Open Enrollment
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OPEN ENROLLMENT#

Background#

The pre-existing application had an extensive Benefits module that included many Professional and Self Service components; however, the module did not fully support the Open Enrollment process. Previous releases gave Benefit Administrators the tools they needed to set up and administer benefit plans, but it lacked the ability to control Open Enrollment periods and guide employees effectively through the election process.

We now have incorporated Open Enrollment and the following will describe the Open Enrollment process and the setup requirements.

Benefits of Using Open Enrollment#

There are many benefits to using Open Enrollment, here are a few:

Key Features#

Below is a list of the some of the key features of the Open Enrollment process:

System Requirements#

Below is a list of requirements / disclaimers for using Open Enrollment:

Open Enrollment Business Process#

Roles The chart below identifies the roles that are typically involved in the Open Enrollment process: ROLE WHAT DUTIES DO THEY PERFORM? Employer • Establishes benefit plans and eligibility rules • Determines Open Enrollment and benefit mid-year change policies • Provides financing Employee • Makes benefit plan elections during Open Enrollment • Notifies Benefit Administrators of life and work events • Updates dependent/beneficiary data Dependent / Beneficiary (Benefit Recipients) • Named by employees on benefit plans • Not directly involved in the Open Enrollment process Manager • Supervises employees • Not directly involved in the Open Enrollment process Benefits Administrator • Recommends, implements and communicates benefit options • Obtains bids and selects benefit providers • Negotiates benefit plans and rates • Sets up and maintains benefit plans and coverages • Changes benefit rate tables as needed • Turns on Open Enrollment for selected employees and benefit plans Benefit Reviewer / Approver • Provides employee assistance and guidance for the Open Enrollment process • Reviews elections and obtains additional information as needed • Makes changes as necessary to incorrect elections • Approves elections or routes them for additional approval, possibly to Payroll • Updates provider web sites as needed for changes Payroll Administrator / Final Approver • Works with the benefit administrators to set up benefits and ensure accurate and timely deductions • Reviews employee elections and provides final approval for payroll processing • Changes incorrect benefit enrollment records • Cross checks benefit amounts for billing purposes Benefit Provider (Supplier) • Provides insurance coverage and administration for benefit plans • Conducts employee meetings to review benefit plans and options • Not directly involved in the Open Enrollment process Application Administrator • Assists others with the usage of the benefit application software • Performs Web Master duties such as writing HTML and providing links where needed for the web pages • Assists with the definition and setup of new plans • Implements workflows • Provides tailoring of system components as required • Troubleshoots application issues • Tests new features • Implements system security and establishes system access rules Systems Administrator • Provides the hardware and operating system environments • Maintains the Application Servers and the Database Servers • Installs new releases and patches • Troubleshoots technical issues • Performs performance tuning as needed • Ensures that adequate backup and recovery procedures are in place • Assists Application Administrator as required