRO – Define Roles
Notes

OPEN ENROLLMENT SET UP#

In order to use the Benefit Open Enrollment facility there are numerous set up requirements that must be fulfilled. There are many options available to allow for the various benefit requirements and to allow clients to tailor the screens and data to their liking.

Step 1: IBPT – Define Benefit Plan Types #

The following fields in IBPT are used for Open Enrollment purposes.

Plan Type: 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: 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: 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 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 shows which relation values fall under each of the recipient types.

Plan Type URL: A URL can be defined to provide the employees with a link in to external documentation that may provide additional information on each plan within the plan type, or to a carrier’s website. This will be displayed on the SS election form WEBOEE beneath the Election Intro ext.

Description: Ensure a description has been defined and is reflective of the plans within the plan type as this will be visible in WEBOEE. Basic HTML tags can be used to tailor the look of the text.

Election Intro Text: This field is used to include introductory text to the plans in the WEBOEE form. This can be used to provide additional instructions to employees. Basic HTML tags can be used to tailor the look of the text.

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”. 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.

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.

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.

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.

Step 4: IPPGU / IPPGC – Define US/CDN Pay Categories #

In order to determine which pay frequency detail record to use to calculate the EE and ER period/monthly/annual calculations, a new pay category is required with the pay category type ”Open Enrollment”. This category will not be used by any payroll 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 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 6: IBPN – Define Benefit Plans/Coverages#

There are certain fields in IBPN that should be defined to accommodate the Open Enrollment process. These fields are listed below:

Plan Details

Description: The description of the benefit plan should be descriptive of the plan as this will be displayed to the employees.

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: 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 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: A display sequence is used to determine the order the benefit plans are listed in the WEBOEE form in Self Service.

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: 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: 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 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 shows which relation values fall under each of the recipient types.

Display Sequence: This will determine the order the coverages are listed within the plans in WEBOEE.

Waiting Period: If there is a waiting period before an employee is eligible for the plan, specify the number of days.

Minimum hrs/wk: Used when an employee must work a minimum number of hours per week to qualify for the plan.

Max # Recipients: If the coverage is only available to a specific number of recipients, define the maximum number allowed.

Max 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: 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: 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: If evidence is required before an employee can be enrolled into a plan, then this should be toggled ON.

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: With this toggle checked ON, this will identify to the employee in WEBOEE if the coverage is Pre Tax or Not.

Exclude From OE: A coverage may be excluded from an Open Enrollment by checking this toggle ON.

Coverage Details

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: 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: 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.

Step 7: IBSC – Define Benefit Schedule#

If new plans have been defined, ensure they have been added to the benefit schedule.

New to the IBSC are the Waiting Period (Days) and Minimum Hrs/Week fields. Any data supplied here will override what has been defined for the coverage.

Step 8: IDGR – Define Groups#

Clients can determine which set of employees are eligible for Open Enrollment by checking ON the toggle Enable OE Elections in IDGR. Only employees tied to a group with this ON will be able to process Open Enrollments.

Step 9: IBET – Define Benefit Event Types#

Open Enrollment is triggered by events whether those are life, work, mass open enrollment or ad hoc events.

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.

Tied to each event type are the benefit plans that employees will be eligible to elect into or make changes to.

Event Type: 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: 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: 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: 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: 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: 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: 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: This field allows clients to include a URL for employees to gain more information on the event.

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: 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: Plans that are not part of a Plan Election Set but should be included in the enrollment should be listed individually.

Description: This is the benefit plan description which will default in once the plan has been selected.

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.

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.

Headers and Footers can be used to tailor the WEBOEE screen. If headers and/or footers are to be used, the preferences Header and/or Footer should be added to the screens in IMFD.

If birth certificate, marriage license or health questionnaire do not meet your business needs, the form item name prompts for these documents may be translated to something else. These media are used in WEBOEE, IBPOE and in VBOEE.

Additional media may be added to the WEBOEE form if documents other than birth certificate, marriage license, or health questionnaire are required. Media codes must first be defined in IMEC for P2K_HR_IDENTITIES. These new media codes would need to be added to the form definition for WEBOEE, IBPOE and VBOEE. The three existing media codes in WEBOEE can be used as an example.

Step 11: IMRO – Define Roles #

In order for employees to make use of Open Enrollment execution rights for the Open Enrollment, forms and reports must be given to the appropriate execution type roles.

Since there are two My Benefit Elections forms, WEBEL and WEBOEE, ensure that execution rights are granted to only one of the forms. To make use of Open Enrollment, employees must have access to WEBOEE. Access to the following new forms and reports should be granted to the appropriate users: IBET, IBOE, IBPOE, VBOEE, IBEV, RBET, RBOE, UBOE, UBPOE.

Notes #

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