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:
  • To have employees take more ownership in every aspect of updating and managing their own information.
  • To improve employee satisfaction by offering more choices and better service.
  • To be able to control Open Enrollment periods.
  • To improve turnaround time and productivity.
  • To reduce paperwork and manual effort.
  • To reduce errors and ensure tax compliance.
  • To improve efficiency and reduce costs.
  • To improve communications and information flow.

Key Features#

Below is a list of the some of the key features of the Open Enrollment process:
  • Handle mass Open Enrollments, ad hoc individual Open Enrollments and life or work event individual Open Enrollments
  • Allow employees to make their own elections in accordance with pre-defined rules
  • Capture life and work events
  • Support all types of benefit plans including flex benefit plans
  • Support mutually exclusive plans where a single coverage can be chosen from a set of plans
  • Show pre-tax employee, post-tax employee and employer costs
  • Show costs by pay period, by month or by year, as requested by employee
  • Provide a summary of all costs to employee prior to submitting their elections
  • Provide links to external material and web sites
  • Communicate actions and events via workflow
  • Provide basic audit and exception reports
  • Produce employee benefit statements

System Requirements#

Below is a list of requirements / disclaimers for using Open Enrollment:
  • The Open Enrollment process depends heavily upon workflow to function smoothly and effortlessly; as a result the Workflow module must be purchased.
  • Currently, Internet Explorer and Firefox version 2.0 are the supported browsers for Self Service.
  • In the near future other browsers will be supported.
  • All of the reports that have been created or updated for the Open Enrollment facility have been written with Windward Reports. You must be properly licensed to use the Windward Reports.
  • PAs are not supported on WEECN when using Benefit Open Enrollment.
  • A set of sample workflows will be provided with the official release.

Open Enrollment Business Process#

Roles The chart below identifies the roles that are typically involved in the Open Enrollment process:
RoleWhat Duties Do They Perform?
EmployerEstablishes benefit plans and eligibility rules

Determines Open Enrollment and benefit mid-year change policies

Provides financing
EmployeeMakes 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
ManagerSupervises employees

Not directly involved in the Open Enrollment process
Benefits AdministratorRecommends, 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 / ApproverProvides 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 ApproverWorks 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 AdministratorAssists 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 AdministratorProvides 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