Use the administration features of Standard and Advanced Benefits to manage your benefits programs.
Use the enrollment windows to process benefits participants into plans and options. You can view monthly premiums for a participant or a compensation object and make premium adjustments if required. Run the system extract batch process to compile enrollment records for transfer to third-party benefits administrators. When you need to update rates and premiums, you can use the Total Compensation Setup Wizard to update multiple rates simultaneously in the wizard or in a spreadsheet.
Advanced Benefits includes all the components of Standard Benefits plus features for pre-enrollment administration, processing default and automatic enrollments, recording expense reimbursements, and modeling benefits eligibility.
See: Advanced Benefits Administration: Overview
Use the implementation features of Standard and Advanced Benefits to set up your benefits programs.
See: Standard and Advanced Benefits Setup: Overview
See: Advanced Benefits Setup: Overview
Standard and Advanced Benefits administration share a number of common features:
Enrollment Management: Enroll participants in plans and options for which they are eligible. It includes enrollments entered by benefits administrators, as well as web-based self-service enrollments. The system provides the following enrollment forms:
Use the Non-Flex enrollment form for most programs that are not funded by flex credits.
Use the Savings Plan enrollment form for plans such as 401(k) plans in the U.S. and stock purchase plans.
Use the Miscellaneous Plan enrollment form for plans you define that are not part of a program.
Use the Flex enrollment form if you are an Advanced Benefits customer and you offer programs that you fund by flex credits.
Continuing Benefits Administration: For benefit plans your enterprise offers to terminated or retired employees, such as COBRA in the U.S., you can control continuing eligibility, enroll participants, and record continuing benefits payments.
Premium Calculation: Run the Premium Calculation process to determine monthly premiums. You can view and adjust premiums for a participant or a compensation object.
System Extract: The product's system extract features let you manage the extract, format, and delivery of benefits data to organizations such as third-party benefit administrators.
Your implementation team can set up Oracle HRMS so that employees and other eligible participants process their own enrollments using a web browser. You can configure SSHR so that an HR professional receives a workflow notification when a participant updates an enrollment.
You can also configure SSHR to allow your participants to search through a third party database of primary care providers.
You can assign programs and plans to reporting groups that you define, then generate reports to meet regulatory or other reporting needs. You can write your own reports, or select from reports delivered with Oracle HRMS.
Various predefined reports let you monitor the enrollment cycle during and after an election period, reconcile premiums, and, for Advanced Benefits, track life events.
See: Reports and Processes in Oracle HRMS, Oracle HRMS Configuring, Reporting, and System Administration
To broaden your understanding of Standard Benefits Administration, and administrative features common to both Standard and Advanced Benefits, see:
Running the Maintain Participant Eligibility Process (Standard Benefits)
Running the Eligibility and Enrollment List Report
Running the Benefits Enrollment and Confirmation Reports
Recalculate Participant Values Overview (Standard Benefits)
Running the Premium Reconciliation Process
Advanced Benefits enables benefits administration based on life events that occur to participants. You can generate enrollment actions, activity rate changes, and communications based on predefined life events or events you define.
In addition to the core features available with Standard Benefits, Advanced Benefits comprises several distinct features:
Participation Management: The system lets you trigger enrollments, activity rate changes, and communications based on the occurrence of a life event to a primary participant or dependent.
The Participation Process: This is the process you run from the concurrent manager to determine eligibility, electable benefit choices, and activity rates for your participants before you process enrollments.
View Participation Information: Based on the results of the Participation Process, you can view a participant's electable choices, active life events, and current elections.
Potential Life Events: The application creates a potential life event when the Participation Process detects a database change that you have defined as indicating the occurrence of a life event. You can manually create potential life events for a person and you can void and back-out life events.
What-if Eligibility: This feature lets you model eligibility, electable choices, and pricing information for a person based on a potential life event. Changes that you model do not effect a person's actual record.
Online Benefits Administration: This feature is useful for HR call centers. Using the Benefits Service Center, you can record a change to a person's HR record, evaluate the change for enrollment impact, and process an election online all from a centralized form. You control the application windows, reports, and processes available to your benefits administrators.
Communications: You send communications to inform employees and other individuals about benefits, enrollment periods, and other information that you need to communicate to a range of potential and former benefits participants.
Reimbursement Requests: If you define a flexible spending account plan or a plan that offers reimbursable goods and services, you can record a participant's reimbursement request as part of the process of managing expense reimbursements.
To learn more about Advanced Benefits Administration, see:
Running the Life Events Summary Report
Modeling a Person's Benefits Eligibility
Online Benefits Administration
Oracle HRMS provides a complete solution for Total Compensation management. Your Oracle Human Resources license includes the Standard Benefits feature set that enables you to manage your enterprise's benefit offerings.
The Oracle Advanced Benefits license provides the Standard Benefits feature set plus additional functionality enabling you to design flexible benefit programs and to administer benefits based on life events.
See: Advanced Benefits Administration
Standard Benefits provides the functionality you need to administer benefit programs that do not offer flex credit based benefits. The Standard product is also useful if you outsource a significant portion of your benefits administration.
If your organization favors a centralized form of benefits administration, you can have your benefits practitioners or other personnel record participant elections. A more distributed method of enrollment is available with web-based self-service enrollment forms.
You can enroll participants in plans for which they have been found ineligible and you can override a participant's benefit elections. You can also define whether or not a person can elect to waive participation in a benefit for which they are eligible.
For US users, Standard Benefits supports the administration of Dependent Coverage Orders and Qualified Domestic Relations Orders (QDROs). For Dependent Coverage Orders, you can require that a participant cover a dependent named in a court order (typically for health coverage). For QDROs, you can define a payment amount or percentage that is withheld from an individual and any benefit distribution restrictions.
Because many plan sponsors outsource at least a portion of their benefits administration, the system enables you to extract and format benefits data for transmission to a third party. You can limit the records that are extracted based on a variety of factors, including only extracting records that have changed since the last system extract.
By licensing Advanced Benefits, you can also fulfill the following business requirements.
In your plan design, you define the qualifying life events that generate enrollment actions and participant communications. Batch processes that your system administrator can schedule to run on a nightly basis detect when a life event has occurred to a participant. Enrollment opportunities are then generated for the participant based on the life event and the rules of your plan design.
You can also define automatic and default enrollments to reduce the time you spend processing enrollments.
You can use the product for "what-if" eligibility modeling. For a given person, you can view what their benefit eligibility results would be if a particular life event occurred. The system does not save these results.
You can send a communication to a person in conjunction with a life event. For example, you can run the communications batch process to send an enrollment kit to a group of employees in advance of a scheduled enrollment period. You can also automatically send a communication when an action item must be completed before an enrollment is valid.
If you use Standard Benefits in Oracle HRMS, you can determine eligibility and ineligibility for current and potential benefits participants through the Maintain Participant Eligibility batch process.
If the eligibility process finds a person newly eligible for one or more compensation objects, the process creates or updates the person's eligibility record. Typically, a gain in eligibility indicates an enrollment opportunity.
If the eligibility process finds a currently enrolled participant ineligible, the process de-enrolls the participant from the newly ineligible compensation object and ends the participant's coverage and rate.
Note: You can define an Oracle Alert to notify a benefits administrator, participant, or other personnel when the process detects a change in eligibility status. For example, you can send an alert to an administrator indicating that the process has de-enrolled a participant. The administrator can then process an unrestricted enrollment to determine if the participant has any new enrollment opportunities, such as for continuing coverage.
Schedule this process before your payroll run so that deductions are not calculated for coverages which should be ended. You should also run the process before writing system extracts to transmit coverage changes to third party carriers.
See: Running the Maintain Participant Eligibility Process
As a Standard Benefits user, you run the Maintain Participant Eligibility Process on a regular basis to manage eligibility for your employer-sponsored benefits programs.
You run this process from the Submit Requests window.
To run the Maintain Participant Eligibility Process
Select the Maintain Participant Eligibility Process in the Name field.
Enter the Parameters field to open the Parameters window.
Enter the Effective Date on which you are running the process.
Select one or more parameters to limit the eligibility determination to a segment of your employee and benefits participant population.
For example, you can determine eligibility for participants currently enrolled in a particular benefits plan or for employees in an organization you select.
Select a Person Selection rule to restrict the process to persons who need to be de-enrolled. For example, persons who are newly terminated or deceased and currently enrolled in an active program.
Reducing the number of persons selected by the Maintain Participant Eligibility Process improves application performance by reducing the number of records written to the eligibility tables.
Choose the OK button.
Complete the batch process request and choose Submit.
Run the Eligibility and Enrollment List to display the total number of eligible and enrolled participants in plans used for Standard and Advanced Benefits and Individual Compensation Distribution. The report also lists recently ineligible and de-enrolled participants.
Recently ineligible persons are those people found ineligible in a compensation object for which they were previously eligible.
This report enables you to:
Reconcile total participant counts with third-party providers
Determine the effectiveness of a plan by comparing the number of eligible people to the actual number of enrolled participants
Monitor trends in changes to the volume of currently enrolled participants
Analyze the impact of potential changes to plan offerings on participants
Generate a mailing list of currently enrolled participants
You run reports from the Submit Requests window.
To run the Eligibility and Enrollment List
Select Eligibility and Enrollment List in the Name field.
In the Parameters window, enter the Reporting Start Date and the Reporting End Date to limit the eligibility and enrollment list to this period.
To view eligibility results, enter the eligibility start and end dates. Or, enter coverage start and end dates for enrollment results.
You can also select other criteria to limit the results of the report:
Person, Person Type
Program
Plan Type, Plan: limits the report to the selected plan type or the plan.
Note: You must select either the Plan Type or the Plan.
Plan Not in Program
Option
Enrollment Method (select a value of Generated for enrollments processed through data conversion or IVR transaction)
Person Selection Rule
Organization
Location
Benefits Group
Reporting Group
Payroll
Person Identifier: the report displays the selected identifier.
Sort Order 1 to Sort Order 3: sorts the report based on your selection.
Indicate if you want to view report results such as:
Note: The default value for the following is Yes:
Display Eligibility and Enrollment Summary: lists people who are Eligible, Currently Enrolled, Enrolled by each Enrollment Method Type, Newly De-enrolled, and Newly Ineligible.
Display Enrolled Participants by Plan: lists people enrolled for the selected plan.
Display All Enrolled Plans by Participant: lists all plans in which the selected participant is enrolled.
Display Mailing Address: displays participant address details in the Enrolled Plans by Participant Section.
Display Email Address: displays participant email addresses in the Enrolled Plans by Participant Section.
Display Date of Birth: displays participant date of birth in the Enrolled Plans by Participant Section.
Display Gender: displays participant gender in the Enrolled Plans by Participant Section.
Choose OK.
In the Submit Request window, verify the parameters you selected, set the schedule and the options for running the report.
Choose the Submit button.
The Participation batch process uses your plan design to determine eligibility and enrollment information for the persons and benefit plans that you select. When you run the batch process, the system performs the following actions:
It determines how system-triggered life events impact a person's eligibility, electability, enrollment, de-enrollment, activity rates and coverage.
It creates related person life events based on these system-triggered life events.
It determines when automatic enrollment is appropriate for benefits, and then automatically enrolls those eligible persons.
It de-enrolls participants who lose their eligibility in programs, plans or options and cancels any of their related current enrollment events.
How often you run the Participation batch process depends on the size of your employee population and the timing of your payroll run. Typically, plan sponsors with large employee populations will run the Participation process daily. Because temporal life events (such as birthdays and length of service anniversaries) occur each day for employees of such large enterprises, these events impact employees' eligibility and electability on a daily basis.
On the other hand, a small employer using a single, biweekly payroll run for all of its employees might find running the Participation batch process before each payroll run sufficient.
When the system encounters multiple active life events, it processes the one with the earliest effective date first. A person can have more than one potential life event at a time, but only one active life event at any point in time.
The Participation process produces a user log file that details what operations took place and what database objects the system updated.
Note: You can process a potential life event for an individual employee using the Process Event button in the Person Life Events window, Potential Life Events tab. See: Viewing a Person's Life Event Information.
If the Benefits Service Center function is setup, then you can also process an individual's active life event from the Desktop Activities list in the Benefits Service Center window. See: Online Benefits Administration (Advanced Benefits).
After processing employee terminations, Advanced Benefits customers run the Participation Process in life event mode to de-enroll a person from any compensation objects.
Note: You should set up the application to detect a life event based on termination. Standard Benefits users can de-enroll a terminated employee by processing an unrestricted enrollment or by running the Maintain Participant Eligibility process.
Because you define all benefits elements with a termination of Final Close, the HR termination process end-dates the person's benefits element entries based on the Final Process Date. However, the Participation process recalculates the element entry end date based on the activity rate end date code for a compensation object according to the following rules.
If the Participation process derives an element entry end date that is earlier than the date derived by the termination process, the Participation process resets the element entry end date to the new date.
If the Participation process derives an element entry end date that is earlier than the date of an existing payroll run result, the Participation process sets the element entry end date to the run result date.
If the Participation process derives an element entry end date that is later than the date derived by the termination process, the Participation process errors for that person. In this instance, an HR professional must reverse the termination and set the Final Processed Date to a future date.
Note: The Participation process only updates the end dates of element entries for elements attached to standard activity rates.
You select a run mode for the Participation process based when you are determining eligibility for a scheduled enrollment or an enrollment based on a life event. You can run the process so that results are not saved or so that results are saved to the database.
The following table describes the different batch process modes.
| Batch Process Mode | Description |
| Selection | Determines eligibility for selected persons for selected compensation objects, but does not create electable choices. You can use Selection mode when determining how many persons are eligible for a compensation object. You can choose to commit the eligibility results to the database or rollback the results of the batch process and not update the database. |
| Scheduled | Determines eligibility, electable choices, and enrollment information for selected persons for selected compensation objects based on a scheduled enrollment event. This mode also determines eligibility for the dependents and beneficiaries of eligible participants. |
| Life Event | Determines eligibility, electable choices, and enrollment information for selected persons for selected compensation objects based on a life event. This mode also determines eligibility for the dependents and beneficiaries of eligible participants.
Note: The Date Earned context for the formula type, Rate Value Calculations has changed from life event occurred date to either the life event occurred date or effective date which ever is later. |
| Temporal | Determines temporal life events based on the derived factors of compensation level, percent of full-time employment, hours worked in period, age, length of service, and combination age and length of service. Note: Life events created by the temporal process must be processed in life event mode. |
Each time you run one of the following batch processes the system creates an audit log if you set the Audit Log parameter to Yes:
Close Action Items Process
Close Enrollments Process
Default Enrollment Process
Participation Process: Life Event
Participation Process: Scheduled
Participation Process: Selection
Participation Process: Temporal
Temporal Communications (Action Item Reminder)
Temporal Communications (Emerging Events)
Temporal Communications (Enrollment Reminder)
Temporal Communications (Mass Mailing)
Audit log files accumulate until you purge them. You should periodically purge batch related tables to help the system run more efficiently.
If the audit logs become full, the application prevents you from running any of the processes which create an Audit log. Run the purge process, then restart the process which was interrupted when the log became full.
Note: By default, the application sets the Audit Log parameter to No.
The Participation Audit Activity Purge process protects ongoing activities by purging data only from completed batch processes. Purging the audit logs does not affect life event or election information.
You can purge the log associated with a single concurrent request ID or purge all logs that were created for a Business Group on a date you select.
The process purges data from the following tables:
BEN_REPORTING
BEN_PERSON_ACTIONS
BEN_BENEFIT_ACTIONS
BEN_BATCH_RANGES
You run the Life Event Back-out process from the Concurrent Manager when a life event has been started for a group of persons in error. For example, you might run this process if a salary increase is incorrectly applied to a group of persons, or if a transfer has been incorrectly processed for an organization.
You can back-out all kinds of life events, including:
Temporal life events (such as number of hours worked)
Scheduled life events (such as an open enrollment period)
Explicit life events (such as an address change or assignment transfer)
When you back-out a life event, the system marks all electable choices and related information, such as payroll contributions, dependent designations, and communications, with a status of backed-out.
Life events can be backed out that have a status of started or processed; you can only back-out a person's most recent life event.
You select run-time criteria to control the persons for whom you are backing out a life event. If you use person selection criteria, such as organization, the person must meet all the criteria you specify.
If you do not select person criteria, the process backs out the life event for all persons who experience the event within the date range you specify.
Note: Enter the same date in the From Occurred Date and To Occurred Date fields to run the life event back-out process for a single date.
You can view the results of the Life Event Back-out process in the Process Report. The Summary Report identifies the run-time parameters you selected and provides the total number of persons for whom the selected life event was backed-out.
Note: Use the Person Life Event window to back-out a life event for a single person.
You can purge person data associated with backed-out and voided life events to reduce the volume of data that you store.
See: Purging Person Data for Backed-Out and Voided Life Events
After you run the Participation batch process to determine eligibility and electable choices for your benefits participants, you use the following batch processes to help you process your enrollments:
Default Enrollment Process
Close Unresolved Action Items Process
Close Enrollments
You run the Default Enrollment batch process to enroll a participant into a plan when the participant fails to make an election by a certain date and you have defined a default enrollment for a plan or option.
You also use this process to enroll a participant in a plan or option that you define as mandatory if the person fails to elect this required plan or option by a certain date.
As a prerequisite, you run the Participation batch process before you run the default enrollment process so that eligible participants can be identified.
The Default Enrollment process also determines any action items that must be completed before the enrollment is considered valid.
Note: If a participant is currently enrolled in a plan or option that is not a default for this enrollment period, the default enrollment process will de-enroll the participant from the compensation object if the participant has not made an explicit election.
As part of your plan design, you define the action items that are required for an enrollment to be valid. You can also define action items as optional.
For example, you may require that a person must provide the date of birth for all dependents covered by a plan if the participant enrolls in the Employee Plus Family option of a medical plan.
You use the Close Unresolved Action Items batch process to close any required or optional action items that have not been completed by the participant. This process also deletes any suspended enrollments for the persons who meet the criteria you specify.
You run this process before you run the close enrollment process.
If a plan that you include as a parameter in this process provides interim coverage to a participant with a suspended enrollment, the process closes the suspended enrollment and preserves the interim coverage. The interim coverage is effective until the interim coverage end date that you define in your plan design.
You run the Close Enrollments batch process to close a person's enrollment after elections have been made and to resolve any incomplete election information. This process marks a person's qualifying life event reason as processed.
Use one of the following close modes when you run the Close Enrollments process:
Force Close closes a person's life event regardless of the enrollment period or any pending workflow approvals.
Normal Close closes a person's life event only after the enrollment period has passed for all unenrolled choices.
Preserve Pending Transactions performs a force close if the process finds no pending workflow approvals.
Some benefit plans require that dependents covered under the plan meet certain eligibility criteria in order to receive coverage. For those plans that require dependents to be under a certain age, you need to run the Maintain Designee Eligibility batch process to determine when a dependent becomes ineligible for benefits coverage based on an age change.
This change in age is called aging out of a benefit.
Each time you run an enrollment batch process or the Maintain Designee Eligibility batch process, the system automatically generates the Activity Summary Report. You can also run this report directly from the Concurrent Manager.
The activity summary report groups information about a batch process into four main categories:
Processing Summary
Number of participants successfully processed
Number of participants processed in error
Number of participants unprocessed
Total number of participants selected
Successful Processing Summary- By Event Type
Number of participants with a life event created
Number of participants without a life event created
Number of participants with a temporal life event created
Total number of participants successfully processed
Successful Processing Summary- By Action
Number of participants without a life event created
Number of participants with a newlife event created
Number of participants with a replaced life event
Total number of participants successfully processed
Error Summary
The activity summary report also lists the total number of errors in the batch process categorized by error type.
This report also includes standard report header information such as the Business Group for which the report was run, the execution start and end times, and the number of people selected and processed in the batch run.
Each time you run an enrollment batch process, the system automatically generates the Audit Log Report. You can also run this report directly from the Concurrent Manager.
The audit log identifies each person in the report by personal and assignment information such as their name, social security number or national identifier, job title, grade level, and organization.
For an audit log report that you generate against a Participation batch process that is run in Life Event mode, the audit log displays information about the life events processed in the batch run.
This report also includes standard report header information, such as the Business Group for which the report was run, the execution start and end times, and the number of people selected and processed in the batch run.
Each time you run an enrollment batch process, the system automatically generates the Errors By Error Type Report and the Errors By Person Report. You can also run these error reports directly from the Concurrent Manager.
Both reports return the same error data but format the data in different ways. The Errors By Error Type Report lists all the errors that occurred for the batch process you select. For each error type, the report lists all the persons with this error and their social security number or national identifier.
The Errors By Person Report lists all the errors that occurred for each person with an error in the batch process you select.
Both reports also include standard report header information such as the Business Group for which the report was run, the execution start and end times, and the number of person selected and processed in the batch run.
If a batch process stops processing before it is complete due to errors or other reasons, you can restart the batch process. The following benefits batch processes can be restarted:
Participation Process
Default Enrollment
Close Unresolved Action Items
Close Enrollments
Note: You use the Batch Process Parameters window to specify the maximum number of errors that can occur for a batch process before the process is aborted.
You run the Participation batch process from the Concurrent Manager to determine eligibility and electable choices for those persons who meet the batch process selection criteria that you specify.
The results of the Participation process contain participation information that you can review before you record any participant's benefit elections.
For each person included in the Participation process results, you can review the compensation objects for which the person is eligible or ineligible, activity rate amounts, the life event reason that determined the electable choice, and other enrollment related information.
You can manually generate a life event for a person, or void a life event that was created in error, if you need to supplement the results of the Participation process.
The system also provides a "what-if" eligibility modeling feature that lets you enter proposed data changes to a participant's record and then view the eligibility results that would occur. The eligibility modeling feature is useful for helping a participant understand how a potential life event, such as a marriage or a work re-location, will effect their benefits eligibility.
You use the View Participation Information window to display, by person, the eligibility results of the Participation batch process. The following data is displayed according to the structure of the compensation object hierarchy:
All programs, plans, and options in plan for which a person is eligible
All programs, plans, and options in plan for which a person is ineligible if you check the Track Ineligible Person field for that compensation object in your plan design
Standard activity rates and actual premiums for plans and options in which a person is enrolled
Important: In order to ensure that the information you display for a person is current, you must first run the Participation batch process for that person.
After you run the Participation process, you can use the Person Life Event window to view any active life event or potential life events that were created for a person. You can also manually create or void a potential life event.
For active life events, you can view the status of the life event, including when the event occurred, when it was processed, and when it was closed.
You can also view any enrollment opportunities that were created for a person and any elections made by the participant in association with the active life event. This information includes:
Enrollment period dates
Enrollment coverage dates
Assignment dates for default and automatic enrollments
Benefit limitations such as required certifications or earliest de-enrollment dates
Activity rate information
Potential life events are database changes that the system detects based on your life event reason definitions. You can review potential life events for a person to ensure that life events are correctly defined, detected, evaluated, and processed.
The system displays the following information for each potential life event detected for a person:
Status
Enrollment period start date, if applicable
Processing dates, such as the date the event occurred and the date it was detected
You can define a user role that restricts which participant life events display on the Person Life Events window when accessed by various HR professionals within your enterprise.
For example, you can restrict employees in your Benefits department from viewing life events related to compensation. Similarly, you can ensure that a Compensation Administrator sees only compensation-related life events.
See: Setting Up a Role Based on a Life Event
You can manually create a life event for a person if the system fails to detect a life event based on your life event definitions. You then run the Participation batch process to create a potential or active life event from the manual life event.
You can void potential life events that the system detects in error. Invalid potential life events may be created if your life event definitions do not fully account for situations where the system detects multiple life events.
You can model eligibility for benefits based on proposed changes to a person's HR record. When you model eligibility, changes are not saved to the database, so you can view different eligibility scenarios without having to manually rollback data.
For example, you can inform an employee of the benefits impact of a re-location or a change in weekly hours worked. You can view eligibility, electable choices, and a plan or option's enrollment rate.
When you model eligibility, the system ignores current life events that are in progress for a given person. What-if eligibility is based only on the data changes you elect to model.
Define the life events for your benefits program and link one or more person changes to each life event
Note: You cannot model eligibility for scheduled life events.
When you define a person change for a life event, you enter a What-if Label that appears as the field label for the data changes you can model.
You select runtime parameters to limit the persons and compensation objects that the system processes when determining eligibility, electable choices, and enrollment information. The parameters that the system displays for selection depend on the mode you select for your batch run. Effective date, derived factor, and validate are required parameters. Some parameters contain default values that you can override if necessary.
Note: A person or compensation object must meet all of the criteria, based on the parameters you select, in order to be included in the batch process run result.
Note: The Participation batch process only processes compensation objects with an active status.
An alphabetical listing of all possible runtime parameters follows.
Benefits GroupSelect a Benefits Group to specify that the system process persons assigned to this Benefits Group.
Comp Object Select Rule Select a formula to limit the compensation objects that are processed in the batch run.
Derived Factors This parameter is required. Select Yes (default) to instruct the system to calculate derived factors (such as age and length of service) in order to determine participation eligibility and activity rates for a compensation object.
Select No if you do not use derived factors to determine participation eligibility or activity rates for the compensation objects you are processing in this batch run.
Effective DateThis parameter is required. Enter the date to use for the Participation process. It is used for determining eligibility, electability, and as a reference point for determining other dates such as start and stop dates for enrollment/coverage and rates.
If you select a mode of Life Event, the Effective Date refers to the date the life event occurs.
If you select a mode of Scheduled or Selection, the Effective Date refers to when this person's elections take effect, such as 1 Jan 2000.
Eligibility ProfileThis parameter is only used for the Selection mode. Select an Eligibility Profile to specify that the system process all persons for all active compensation objects that use the selected eligibility profile.
Enrollment Start Date This parameter is only used for the Scheduled mode. Enter the enrollment start date to specify that the system process only persons with this enrollment start date.
Legal EntitySelect a Legal Entity (GRE) to specify that the system process all active employees (and their related persons) whose primary assignment is to the Legal Entity (US only).
Life Event This parameter is only used for the Life Event mode and Temporal mode. Select a Life Event to specify that the system process persons experiencing this Life Event.
Life Event Occurred on Date This parameter is only used for the Scheduled mode. Enter the life event occurred on date to specify that the system process only persons experiencing a life event that occurred on this date.
LocationSelect a Location to specify that the system process all employees (and their related persons) assigned to that Location.
Only Programs Select Yes to specify that the system process all persons for all programs.
Plans Not in Programs The system does not determine eligibility, electable choices, or enrollment information for any plans in programs or options in plans.
Select Yes to specify that the system process all persons for all not in program plans.
Option Name This parameter is only used for the Selection mode. Select the name of the option whose participants and eligible persons the system processes during this batch run.
OrganizationSelect an Organization to specify that the system process all employees (and their related persons) whose primary assignment is to the Organization.
PayrollSelect a Payroll to specify that the system process employees (and their related persons) whose primary assignment is to this Payroll.
Person NameSelect one person for processing.
Person Selection Rule Select a FastFormula rule designed to limit which persons are processed by the batch run. The Person Selection Rule and the Person Name parameters are mutually exclusive.
Person TypeSelect one person type for processing.
Plan Name Select the name of the plan whose participants and eligible persons the system processes during this batch run.
Plan TypeSelect the Plan Type whose participants and eligible persons the system processes during this batch run. This includes all active plans and options in plan of the selected plan type.
Postal Zip RangeSelect a Postal Zip Range to specify that the system process employees (and their related persons) whose primary assignment is located within or is equal to this postal or zip code (US) range.
Program Name Select one program for processing. The system processes all participants and eligible person for the specified program, plans in that program, and options in plan in that program.
Reporting Group Select a Reporting Group to specify that the system process all persons for all active programs and plans associated with this Reporting Group.
Validate This parameter is required. Selecting a value of Rollback lets you view the results of this batch run but prevents the system from making any changes to database data.
Running the Participation batch process first with a Validate value of Rollback is a good idea. After the batch run is processed, you can view the results in the log. When you are satisfied with the results, rerun the batch process using a Validate value of Commit.
Variable Rate Profile This parameter is only used for the Selection mode. Select a Variable Rate Profile to specify that the system process all persons for all active compensation objects that use the selected variable rate profile.
You use the Batch Process Parameters window to set the parameters for a batch process before you run the process. Based on your processing needs, you can define the number of processing threads, the chunk size, and the maximum number of errors allowed in a batch run.
To define parameters for a batch process
Select the batch process for which you are defining parameters in the Name field.
Enter the number of Threads to use for this process.
Enter the number of persons who can be processed per thread in the Chunk Size field.
Enter the maximum number of errors to allow per thread in the Max Errors field.
Save your work.
You run the Participation Batch Process from the Submit Requests window. Select runtime parameters as needed. The parameters of effective date, derived factor, and validate are required each time you run the process.
To run the Participation batch process
Check the Single Request field.
Select a Participation batch process in the Request Name field. Choose one of the following:
Participation Process: Selection
Participation Process: Scheduled
Participation Process: Life Event
Note: You can process a potential life event for an individual employee using the Process Event button in the Person Life Events window, Potential Life Events tab. See: Viewing a Person's Life Event Information.
If the Benefits Service Center function is setup, then you can also process an individual's active life event from the Desktop Activities list in the Benefits Service Center window. See: Online Benefits Administration (Advanced Benefits).
Select one or more runtime parameters in the resulting Parameters window to limit the group of persons the system will process during this batch run.
See: Runtime Parameters for the Participation Batch Process
Important: If you select more than one runtime parameter for a batch run, the system only returns persons who satisfy all the criteria you specify.
Choose the Submit Request button to submit this batch run for system processing.
You use the Monitor Batch Process window to view information about a batch process that you have started, including the percentage of completion of that process.
To monitor a batch process
Query the process you want to view by its request ID.
The system displays the:
Request ID
Batch Process name
process Status
% Complete
You can restrict the display of participant life events based on the role of an HR professional in your enterprise. Choose from the following windows that enable this restriction:
Person Life Events
View Enrollment Results
Enrollment Override
For example, you can restrict employees in your Benefits department from viewing enrollment results related to compensation. Similarly, you can ensure that a Compensation Administrator sees only compensation-related life events.
Navigate to the Information Types Security window.
Select the Information Type of BEN_LER_TYP_CD and attach the type to the required Responsibility.
Save your work and close the Information Types Security window.
Navigate to the Roles window.
Create a new Role and select a Role Type.
Choose the Extra Information tab.
Select a Life Event Type based on the kind of life events you want to display to this user. You can have multiple types for the same user.
Choose one or more:
Benefits
Compensation (for Compensation Workbench)
Absence (UK only)
Grade Step Progression
Note: Selecting Benefits restricts the view to life events you define with a type of Work, Personal, or Unrestricted or to any of the seeded life events for Advanced Benefits.
For each type, indicate if the person has Read/Write access.
Employees with Write access can void and back out life events.
Choose the Users tab.
Select the person to whom you are assigning this role.
If you do not define a role for a user with specific life event types, the user can access all the life event types with no restrictions.
Run the Life Events Summary Report to analyze life events that occur to your compensation and benefits participants.
The report enables administrators to monitor changes to the employee population. This helps you to:
Determine the number of participants with detected life events so you can resource for upcoming administrative needs
Analyze the frequency of a given life event among your employees
Analyze the status of a life event for participants during a specified period
Compare the number of events occurring during two periods
The report provides:
A summary total of the number of potential and active life events that occur within the reporting and comparison periods
All life events by life event status, life event name, and by the person's assignment location
Life Events by plan with person details, such as name, Social Security Number, and location, and other life event information such as status, type, and the life event occurred on or notification date
You run reports from the Submit Requests window.
To run the Life Events Summary Report
Select Life Events Summary Report in the Name field.
In the Parameters window, select the Report Module. Choose from:
Summary Totals
Life Events by Plan with Person Details
All Modules
Enter the Report Run Date.
Select other criteria to limit the results of the report to a specific person:
Person Name, National Identifier
Enter the Reporting Period Start Date and the Reporting Period End Date to limit the report to this period.
You can also select other criteria to limit the results of the report:
Comparison Period Start Date, Comparison Period End Date
Note: If you specify one of these dates, you must also specify the other.
Location
Assignment Type
Organization
Reporting Group: limits the report to all plans attached to the selected reporting group.
Benefit Group
Plan: limits the report to the selected plan.
Note: You cannot process the report if you select a plan that is not attached to the selected reporting group.
Life Event
Life Event Type
Select the Sort Order:
Sort Order 1: The default value is Person Name
Sort Order 2: The default value is Life Event Status
Sort Order 3: The default value is Life Event Name
Sort Order 4: The default value is Life Event Occurred Date
The default value for Display Flexfields is No. Select Yes to report on information contained in the flexfields.
Choose OK.
In the Submit Request window, verify the parameters you selected, set the schedule and the options for running the report.
Choose the Submit button.
You use the Reopen Life Events Process to reopen a large volume of life events as a batch. You do this using the Submit Requests window.
To run the Reopen Life Events Process:
Enter Reopen Life Events Process in the Name field. Click the Parameters field to open the Parameters window.
In the Parameters window, enter the following details:
Effective Date
Validate
Life Event
From Occurred Date
Organization
Location
Person Benefit Group
Legal Entity
Person Selection Rule
Click OK and submit your request.
The Participation Audit Activity Purge process purges data that accumulates in the audit tables when you run the Participation batch process--or any Advanced Benefits process which creates an audit log-- with the audit log turned on.
You run reports from the Submit Requests window.
See: Purging Batch Related Tables
To run the Participant Audit Activity Purge Process
Select the Participation Audit Activity Purge process in the Name field.
Enter the Parameters field to open the Parameters window.
Do one of the following:
Enter a Concurrent Request ID to purge the audit logs associated with a single batch process.
Or
Select a Business Group to purge all the audit logs for the business group on a date you specify, then
Enter the Effective Date for which you want to purge all audit logs for the Business Group.
Choose the OK button.
Complete the batch process request and choose Submit.
With the exception of unrestricted life events, you can back out or void any type of life event for a person. You should periodically purge this backed-out and voided data to reduce the volume of person data stored in your database.
You can purge person data related to backed-out and voided life events for Advanced Benefits and Compensation Workbench plans. The purge process removes a variety of data such as enrollment rates, premium results, and electable choice information.
You run processes from the Submit Requests window.
To purge person data for backed-out and voided life events
Select Purge Backed-out Or Voided Life Events in the Name field.
Enter the Effective Date of the process.
Select the Life Event for which you want to purge backed-out or voided person data.
Or, select a Life Event Type to purge all backed-out or voided instances of that life event type.
Enter a From and To Occurred Date to limit the purge to events that occurred within that date range.
You can select from a variety of parameters that limit the purge to a specific group of persons:
Person Name
Person Selection Rule
Organization
Location
Benefits Group
Legal Entity
Payroll
Select a Backed Out Status of Voided or Backed Out.
If you select Backed Out, the process purges data related to both backed-out and voided life events.
Select Yes in the Audit Log field to generate a results log for this process that indicates the number of rows deleted.
Select Yes in the Delete Life Events field to remove potential life events with a status of Voided.
Selecting Yes does not remove potential life events with a status of Unprocessed.
Click OK.
Complete the batch process request and click Submit.
The purge process deletes data from the tables listed below. To improve system performance, a database administrator should optimize these tables through sizing, indexing, and standard performance tuning after purging data.
Ben_elig_per_f
Ben_elig_per_opt_f
Ben_enrt_rt
Ben_enrt_prem
Ben_enrt_bnft
ben_elctbl_chc_ctfn
ben_elig_per_elctbl_chc
ben_pil_elctbl_chc_popl
ben_elig_dpnt
ben_prtt_rt_val
ben_prtt_enrt_actn_f
ben_prtt_prem_f
ben_prtt_enrt_ctfn_prvdd_f
ben_elig_cvrd_dpnt_f
ben_prtt_enrt_rslt_f
ben_pl_bnf_f
You use the View Participation Information window to display information that the Participation batch process generates for a person.
Important: In order to ensure that the information you display for a person is current, you must first run the Participation batch process for that person.
To display participation information for a person
Query a person whose participation information you want to view.
The system displays the hierarchy of compensation objects for which this person is eligible or ineligible and the participation start and end dates.
Choose the Info Online button from the toolbar--available if you license the third party product Authoria HR--to display a context-sensitive list of pages in the Authoria HR repository.
You use the Person Life Events window to date effectively view information about a life event that occurs to a person. Although a person can have more than one potential life event at a time, the system only displays information about the active life event.
To view a person's life events
Find the person for whom you are viewing life event information.
The system displays a list of life events for the person on the Life Events and Potential Life Events tabs.
Event is the name of the life event experienced by this person as of the effective date.
Status indicates the degree to which the system has processed this life event.
Started: An enrollment opportunity that is available to make elections and changes.
Manual: Prevents a life event from processing without manual intervention.
Detected:The Participation batch process has detected the change in data as a potential life event.
Processed:The Participation batch process has determined whether this potential life event is an actual life event.
Unprocessed:You have created this life event manually. (The next time you run the Participation batch process, this process will change its status to Detected.)
Voided: You have specified that this potential life event is not an actual life event.
Important: Only the Participation batch process can set the status of a potential life event to Detected or Processed. You can manually set the status of a potential life event to Unprocessed or Voided; the system cannot set the status to Unprocessed or Voided.
Life Event Occurred On Dateindicates the date the potential life event occurred.
On the Life Events tab, select a life event and do one of the following:
Choose the Enrollment Opportunities button to view enrollment information based on this life event, such as the enrollment period start and end dates.
Choose the Close Event button to prevent any further processing of the life event.
Choose the Back Out Event button to roll back any updates generated by the Participation Process (such as updates to eligibility, rates, automatic de-enrollments, and so on)
You can only back out the latest life event.
If the life event is related to an absence, choose the View Absence Details button to see the absence record.
Check the Show Backed Out Events check box to view life events with a status of Backed-Out.
On the Potential Life Events tab:
Select the Show Voided Potential Life Event check box to view unprocessed life events that were voided.
Change the status of Unprocessed or Detected life events to Void or Manual.
Add potential life events.
Select the earliest occurring potential life event in the Unprocessed or Detected status and click Process Event to process the life event.
Choose the Info Online button from the toolbar--available if you license the third party product Authoria HR--to display a context-sensitive list of pages in the Authoria HR repository.
You use the Display Enrollment Information window to view any electable choices a person has based on an active life event.
You navigate to this window by querying a person's record in the View Person Life Event Information window and then choosing the Enrollment Opportunities button.
To view a person's electable choices based on a life event
Select a program or plan from the list of electable choices.
The system displays information about the program or plan.
Status indicates the status of the program or plan.
UOM is the unit of measure in which the benefit is expressed.
Enrollment Period Start Date is the date on which this person can enroll in this program or plan.
Enrollment Period End Date is the last date on which this person can enroll in this program or plan.
Default Enrollment Date is the date on which this person is enrolled in this program or plan if they fail to make an election.
Enrollment Type Cycle indicates the type of enrollment cycle (open, unrestricted, administrative, or life event) that resulted in the electable choice for this person and this program or plan.
Election Made Date is the date this person elected this benefit.
Processing End Date identifies the latest date on which the plan sponsor can apply elections for this enrollment period.
Close Enrollment Date to Use is the date on which enrollments are considered closed for this program or plan.
Activity Reference Period identifies the time period in which activity rates are expressed.
Default Assigned Date identifies the date on which this program or plan was assigned as the default if the person failed to make an election.
Automatically Assigned Date is the date on which this program or plan was automatically assigned to this person.
When the system fails to detect a change to a person's record as a potential life event, you can use the Person Life Event window to create that potential life event manually.
After you create a potential life event for a person, you run the Participation batch process to determine eligibility and electable choices based on the life event.
To manually create a potential life event for a person
Query the name of the person for whom you are manually creating a potential life event.
The list of current potential life events for this person is displayed.
Create a new row in the Potential Life Events block.
Select the name of this potential life event in the Life Event field.
Select a Status of Unprocessed to indicate that this potential life event has been created manually.
Enter the Occurred Date to indicate the date the potential life event occurred.
Save your work.
You can process a potential life event with the Unprocessed status using the Process Event button.
When the system improperly identifies a data change as a potential life event, you can manually void that potential life event using the Person Life Event window.
To manually void a potential life event for a person
Query the name of the person for whom you are manually voiding a potential life event.
The list of current potential life events for this person is displayed.
Select the potential life event.
Select a Status of Voided to indicate that this potential life event has been manually voided.
Save your work.
You can use the Person Life Events window to re-open the most recently processed life event for a person by changing the life event status from Processed to Started.
After you re-open a person's life event, you can make election changes, dependent designation changes, or changes to the participant's enrollment window. Use this feature when you do not want to back-out and re-process life events or override enrollments.
Re-opening a person's life event does not cause the application to re-evaluate eligibility or electability. However, if the initial processing of the person's life event caused an eligibility loss to one or more COBRA qualified beneficiaries, re-opening the life event forces the application to re-evaluate eligibility for COBRA qualified beneficiaries.
The application does not re-calculate activity rates--other than those rates you or the participant enter during enrollment--when you re-open a processed life event.
Note: You cannot re-open a life event when a future-dated life event exists with a status of Started or Processed.
To re-open a processed life event for a person
Query the name of the person for whom you are re-opening a processed life event.
Choose the Life Events tab.
Select the person's most recent life event.
If the application allows you to re-open this life event, the Close Event button changes to read Re-open.
Choose the Re-open button.
Verify that the application changed the life event status from Processed to Started.
Save your work.
You can now navigate to the appropriate enrollment window and re-process elections for the person as necessary.
To set up What-if Modeling, you need to do the following:
In the Person Change window, add the What-if label to person data changes. You must do this for data changes to display in Self-Service Benefits What-if.
Attach the Benefit Compensation Objects EIT to the Responsibility. Your EIT setup determines the compensation objects you want to include or exclude from the compensation object hierarchy.
See: Setting Up Extra Information Types Against a Responsibility, Oracle HRMS Configuring, Reporting, and System Administration Guide
Define Roles from the Maintain Roles window. This is optional, and you can configure this if you want to restrict which plans display based on the role of the self-service user.
See: Associating Transaction Workflow Roles to Users, Oracle HRMS Configuring, Reporting, and System Administration Guide
Save your work.
You use the Determine What-If Eligibility/Ineligibility Participation window to model the impact of an HR change to a person's eligibility and electability for benefits.
Note: The system automatically rolls back the proposed data changes and eligibility results when you clear or exit the window.
To model a person's benefits eligibility
Query the Name of the person for whom you want to model benefits eligibility.
Note: The person's current eligibility and electability for benefits is displayed in the Eligibility and Electability tabbed regions.
Choose the Data Changes tabbed region.
Enter the data change or changes for which you want to model eligibility by clicking into the appropriate field and entering or selecting a value.
Note: The available data change fields are limited to the data changes associated with your life event definitions and to derived factors such as salary and hours worked.
Enter the Effective Date of the proposed data changes.
Choose the Process Events button to determine eligibility and electability for benefits.
The system displays the hierarchical structure of compensation objects for which the person is eligible based on the data changes you selected.
Choose the Eligibility or Electability tabbed region to view the results of the eligibility modeling.
You can view rate information for a plan or option by highlighting the rate in the Eligibility or Electability tabbed region and choosing the traffic light button.
The system is designed with features that enable you to perform a variety of tasks from a central form called the Benefits Service Center.
You use the Benefits Service Center window if the requirements of your organization include the need to perform various benefits and HR-related functions in a real-time environment.
Common requests that you can process include changing a person's address or phone number, adding a dependent or beneficiary, or changing a person's marital status. These and other changes may trigger a life event that enables enrollment, change in enrollment, or de-enrollment in one or more benefits.
Using this window you can:
Authenticate a caller's identity
Perform a variety of desktop activities, such as viewing current enrollments, sending communications, and entering personnel changes
Evaluate changes to a person's record for enrollment impact
Enroll eligible participants in benefit plans
See: Processing a Request Using the Benefits Service Center
You can verify the identity of a caller using your organization's authentication criteria. You query the person's record based on the authentication criteria provided by the caller. If the caller's information is authentic, the query displays information about the person such as their address and any life event that is currently active for the person.
If necessary, you can use the results of the query for further caller authentication.
The action you take after you authenticate a caller's identity depends on the caller's request, the status of any open life events, and the person's electable benefit choices, if applicable.
You can select an action or form from a list of desktop activities based on the caller's request. For example, you select the People form if the person needs to change their address. You select the Person Communication form if the person is requesting literature about a benefit plan that you offer.
A special feature of online benefits administration is the ability to process a life event in real-time. When you query a person's record, the system indicates if the person has an open life event.
When you process the life event, the system determines if the life event results in the creation of electable benefit choices for the person. You can then enroll a person in one or more benefit plans for which they are eligible based on this life event.
The participant's request determines how you use the Benefits Service Center window. You can authenticate a caller's identity, change a person's HR record, process an active life event, enter enrollment elections, and send communications, among other tasks.
Note: Use of the Benefits Service Center assumes that you have familiarity with the HR system and the tasks performed by a benefits administrator. Refer to the other areas of your user documentation for more specific help on forms that you can access from this window.
To process a request using the Benefits Service Center:
Verify the caller's identity by entering a query in the Person block.
If the query is correct, the system displays:
The person's name and other identifying information
The person's address
The name and status of the active life event associated with the person, if applicable
Choose the Details button to view details about the person's assignment.
Select a form or action from the Desktop Activities list depending on the participant's request.
People Form- You use this form to enter changes to a person's record such as change of name, address, or marital status.
Process Life Events- Select this action if the person has an active life event that you want to process.
View Person Life Events- Select this desktop activity to open the Display Person Life Event Information window and view information about a person's active life event.
View Person Participation- You use this desktop activity to view the benefit program, plans, and options for which a person is eligible, including the activity rate for the benefit.
Dependent/Beneficiary- You select this option to view a person's dependents and beneficiaries and to add dependents and beneficiaries for a benefit.
Person Communication- You use this feature to send communications to a person.
Override Plan Enrollment- You use this feature to override eligibility results.
Person Participation Override- You use the Person Participation Information window to override eligibility criteria for a person before you run the Participation batch process to determine eligibility and electable choices.
Flex Enrollment form- You use this form to enroll a person in a flexible benefits program.
Non Flex Enrollment form- You use this form to enroll a person in a program that does not use flex credits for participation.
Miscellaneous Enrollment form- You use this form to enroll a person in a plan that is not part of a program.
Savings form- You use this form to enroll a person in a savings and investment plan.
Summary of Enrollment- You select this form to view a person's benefit elections
Complete the form based on the desktop activity you select.
Enrollment management is the process of registering your employees and other eligible participants in benefit plans and options. It includes recording contribution rates and coverage amounts and entering the dependents and beneficiaries of the primary participant into the system.
Enrollments commonly occur when a benefits specialist enters a participant's elections into the HR system. However, for Advanced Benefits users, enrollments can also include default enrollments for persons who do not specify elections during an enrollment period and automatic enrollments which are typically used to enter newly hired employees into interim coverage until they can make their own elections.
Because enrolling employees in benefits programs can be a labor intensive process for an organization with many employees, the product enables self-service enrollments using web enrollment forms and interactive voice response technology (IVR).
Enrollment eligibility and electable benefit choices are based on the eligibility profiles and enrollment requirements that you associate with a benefit.
You can override eligibility results if you are an Advanced Benefits customer. You can grant an exception so that an ineligible person can enroll in a plan or option for which they are otherwise ineligible. Conversely, you can waive a person's participation in a plan for which they have met the eligibility criteria.
The system is delivered with four enrollment forms:
Flex Enrollment (Advanced Benefits)
Non-Flex Enrollment
Savings Plan Enrollment
Miscellaneous Plan Enrollment
You use the Flex enrollment form to enroll participants in flexible benefits programs and vacation buy/sell programs.
You use the Non-Flex enrollment form if you are implementing a benefits program that does not use flex credits.
You use the Savings Plan form to enroll a participant in an investment plan.
You use the Miscellaneous Plan form to enroll participants in plans that are not part of a program.
You manage open enrollment and life event enrollment for a flex program or a flex plus core program using the Flex Enrollment form.
You use the form to enter an eligible person's elections, contribution rates, and coverage levels. As elections are entered, the system calculates the eligible person's spent and unspent flex credits.
From the Flex Enrollment window you can taskflow to windows that enable you to:
View the flex credits an eligible person can spend
Distribute excess flex credits, as allowed by your flex program definition
Record receipt of certifications required for enrollment in the program
Record completed enrollment action items
Enter plan dependents and beneficiaries
Record a participant's primary care provider
You use the Non-Flex Enrollment form to enroll participants in plans and options that are not funded by flex credits. This is the enrollment form you use if you have not purchased the Advanced Benefits product license, or if you are an Advanced Benefits customer who maintains benefit programs that are not funded by flex credits.
You use the form to enter an eligible person's elections, contribution rates, and coverage levels. From the Non-Flex Enrollment window you can taskflow to windows that enable you to:
Record completed enrollment action items (Advanced Benefits)
Record receipt of certifications required for enrollment in the program (Advanced Benefits)
Enter plan dependents and beneficiaries
Record a participant's primary care provider
You use the Savings Plan Enrollment form to record a person's contribution rate and their investment option elections for a savings plan.
From the Savings Plan Enrollment form you can taskflow to windows that enable you to:
Record completed action items (Advanced Benefits)
Record receipt of certifications required for enrollment in the program (Advanced Benefits)
Enter plan dependents and beneficiaries
Important: The product does not accommodate 401(k) balance transfers from other benefits systems for employees who are rolling over 401(k) balances from a previous employer.
You use the Miscellaneous Plan Enrollment form to enroll a participant in a plan that is not part of a program and is not a savings plan. Miscellaneous plans do not provide flex credits to participants.
You use the form to enter an eligible person's elections, contribution rates, and coverage levels. From the Miscellaneous Enrollment form you can taskflow to windows that enable you to:
Record completed action items (Advanced Benefits)
Record receipt of certifications required for enrollment in the program (Advanced Benefits)
Enter plan dependents and beneficiaries
Record a participant's primary care provider
Note: The special plan rates feature is reserved for future use.
Special contribution rates are sometimes offered by a benefits carrier for the joint election of two plans. When a participant elects a plan that is defined as part of a special rate pair, they receive a discounted rate on the second plan.
You use the Special Rates form to view any special rates offered for the plans in a Flex program, Non-Flex program, or for a miscellaneous (not in program) plan.
As part of enrolling a participant in a benefit, you can view the action items that must be completed before the enrollment is valid.
From the Person Enrollment Action Items form, you can navigate to the following forms to enter changes to the record of a participant, dependent, or beneficiary in order to complete the action item.
Person Enrollment Certification
Dependent/Beneficiary Designation
People
You define required action items as part of your plan design.
If you process a subsequent life event for a participant with an open action item, how the application processes the suspended election and any interim coverage for the participant depends on a variety of factors. The scenarios below outline how the application processes action items under different conditions.
Scenario 1: If you process a subsequent life event with an occurred on date that is before the action item due date of the original event, the application retains the action item, certification, interim coverage, and suspended enrollment for the original election. If the subsequent life event occurred on date is after the action item due date, you close the action item by running the Close Unresolved Action Item Process. The application assigns the interim election to the employee as the actual election and deletes the suspended election.
Scenario 2: If you process a subsequent life event before the action item due date, the application creates a new action item. Suspended elections and interim coverage carry forward, and you can complete the action item when you receive the required certification. If you want to close the action item prior to processing the subsequent life event, you must back out the life event; however, if the action item completion date is on or after the subsequent life event, you do not need to back out the life event.
Scenario 3: For a subsequent life event, the participant is eligible for a plan but has no electable choices. In this case, the application does not end date the action item from the original life event. Suspended enrollments and interim coverage carry forward to the subsequent event. The application creates a new action item that corresponds to the new enrollment results created for suspended elections and interim coverage.
Scenario 4: If the participant makes an election change based on a subsequent life event, the application retains the action item and suspended election for the original life event. If necessary, the application creates a new action item with a new due date for the new enrollment based on the subsequent life event.
As part of enrollment processing, you record the persons selected by a participant as dependents or beneficiaries of a plan or option. The system displays eligible designees for participants with enrollments in progress.
Because you can limit the relationship type of the dependents who are eligible to receive coverage under a benefit plan, the system displays only those dependents eligible for coverage. For example, if a participant elects employee plus spouse coverage, the system only displays dependents of the spouse relationship type.
You use the Dependent/Beneficiary Designation form to:
Enter and modify dependent or beneficiary designation information
Assign a benefit to a beneficiary as a percentage or an amount
Monitor certification requirements (Advanced Benefits)
Participants can designate dependents at the plan or option level; beneficiaries are designated at the plan level.
You can record in the system the physician or dentist that a participant elects to be their primary care provider. Providers are categorized by their service provider type, such as General Practitioner, Dentist, or Ob/Gyn. The system provides these and other service provider types and your system administrator can extend this list as part of your implementation.
Note: A person can have only one primary care provider of each provider type within the a plan.
After you enroll a participant in a benefit, you can display the enrollment results for that person.
Enrollment information is date effectively displayed so that you can view historical or future-dated information. You can display enrollment results that are created by one of the following means:
An electable choice is saved on an enrollment form
A default or automatic enrollment is processed
The close enrollment process has completed
The ability to override eligibility results is a requirement for enterprises with a high need for flexible benefits administration. Grand-fathered coverage, special employment terms, or required adjustments for highly compensated employees are all typical reasons for overriding eligibility results.
You use the Person Participation Information window to override eligibility results for a person for one or more plans after you run the Participation process to determine eligibility and electable choices. You then enroll the person using the Enrollment Override window.
You also use the Person Participation Information window to record an election for a person who was not processed in the Participation batch process.
You use the Enrollment Override window to enroll a person in a plan or option for which they have been found ineligible. You can also use this window to override rate and coverage amounts for a plan or an option and to override dependent eligibility results.
You can allow an eligible person to waive participation in a plan type or plan in one of two ways. You can enroll the person in a special plan called a waive plan, or, if you are an Advanced Benefits customer, you can use the Waive Participation form to specify which plan types or plans a person is waiving.
You typically define a waive plan when you want the waive plan to appear to the participant as an electable choice.
When you waive a person's participation in a plan type, the person waives the ability to enroll in all plans in that plan type. You cannot override a plan type waiver for any plans in that plan type.
A variety of common business practices dictate that enrollment coverage may start retroactive to the current system date. These examples include:
Enrollments based on retroactive life events, including enrollments that replace existing coverage
Enrollment coverage and activity rates that start based on the life event occurred date as opposed to the life event notification date
Suspended coverage that becomes unsuspended when interim coverage had been assigned
Note: SSHR users: Suspended plan rates are not included in displayed used amounts, and so are not deducted from Flex credits.
Participant election changes within an enrollment period
Participant elections that replace automatically assigned coverage
Administrative changes to current enrollments
You define enrollment coverage start dates and activity rate start dates for a compensation object as part of your plan design. Because coverage can start based on a date prior to an election, there is the potential for activity rates to also start before the election is recorded.
If a payroll run occurs between the activity rate start date and the election date, the activity rate will not be processed in the payroll run. Since the election had not yet occurred, the activity rate did not exist for the payroll run.
In this scenario, and in other cases where activity rates start before an election is recorded in the system, you may need to create payroll adjustments to deduct payments if your organization requires retroactive benefits payments.
For retroactive enrollments that replace a previous enrollment, the system end-dates the previous enrollment based on the coverage and rate end dates defined for the compensation object. You should define your enrollment coverage and rate start and end dates such that overlapping dates do not occur.
You can use the product to record court orders that require a participant to provide coverage for a dependent or that place restrictions on how a benefit payment can be distributed.
In the US, regulations termed Qualified Medical Child Support Orders (QMCSO) require a participant to cover a dependent when the participant is eligible for a plan and a court order has been issued.
A Qualified Domestic Relations Order (QDRO) is a judgement, decree, or order that relates to the provision of child support, alimony payment, or marital property rights to a spouse, child, or other dependent of a participant.
You can use the product to:
Record those persons subject to a Qualified Medical Child Support Order or a Qualified Domestic Relations Order
Specify the benefit plan or plan type that is subject to the provisions of the court order
Enter the names of the claimants eligible to receive benefit coverages based on the court order
For QDROs, enter the benefit amount or benefit percentage due to each applicable claimant or designee
During enrollment, the system issues a warning message indicating that a participant is subject to a court order. This warning does not prevent the election because the participant may have covered the dependent outside of the employer's plan.
You define enrollment requirements and restrictions for QMCSOs and QDROs as part of your plan design.
You use the Flex Program window to enroll an eligible participant in a flex program. Completing an enrollment involves:
Selecting the plan and option in which the person is enrolling
Entering coverage levels for those plans that provide coverage
Entering the contribution value per activity period for those plans that allow a participant to choose their contribution amount
Entering the annual contribution amount for those plans that allow a participant to specify the annual contribution to a plan
Saving the person's election
Completing dependent and beneficiary designations
Important: Before you use this window, you must run the Participation batch process to 1) ensure that the list of eligible persons for this enrollment cycle is up-to-date, and 2) create available enrollment choices for those persons.
To enroll a person in a flex program
Set the effective date.
Query the Name, Social Security number, or other standard identifying information for the person you are enrolling.
Select the Program in which the person is enrolling.
Important: If you take no enrollment action, the participant will be enrolled in the plans and options that are currently displayed.
Tab into a blank Plan Type field and select the Plan Type that contains the plan and option that the person is electing.
Select the person's election in the Plan and Option field.
Choose the Info Online button from the toolbar--available if you license the third party product Authoria HR--to display a context-sensitive list of pages in the Authoria HR repository.
Complete the election by entering participant values, where appropriate, in the tabbed regions of the enrollment window.
Choose the Recalculate button to update the standard rate or coverage amount based on election information you entered.
You only need to recalculate a rate if your system administrator defined a Post Enrollment Calculation rule for the standard rate or coverage calculation.
Save this person's elections when you have completed the enrollment.
Flex Credit Summary
Based on the participant's current elections, the system displays a flex credit summary for the currently selected plan type.
Provided: The total flex credits provided for the plan type
Less Used: The amount of flex credits spent on the plans and options in this plan type. Typically this is the pre-tax amount.
Excess: The amount of flex credits left unspent.
Forfeited: The amount of flex credits that will be forfeited if they are not spent.
Other: The cash amount spent that does not decrement a benefits pool; this amount typically reflects the amount of after-tax cash spent on a benefit.
Net: The sum of pre-tax and after-tax contributions.
General Tab
Choose the General tab. The system displays the following view-only information:
The Coverage Start and End date for this plan or option
The Start Code used to calculate the coverage start date
The Original Start date that this person enrolled in this plan
The effective date of the enrollment
Note: The Enrolled field appears checked if a person is currently enrolled in this plan or option.
Amount Tab
Choose the Amount tab.
The tax type of this activity rate appears in the Taxability field.
Enter the annual coverage amount that can be elected for this plan or option in the Annual Amount field.
Use this field if the participant can elect an annual amount to contribute to a plan. The system displays the minimum and maximum annual contribution amounts based on your plan definition.
Enter the Defined Amount of the contribution or distribution, if applicable. The system displays the following view-only information:
The Increment by which a contribution or distribution can be increased or decreased.
The Minimum and Maximum contribution or distribution amount.
Note: The fields in the Communicated block indicate the communicated activity rate for this contribution or distribution if this rate is different than the actual amount that is used for element entries.
Rate Tab
Choose the Rate tab. The system displays the following view-only information:
The activity rate Start and End date and the unit of measure in which the rate is expressed
A checkbox indicating if the activity rate has been overriden for this plan or option and the date through which the rate is overriden
Benefit Tab
Choose the Benefit tab.
Enter the benefit Amount if the participant can choose the amount they contribute to this plan or option.
The remainder of the fields in the Benefit tabbed region contain view-only information:
The Type field displays the tax type of this benefit.
The Calculation field displays the calculation method used to derive the activity rate for this benefit.
The Minimum and Maximum fields display this plan or option's coverage limits for this participant.
The Increment field displays the increments in which coverage can be increased or decreased.
Limitation Tab
Select the Limitation tab. The system displays the following view-only information:
The Certification Alert field appears checked if the participant is required to provide certification before being enrolled in this benefit.
The Suspended field appears checked if enrollment in this benefit has been suspended pending the completion of an action item, such as providing required certification.
The Interim field appears checked if this plan or option has been assigned to the participant as interim coverage pending the completion of an action item.
The Automatic field appears checked if the participant has been automatically enrolled in this plan or option.
The Dependents field indicates if dependents are required or optional for this plan.
The Earliest De-enroll field indicates the earliest date on which a participant can de-enroll from this plan or option.
The Must Also Enroll In field displays any plan or option in which a participant must be enrolled in order to make this election.
Note: This field is reserved for future use.
The Override Through date indicates the date through which the enrollment has been overriden.
The Override Reason indicates the reason given for the override.
You use the same process to manually delete an enrollment regardless of the enrollment form in which you entered the enrollment.
To deenroll newly ineligible participants in batch, Standard Benefits users can run the Maintain Participant Eligibility process; Advanced Benefits users can run the Life Event mode of the Participation Process.
To manually delete an enrollment
Open the form in which you entered the enrollment. Choose from:
Flex Program Enrollment form
Non-Flex Program Enrollment form
Savings Plan Enrollment form
Miscellaneous Plan Enrollment form
Set the effective date.
Query the Name, Social Security number, or other standard identifying information for the person whose enrollment you are deleting.
Select the plan and option you are deleting.
Note: To delete a savings plan enrollment, you delete both the savings plan and any options in which the person is enrolled.
Choose the Delete Record icon on the toolbar.
Save your work.
You can view the flex credits available to a participant and the benefit pool that provides the credits.
To view a person's available flex credits
Query a participant in the Flex Enrollment window then choose the Flex Credits button. The system displays:
The flex credits available for various compensation objects
The benefit pool providing the flex credits
The system also indicates if the flex credits for an option may be forfeited.
If you allow participants to specify how they allocate their excess flex credits after they have made their elections, you can view this information for a person in the Excess Credits window.
To allocate excess credits
Choose the Excess Credits button. The system displays:
The benefit pool that provides the flex credits for the plans and options that the participant has elected
The plan types, plans, and options that the participant has elected
The amount of flex credits provided based on elected plans and options
The amount of flex credits used by the participant for each electable plan or option
The amount of flex credits to be distributed as cash, if applicable
The amount of flex credits to be forfeited if the participant does not elect to use them
A check box indicating the credits were rolled over into this plan or option
You use the Non-Flex Program window to enroll an eligible participant in a program that is not funded by flex credits. Completing an enrollment involves:
Selecting the plan and option in which the person is enrolling
Entering coverage levels for those plans that provide coverage
Entering the contribution value per activity period for those plans that allow a participant to choose their contribution amount
Entering the annual contribution amount for those plans that allow a participant to specify the annual contribution to a plan
Saving the person's election
Completing dependent and beneficiary designations
Important: For Advanced Benefits users, you must run the Participation batch process before you use this window to 1) ensure that the list of eligible persons for this enrollment cycle is up-to-date, and 2) create available enrollment choices for those persons.
Important: If you are using Standard Benefits, electable choices are created when you query the program in the enrollment window for a participant.
To enroll a person in a non-flex program
Set the effective date.
Query the Name, Social Security number, or other standard identifying information for the person you are enrolling.
Select the Program in which the person is enrolling.
Important: If you take no enrollment action, the participant will be enrolled in the plans and options that are currently displayed.
Tab into a blank Plan Type field and select the Plan Type that contains the plan and option that the person is electing.
Select the person's election in the Plan and Option field.
Choose the Info Online button from the toolbar--available if you license the third party product Authoria HR--to display a context-sensitive list of pages in the Authoria HR repository.
Complete the election by entering participant values, where appropriate, in the tabbed regions of the enrollment window.
Choose the Recalculate button to update the standard rate or coverage amount based on election information you entered.
You only need to recalculate a rate if your system administrator defined a Post Enrollment Calculation rule for the standard rate or coverage calculation.
Save this person's elections when you have completed the enrollment.
General Tab
Choose the General tab. The system displays the following view-only information:
The Coverage Start and End date for this plan or option
The Start Code used to calculate the coverage start date
The Original Start date that this person enrolled in this plan
The effective date of the enrollment
Note: The Enrolled field appears checked if a person is currently enrolled in this plan or option.
Amount Tab
Choose the Amount tab.
The tax type of this activity rate appears in the Taxability field.
Enter the annual coverage amount that can be elected for this plan or option in the Annual Amount field.
Use this field if the participant can elect an annual amount to contribute to a plan. The system displays the minimum and maximum annual contribution amounts based on your plan definition.
Enter the Defined Amount of the contribution or distribution, if applicable. The system displays the following view-only information:
The Increment by which a contribution or distribution can be increased or decreased.
The Minimum and Maximum contribution or distribution amount.
Note: The fields in the Communicated block indicate the communicated activity rate for this contribution or distribution if this rate is different than the actual amount that is used for element entries.
Rate Tab
Choose the Rate tab. The system displays the following view-only information:
The activity rate Start and End date and the unit of measure in which the rate is expressed
A checkbox indicating if the activity rate has been overriden for this plan or option and the date through which the rate is overriden
Benefit Tab
Choose the Benefit tab.
Enter the benefit Amount if the participant can choose the amount they contribute to this plan or option.
The remainder of the fields in the Benefit tabbed region contain view-only information:
The Type field displays the tax type of this benefit.
The Calculation field displays the calculation method used to derive the activity rate for this benefit.
The Minimum and Maximum fields display this plan or option's coverage limits for this participant.
The Increment field displays the increments in which coverage can be increased or decreased.
Limitation Tab
Select the Limitation tab. The system displays the following view-only information:
The Certification Alert field appears checked if the participant is required to provide certification before being enrolled in this benefit.
The Suspended field appears checked if enrollment in this benefit has been suspended pending the completion of an action item, such as providing required certification.
The Interim field appears checked if this plan or option has been assigned to the participant as interim coverage pending the completion of an action item.
The Automatic field appears checked if the participant has been automatically enrolled in this plan or option.
The Dependents field indicates if dependents are required or optional for this plan.
The Earliest De-enroll field indicates the earliest date on which a participant can de-enroll from this plan or option.
The Must Also Enroll In field displays any plan or option in which a participant must be enrolled in order to make this election.
Note: This field is reserved for future use.
The Override Through date indicates the date through which the enrollment has been overriden.
The Override Reason indicates the reason given for the override.
You use the Savings Plan window to enroll an eligible participant in a savings plan. Completing an enrollment involves:
Selecting the plan and option in which the person is enrolling
Entering the contribution amount or percentage per activity period for those plans that allow a participant to choose their contribution level
Saving the person's election
Completing dependent and beneficiary designations
Important: For Advanced Benefits users, you must run the Participation batch process before you use this window to 1) ensure that the list of eligible persons for this enrollment cycle is up-to-date, and 2) create available enrollment choices for those persons.
Important: If you are using Standard Benefits, electable choices are created for the participant when you query the participant in the enrollment window.
To enroll a person in a savings plan
Set the effective date.
Query the Name, Social Security number, or other standard identifying information for this person.
Select the savings plan in which the person is enrolling in the Name field.
The system displays the following view-only information:
The Life Event reason prompting this savings plan enrollment
In the Coverage block the system displays:
The Coverage Start and End date for this savings plan
The Start Code used to calculate the coverage start date
The Original Start date that this person enrolled in this plan
In the Override block the system displays:
The date through which a savings plan can be overriden and the reason supporting the override
The other fields in the Savings Plan window display information about the status of this savings plan.
Note: The Enrolled field appears checked if a person is currently contributing to this plan.
The Automatic field appears checked if the participant has been automatically enrolled in this plan
The Suspended field appears checked if enrollment in this plan has been suspended pending the completion of an action item, such as providing required certification
The Interim field appears checked if this plan has been assigned to the participant as interim coverage pending the completion of an action item
The Certification Alert field appears checked if the participant is required to provide certification before enrolling in this plan
The Earliest De-enroll field indicates the earliest date on which a participant can de-enroll from this plan
The Currency field indicates the currency in which this benefit is paid.
The Must Also Enroll In field displays any plan in which a participant must be enrolled in order to make this election
Note: This field is reserved for future use.
Choose the Info Online button from the toolbar--available if you license the third party product Authoria HR--to display a context-sensitive list of pages in the Authoria HR repository.
You use the Rates window to enter the total contribution percentage or amount for a savings plan. You then use the Investment Options window to enter the contribution amount for one or more options in the plan.
Note: As a prerequisite, you must check the Enroll in Plan and Option field in the Plan Enrollment Requirements window when you define the savings plan if a participant can enroll in both the plan and the options in that plan.
Query the Name, Social Security number, or other standard identifying information for this person in the Savings Plan window.
Select the savings plan in which the person is enrolling in the Name field.
Choose the Rates button.
General Tab
Choose the General tab. The system displays the following view-only information:
The Name of the activity rate definition
The Activity Type, for example Employee Contribution or Employer Contribution
The unit of measure (UOM) for the currency of the activity rate
The activity rate Start and End dates
Types Tab
Choose the Types tab. The system displays:
The Tax Type of the activity rate, such as pre-tax or aftertax
The Calculation method used to derive the activity rate
Check the Stop Contribution field if the employee's participation in this investment plan has ended.
Defined Amount Tab
Choose the Defined Amount tab.
Enter the Amount or percentage of the contribution or distribution. The system displays the following view-only information:
The activity rate Period
The Minimum and Maximum contribution or distribution amount
The Increment by which a contribution or distribution can be increased or decreased
Note: The Enter Value at Enrollment field appears checked to indicate that the investment amount is entered during the enrollment, as opposed to being a default amount.
Communicated Amount Tab
Note: The fields in the Communicated Amount tabbed region indicate the communicated activity rate for this contribution or distribution if this rate is different than the actual amount that is used for element entries.
Choose the Annual Amount tab.
Enter the annual amount or percentage that is contributed to the investment plan in the Amount field.
Use this field if the participant can elect an annual amount to contribute to a plan. The system displays the minimum and maximum annual contribution amounts based on your savings plan definition.
Save this person's elections.
You use the Investment Options window to enter a participant's elections for a savings plan.
Query the Name, Social Security number, or other standard identifying information for this person in the Savings Plan window.
Select the savings plan in which the person is enrolling in the Name field.
Choose the Investment Options button.
General Tab
Choose the General tab.
Select a savings plan investment option in the Name field.
Note: The Enrolled field appears checked if a person is currently contributing to this option.
The system displays the following view-only information:
The Coverage Start and End date for this option
The Start Code used to calculate the coverage start date
The Original Start date that this person enrolled in this option
Amount Tab
Choose the Amount tab.
Select a savings plan investment option in the Name field.
Check the Stop Contribution field if the employee's participation in this investment option has ended.
Enter the annual amount or percentage that is contributed to the investment option in the Amount field.
Use this field if the participant can elect an annual amount to contribute to an option. The system displays the minimum and maximum annual contribution amounts based on your option definition.
Enter the Defined Amount of the contribution or distribution, if applicable. The system displays the following view-only information:
The Increment by which a contribution or distribution can be increased or decreased.
The Minimum and Maximum contribution or distribution amount.
Note: The fields in the Communicated block indicate the communicated activity rate for this contribution or distribution if this rate is different than the actual amount that is used for element entries.
Rate Tab
Choose the Rate tab. The system displays the following view-only information:
The Taxability of this activity rate
The activity rate Start and End date and the unit of measure (UOM) in which the rate is expressed
A checkbox indicating if the activity rate has been overriden for this option and the date through which the rate is overriden
You use the Miscellaneous Plan window to enroll an eligible participant in a plan that is not associated with a program. Such plans are called not in program plans. Miscellaneous plans do not provide flex credits to participants. Completing an enrollment involves:
Selecting the plan and option in which the person is enrolling
Entering coverage levels for those plans that provide coverage
Entering the contribution value per activity period for those plans that allow a participant to choose their contribution amount
Entering the annual contribution amount for those plans that allow a participant to specify the annual contribution to a plan
Saving the person's election
Completing dependent and beneficiary designations
Important: For Advanced Benefits users, you must run the Participation batch process before you use this window to 1) ensure that the list of eligible persons for this enrollment cycle is up-to-date, and 2) create available enrollment choices for those persons.
Important: If you are using Standard Benefits, electable choices are created for the participant when you query the participant in the enrollment window.
To enroll a person in a miscellaneous plan
Set the effective date.
In the Find Person window, enter the Name, Employee Number, or Social Security number for the person you are enrolling and choose the Find button.
General Tab
Choose the General tab.
Select the not in program Plan and Option in which the person is enrolling.
Note: If you take no enrollment action, the participant will be enrolled in the plans and options that are currently displayed.
The system displays the following view-only information:
The Status of the enrollment
The Plan Type of the electable plan
The Life Event reason prompting this enrollment
The Frequency of the benefit distribution or contribution
The Certification Required Alert field appears checked if the participant is required to provide certification before being enrolled in this benefit.
The Pending Approval field appears checked if enrollment in this benefit has been suspended pending the completion of an action item, such as providing required certification.
The Currency in which this benefit is paid
In the Benefit/Coverage region the system displays:
The Amount of the contribution or distribution and its currency (in the UOM field).
The Coverage Start and End date for this plan
The Original Start date that this person enrolled in this plan
Choose the Info Online button from the toolbar--available if you license the third party product Authoria HR--to display a context-sensitive list of pages in the Authoria HR repository.
Benefit/Coverage Tab
Choose the Benefit/Coverage tab.
The system displays the following view-only information:
The tax Type of this benefit
The Calculation Method used to derive the activity rate for this benefit
The Start Date Code used to calculate the coverage start date
In the Amount Limitations region, the system displays:
The coverage limits for this participant this plan and option
The increments in which coverage can be increased or decrease
Enrollment Tab
Select the Enrollment tab. The system displays the following view-only information:
The Automatic Enrollment field appears checked if the participant has been automatically enrolled in this plan or option.
The Dependents field indicates if dependents are required or optional for this plan.
The Must Also Enroll In field displays any plan or option in which a participant must be enrolled in order to make this election.
Note: This field is reserved for future use.
The Earliest De-enroll field indicates the earliest date on which a participant can de-enroll from this plan or option.
The Override Through date indicates the date through which the enrollment has been overriden.
The Override Reason indicates the reason given for the override.
Save this person's elections.
Before enrolling a participant in a flex program, non-flex program, or plan not in program, you can view special rates for which the participant may be eligible if certain plans are elected in conjunction with one another.
For example, you could define a medical plan so that the participant receives a special rate for a dental plan if they elect both plans. You define special rates using the variable rate profiles window.
See: Defining the Criteria in a Variable Rate Profile
To view special rates for a plan or option
Query a participant in the Flex Enrollment, Non-Flex Enrollment, or Miscellaneous Plan Enrollment window depending on the type of plan in which the participant is enrolling.
Choose the Special Rates button. The system displays:
The plan type, plan, and option that must be elected by the participant to receive the special rate on the related compensation object
The related plan type, plan, and option for which a special rate is available
The standard rate for the related plan if the selected plan is not elected
The special rate for the related plan if the selected plan is elected
You date effectively enter, update, and delete a person's primary care providers in the Primary Care Providers window.
To select a primary care provider for a person
Query the Person whose primary care provider you are entering.
Select the Plan Type and Plan for which you are entering the person's primary care provider.
The available plans are limited to the plans in which the participant or their dependent is currently enrolled.
Select a provider in the Identifier, Name, and Type fields.
If you enter the provider's identifier, the system fills in the Name and Type fields if a provider exists with the same identifier for this plan.
If necessary, select providers of a different service provider type in this plan, or select providers for different plans.
Save your work.
In Oracle iRecruitment, when managers or recruiters create offers for applicants they can select the compensation plans for applicants. iRecruitment includes these compensation plans in the offer letters to applicants. As an HR administrator, you can run the iRecruitment Create Enrollment process to automatically enroll new hires in the compensation plans included in their offer letters. This program processes the compensation plans associated with an offer and creates the enrollment records for the employee.
Using this program, you can create enrollment records for:
An individual person hired for a vacancy.
All the employees hired for a vacancy.
All the employees hired in a business group.
You run this process from the Submit Request window.
To run the iRecruitment Create Enrollment process
Select the iRecruitment Create Enrollment Process in the Name field.
Click in the Parameters field to open the Parameters window.
Select the business group for which you want to run the process. iRecruitment processes the compensation plans for the new hires in this business group and enrolls them into the relevant compensation plans. The business group information is mandatory.
Optionally, you can run the process for a specific vacancy or an employee in the business group.
If you leave these fields blank, then the application creates enrollment records for all the new hires in the business group.
Click Submit, and then OK.
After you run the process, you can view the enrollments in the View Enrollment Results window. For more information, see: Displaying Enrollment Results
You use the View Enrollment Results window to display a person's enrollment information. This is a read-only form.
You can display enrollment information after an enrollment result is created by one of these means: an electable choice is saved on an enrollment form, a default enrollment is processed, or the close enrollment process has completed.
Enrollment information is date effectively displayed so that you can also view historical information.
To display enrollment results for a person
Set the effective date to the date for which you want to view enrollment results.
Query the person for whom you want to view enrollment results.
The system displays enrollment information for the compensation objects in which the person is enrolled.
Check the View By Coverage Date field to view the person's enrollment information as of their coverage start date.
Or, check the View By Session Date to view the person's enrollment information as of the system's effective date.
Choose from the available tabbed regions and task flow windows to view enrollment results.
The system displays the windows that can be accessed from this form in read-only mode.
Choose the Info Online button from the toolbar--available if you license the third party product Authoria HR--to display a context-sensitive list of pages in the Authoria HR repository.
Run the Benefits Enrollment Kit Report to view electable choices for one or more persons. The report also displays enrollment deadlines and indicates any default plans that will be in effect if the person makes no election.
Run the Benefits Confirmation and Summary Report to view enrollment results for one or more benefits participants. The report displays results for participants who are enrolled in:
Plans in program
Plans not in program
Multiple programs
Use the Submit Request window to run either report. You need a postscript viewer to see the results of the report.
To run the benefits enrollment or confirmation report
Select Benefits Reports Wrapper Process in the Name field.
Enter the Parameters field to open the parameters window.
In the Report Name field, select either the Benefits Enrollment Kit Report or the Benefits Confirmation and Summary Report.
Enter the Effective Date of the report.
Select from a variety of criteria to limit the results of the report, such as a:
Compensation object
Life event
Type of assignment
Coverage start and end date
Indicate if you want to report on results such as:
Dependents and beneficiaries
Action items and certifications
Flexfield data
Choose the OK button.
Complete the batch process request and choose Submit.
You use the Manage Open Enrollment Window Process to modify an existing Open Enrollment window's enrollment period end date, processing end date, default enrollment date, and provide a certain number of days of extension. You can run this process for more than an employee at a time. You do this using the Submit Requests window.
To run the Manage Open Enrollment Window Process:
Enter Manage Open Enrollment Window Process in the Name field. Click the Parameters field to open the Parameters window.
In the Parameters window, enter the following details:
Validate
Person Name
Person Selection Rule
Program Name
Plan Name
Life Event Occurred Date
Life Event
New Enrollment End Date
New Processing End Date
New Default Enrollment Date
Number of Days to Extend
Organization
Benefits Group
Location
Postal Zip Range
Click OK and submit your request.
You use the Dependent/Beneficiary Designation window to view enrollment information for the dependent of a participant, including the following:
The plan and option in which the dependent is enrolled
The name of the dependent and their relationship to the participant
Coverage dates
Note: You can only view dependent information when your effective date is between the dependent coverage start and end date for the compensation object.
To view dependent information
Query the name of the participant for whom you are viewing dependent designations.
Choose the View Dependents tab.
Highlight a Plan:Option in which the participant is enrolled.
The system displays the dependents that have been designated for that plan or option.
Choose the Designate Dependents tab or the Designate Beneficiaries tab to create a designation.
Use the Dependent/Beneficiary Designation window to designate a participant's dependents.
The participant must have an open life event to designate a dependent if you are using Advanced Benefits. Standard Benefits customers, or Advanced Benefits customers using the Unrestricted enrollment type, may designate dependents at any time.
Note: As a prerequisite, you must enter the participant's contacts into the system before you can designate a contact as a dependent. Check the Personal Relationship field for each potential dependent on the Contact window. The dependent must also meet the designation requirements defined for the plan and option and the requirements of any dependent eligibility profiles linked to the compensation object before becoming an eligible dependent.
See: Entering Next of Kin and Other Contacts, Oracle HRMS Workforce Sourcing, Deployment, and Talent Management Guide
To enter or modify a participant's dependent designation
Query the name of the participant for whom you are entering or modifying dependent designations.
Select the plan and option for which the participant is designating a dependent in the Plan:Option field.
Any eligible dependents for this plan and option are displayed in the Eligible Dependents field.
The Employee field appears checked if this dependent is also an employee.
The Start and Through dates indicate the dependent coverage start and end dates for this plan.
Check the Covered field to indicate that this person is a dependent for this benefit.
Uncheck the Covered field to undesignate a dependent previously covered by this benefit.
Choose the Certifications button to open the Dependent Certifications window.
The system displays any certifications that must be submitted for this dependent.
Enter the Date Received to record receipt of a certification.
Save your work.
Close the Dependent Certifications window.
Choose the Care Providers button to specify a primary care provider for a dependent.
Choose the Contacts button to open the More Contacts window where you can view the dependents who were found ineligible for the selected plan or option.
Select a dependent from the list and choose the Designate button to have the system check for this dependent's eligibility.
If the dependent is found eligible, the dependent will be added to the list of designees in the Eligible Dependents field, the Covered field will appear checked, and the record will automatically be saved.
Choose the Contacts button to open the Contact window where you can add a new contact for this primary participant.
You can designate a person or an organization as a beneficiary for plans that allow or require beneficiary designation using the Dependent/Beneficiary Designation window.
You can designate a beneficiary at any time, even after a life event or enrollment period is closed. However, for Advanced Benefits customers, beneficiary certifications only restrict designations when the participant's life event is open.
Beneficiary designation restrictions are based on your plan design.
See: Maintaining Beneficiary Designation Requirements for a Plan
To enter or modify a participant's beneficiary designation
Query the name of the participant for whom you are entering or modifying beneficiary designations.
Choose the Designate Beneficiaries tab.
Select a Plan for which you are entering or modifying beneficiary designation information for this participant.
Select a beneficiary name in the Beneficiaries field to designate a person or charitable organization as this participant's beneficiary.
Select this beneficiary's Type, either Primary or Contingent.
If the participant is assigning a percentage of the benefit to the beneficiary, enter the % value of the total value of this benefit.
While you do not need to need to enter an Amount value, you must enter at least one % value. The sum of all % values for a plan must equal 100%. If you specify a monetary Amount, the system pays this Amount value before it pays out any % values. In such a case, the % values refer to the paid benefit following the deduction of the Amount value.
If the participant is assigning a monetary amount from this benefit to this beneficiary, enter this monetary Amount.
Choose the Details button to open the Details window if you want to enter trustee information or special instructions regarding this beneficiary designation for this participant for this plan.
If appropriate, select a Trustee to oversee the benefits the participant assigns to this beneficiary.
The trustee is the person you identify for a designated beneficiary who is a minor. During implementation, your system administrator can configure the application to require a participant to identity a trustee for beneficiaries who are minors. You can generate an action item that suspends the election pending the assignment of a trustee.
If appropriate, enter Instructions regarding this beneficiary designation.
Close the Details window.
Choose the Certifications button to open the Beneficiary Certifications window.
The system displays any certifications that must be submitted for this beneficiary.
Enter the Date Received to record receipt of a certification.
Save your work.
To add a new beneficiary for a participant
From the Dependent/Beneficiary Designation window, choose the Designate Beneficiaries tab then choose the Contacts or Organizations button depending on whether the beneficiary is a person or an organization.
Complete the Contacts or Organizations window, as appropriate.
Save your work.
See Also:Entering Next of Kin and Other Contacts, Oracle HRMS Workforce Sourcing, Deployment, and Talent Management Guide
Creating an Organization, Oracle HRMS Enterprise and Workforce Management Guide
You use the Person Enrollment Action Items window to view and complete enrollment action items that have been created for a person. Action items are based on the enrollment requirements for the compensation objects in which the person is enrolling or de-enrolling. The following action items can be completed using this form:
Beneficiary address
Beneficiary date of birth
Beneficiary social security number
Beneficiary requires spousal consent certification
Dependent date of birth
Dependent social security number
Enrollment certifications
To complete an action item for a person
Query the Name, Social Security number, or other standard identifying information for this person.
Select the action item that the person is requested or required to complete in the Action Items field. The system displays:
A description of this action item
The compensation object in which the person is enrolling, de-enrolling, or changing elections
The life event prompting this enrollment, de-enrollment, or change in elections
The Due Date by which the action item is to be completed
Whether the action item is Required
Use the task flow buttons to navigate to the Certifications, People, or Designee window and complete the missing information, depending on the action item to be completed.
Check the Completed field when the action item is complete.
Note: If the action item is for a missing certification, the Completed field appears checked when you enter the certification received date and save.
Select the Show Completed Action Items check box to display all completed and open action items for a person.
Save your work. You cannot save in this form unless the action item is complete.
Note: When a required action item is completed, the system unsuspends the participant's election if there are no other incomplete required action items and there is no more than one optional action item left incomplete. If a required action item is not completed, the enrollment is end-dated as of the effective date of the Close Enrollment process if the action is due before the close of enrollment.
For more information on how the application processes action items, see: Action Items and Certifications (Advanced Benefits)
You record the receipt of enrollment certifications for a person using the Person Enrollment Certifications window.
You can also add and delete certifications or mark a received certification as denied.
Note: Use the Dependent/Beneficiary Designation window to record receipt of enrollment certifications for dependents and beneficiaries.
To record receipt of an enrollment certification for a person
In the Find Person window, enter the Name, Employee Number, or Social Security number for this person and choose the Find button.
Select the certification type submitted by the participant in the Certifications field. The system displays:
The compensation object and life event that generated the certification
The due date by which the certification must be completed
A check box indicating if certification is required for enrollment in this compensation object
A check box indicating if the participant's enrollment in this compensation object has been suspended pending the completion of any action items.
Check the Received field to indicate that this certification has been received.
Note: You can un-check the Received field after you save, if necessary.
Check the Denied field if this certification has been rejected.
To add a certification for a person
Select a new certification from the list of certification types to add a certification to this participant's election.
Check the Required field to indicate that failure to provide this certification results in a suspended election.
Select the reason for the certification in the Due To field.
Save your work.
To delete a certification for an election
Select the certification type and choose the delete icon from the toolbar.
Save your work.
To record receipt of a certification required by an activity rate
Choose the Rate Certification button.
This button appears for enrollments in compensation objects that have standard rates that require certification.
Do one of the following:
Mark the certification as Received. This enters the element associated with the standard rate on the date calculated by the rate start date code. (This code is specified on the Plan Enrollment Requirements window.)
Mark the certification as Denied. The Rate Certification Required check box remains checked on the View Enrollment Results window.
Note: Once the certification is marked as Received, you cannot change it to Denied. Instead, you can delete the rate on the Miscellaneous Plan enrollment window or set the rate to zero on the Enrollment Override window. You can always update a certification from Denied to Received.
Save your work.
You use the Enrollment Override window to override election information after you have used the Participation Overrides window to specify that a person can enroll in a plan or option for which they have been found ineligible.
You can also override the rate and coverage amounts for a given benefit. If the participant designates a dependent for the plan, you can override the dependents that are covered by the plan.
Caution: You can set your effective date to any date and override enrollment information without backing out subsequent life events. You do not need to reprocess life events after you correct data. However, you must not compromise data integrity when processing an override. The application does not validate data, such as activity rates, that you enter in the Enrollment Override window.
To override enrollment results for a plan
Set the effective date.
Query the Name of the person for whom you want to override enrollment results.
Note: The system displays the programs, plans, and options in which the person is currently enrolled.
General Tab
Choose the General tab if it is not already selected.
Select the plan and option you want to override.
Do one of the following:
Delete the enrollment by choosing the delete icon on the toolbar. Then, add a new row to the enrollment and select the plan and option in which you are enrolling the participant.
Or, override the enrollment by selecting a new plan and option from the list of values in the Plan field.
Note: The list of electable plans is based on the plan type of the plan in which the participant is currently enrolled.
Note: The Overridden field appears checked if this plan is an overriding plan and not a plan in which the participant was enrolled under normal circumstances.
Override Tab
Check the Overridden field to override this plan or option.
Enter the date through which the system overrides the otherwise ineligible person's participation in this plan or option in the Thru field.
Note: You enter the override through date if you only want the override to be in effect for a limited period of time. The override through date cannot be later than the coverage end date.
Select the reason you are allowing this overriding enrollment in the Reason field.
Coverage Tab
Enter the following dates, as applicable:
Coverage Start date
Coverage End date
Note: When you override a plan in which a person is enrolled, the new enrollment begins as of the coverage start date you enter. If you do not enter a coverage end date, coverage for the plan ends based on the coverage end date code defined for the plan.
Original Start Date
Earliest De-enrollment date
Benefit Tab
Enter the new coverage amount for this plan or option in the Value field.
Select the unit of measure of the benefit in the UOM field.
Enter the tax type of this benefit in the Type field.
Save your work.
You use the Override Dependents window to override a participant's dependent designations for a plan.
Note: You use the Dependent/Beneficiary Designation form to enter a participant's beneficiaries for an overriding plan.
You use the Participation Overrides window to maintain override information for a potential benefits participant who is otherwise ineligible to participate in a particular program.
To override participation information for a person
Query the Name of the person for whom you are overriding participation information.
Check the View By Session Date field to view the person's participation information as of the system's effective date.
Or, check the View By Participation Date to view this information as of the person's participation start date.
Select the Level in the compensation object hierarchy at which you are defining override information.
Select the Compensation Object for which you are overriding participation eligibility information for this person.
Check the Eligible field if this person is eligible for this benefit.
Choose the General tab if it is not already selected.
Select the Life Event Reason explaining why you are overriding this person's eligibility/ineligibility for this program or plan.
Enter the Waiting Period Completion Date if the participant must wait until a certain date before enrolling or de-enrolling in this compensation object.
Enter the Participation Start and End Dates through which this person participates in this program or plan.
Check the Restricted Distribution field if some organization (typically a court) has placed a restriction on the distribution of benefits to this participant.
For example, a QDRO (US) specifies a portion of the participant's retirement benefits must be paid to that person's prior spouse.
Check the Highly Compensated field if this person is highly compensated according to the terms of the plan.
Check the Key Employee field if this person is a key employee according to the terms of the plan.
Check the Dependents Only field if this plan only covers this person's dependents.
Save your work.
You can override the run results of the Participation batch process for a person in the Participation Overrides window.
You can also freeze the future calculation of derived factors, such as age or length of service, for a person in a program or plan. The ability to freeze derived factors is useful when you want to exempt a participant from the eligibility rules that are linked to a particular derived factor.
To override eligible participation information for a person
Query the Name of the person for whom you are overriding participation information.
Choose the Eligibility tab if it is not already selected.
Age and Length of Service
Choose the Age/Length of Service alternate region.
If you want the person's age to differ from that shown in the Age field, modify or enter that number.
If you want the person's age UOM to differ, modify or enter the unit of measure.
If you want the person's length of service to differ from that shown in the LOS field, modify or enter that number.
If you want the person's length of service UOM to differ, modify or enter that unit of measure.
If you want the person's number of hours worked to differ from that shown in the Hours Worked field, modify or enter that number.
If you want to modify the period in which the Hours Worked are measured, select a new value in the In Period field.
Enter the person's age and length of service in the Age & LOS field if you are overriding this derived value.
Compensation
Choose the Compensation alternate region.
If you want the person's computed compensation level to differ from that shown in the Compensation Reference field, modify or enter that number.
If you want the person's compensation currency to differ, enter that Currency.
If you want the calendar date the system uses to determine this person's length of service to differ from that shown in the Override Service Date field, modify or enter that date.
If you want the person's percent of full-time employment to differ from that shown in the Percent Full Time field, modify or enter that percentage.
Enter or modify the Hours Worked Qualification value if the system calculates the hours worked once (for a life event or an open enrollment period) or on a continuing basis each time you run the Participation batch process.
Freeze
In the Freeze block, check the derived factors you do not want the system to recalculate the next time it calculates derived factors for this person.
Save your work.
You can use the Participation Overrides window to override the certifications required to enroll in a waive plan.
To override waive participation information for a person
Query the Name of the person for whom you are overriding participation information.
Waive
Choose the Waive tab if it is not already selected.
Check the Waive Plan field if this person is waiving this program or plan.
Select the Certification Type that this person is waiving for this program or plan.
Select a Reason explaining why this person is being allowed to waive this certification type for this program or plan.
Override
Choose the Override tab.
Check the No Maximum Participation field if special circumstances dictate that this person is eligible or ineligible for this plan or program.
Checking this field indicates that this person's eligibility/ ineligibility for the specified compensation object remains in force for an indefinite period of time, regardless of changes to this person's derivable or temporal information.
Check the Override field to override the otherwise ineligible person's participation in this plan.
Enter the date through which the system overrides the otherwise ineligible person's participation in this plan in the Through Date field.
Select a Reason explaining why you are overriding the otherwise ineligible person's participation in this plan.
Save your work.
You can override eligibility results for a person enrolling in a plan option by using the Participation Overrides window.
Choosing to override eligibility results for one or more options in a plan is useful when you do not want to override the eligibility results for all options in a plan.
To override participation information for a person for an option in a plan
Query the Name of the person for whom you are overriding participation information.
Select the program and plan that contains the option to override.
Choose the Options button.
Select the name of the option in this plan for which you are overriding participation information in the Eligible Options field.
Check the Eligible field if you want this otherwise ineligible person to be eligible to participate in this option in this plan.
Conversely, do not check the Eligible field if you want this otherwise eligible person to be ineligible to participate in this option in this plan.
Enter a Waiting Period Completion Date to change the date that must pass before a person is eligible for this benefit.
Enter the Start and End Dates through which this person is eligible/ineligible to participate in this option in this plan.
Check the Override field if special circumstances dictate that this person is deemed eligible or ineligible for this option in this plan.
Check the No Maximum Participation Override Through field if this person's eligibility or ineligibility for this option in plan remains in force for an indefinite period of time regardless of changes to this person's derivable or temporal information.
Select an Hours Worked Qualification code to indicate if the participant must meet the hours worked in period eligibility criteria once or on a recurring basis to qualify for this benefit.
Enter the date through which this override remains effective for this person's participation in the Override Through Date field, and select the Override Reason.
Save your work.
You use the Waive Participation window to enter waive information for plan types and plans in a program.
To manage eligible person waivers for a plan type in a program
Query the Person who is eligible to receive the participation waiver.
Select the Program associated with the plan type or plans that this person is electing to waive.
Choose the Plan Type tab or the Plan tab depending if you are waiving all the plans in a plan type or only selected plans.
Select a Plan Type or Plan in this program that this person is electing to waive.
Select the Waive Reason that supports why this person is waiving participation in this plan type or plan.
Select the Certification Provided code that indicates this person provided the certification required to waive participation in this plan type or plan.
Check the Preferred field if this waive Certification is preferred, but not required.
Save your work.
You use the Court Orders window to record a Qualified Medical Child Support Order or a Qualified Domestic Relation Orders for participants in the US who are subject to either of these court orders.
When a participant enrolls in a plan type or plan that is subject to a court order, the system determines if the participant's dependents that are named in the court order are covered by the plan type or plan in question. A warning message is issued at the time of enrollment notifying the benefits administrator of the court order.
To maintain a court order for a participant
Query the person for whom you are entering a court order.
Select a court order type in the Type field.
Enter a court order identifier in the Order ID field.
Do one of the following:
Select the plan subject to the court order in the Plan field.
Or, select the Plan Type if the court order applies to all plans in the plan type.
Enter the name of the court that issued the order in the Issuing Court field.
Complete these date-related fields.
Issued Date- the date the court issued the order
Received Date- the date your organization received the order
Qualified Date- the date you validated that the order satisfies the criteria of a qualified order
Enter a Description of the court order.
In the Period in Effect block:
Enter the dates on which dependent coverage starts and ends based on this court order.
In the QDRO Payment block:
Specify the QDRO payment amount in either the Amount field or the % (Percent) field.
Enter the unit of measure of this payment, if the order is for an amount.
Select a distribution method in the Distribution field.
Enter the Number of Payments that must be made Per Period
In the Cited block:
Select the name of the dependent or other person cited as a recipient of this benefit based on the court order.
Choose the Contacts button if you need to add a dependent for this participant.
Save your work.
You use the Record Continuing Benefits Payment window to enter the amount paid by a participant for participation in a continuing benefits plan, such as US COBRA plans.
To record a continuing benefits payment
Query the person for whom you are recording a continuing benefits payment.
The system displays all plans in which the participant is currently enrolled.
Select the plan and option for which you are recording a payment.
The system display the activity rate for the plan you select and the Expected Payment Amount.
Enter the participant's payment amount in the Current Payment Amount field.
Save your work.
You use the Record Contributions or Distributions window to enter an amount paid by or paid to a participant in association with a plan or an option.
To record a contribution or distribution
Query the person for whom you are recording a contribution or distribution.
Choose the Activities tab.
Select the activity rate for which you are recording a contribution or distribution in the Activity field.
Enter the Amount of the participant's payment or distribution.
Choose the Compensation Objects tab to view the plans and options associated with the activity rate for which you are recording a contribution or distribution.
Choose the Display Payments button to display the Payments window. You can view the element associated with an activity rate and any payments recorded by the element in this window.
Save your work.
Oracle HRMS uses benefits assignments to maintain eligibility for continuing benefits. The application creates a benefits assignment as a copy of the employee's primary assignment when certain events occur, such as the termination of the employee or a qualifying reduction in hours.
See: Continuing Eligibility: Benefits Assignments
You can view, update, manually create, and end a person's benefits assignment. For example, special circumstances may dictate that you want to change an ex-employee's payroll. If so, you can update the payroll on the person's benefits assignment.
You can update or delete a benefits assignment without affecting the original employee assignment.
See: Maintaining a Benefits Assignment
You use the Benefits Assignment window to view, update, and manually create a person's benefits assignment.
The application automatically creates benefits assignments based on certain events, such as an employee termination, if you set up the auto-generation of benefits assignments when you define the default payroll for a business group.
See: Defining Benefits Defaults Monthly for a Business Group, Oracle HRMS Enterprise and Workforce Management Guide
See: Continuing Eligibility: Benefits Assignments
To maintain a benefits assignment
Query the person for whom you are maintaining a benefits assignment.
Select the person's location and organization.
Insert the person's assignment status in the Status field.
Note: You can only manually insert a person's assignment status. You cannot update an assignment status that the system copies from the person's assignment record.
Update other assignment information as necessary.
Enter the person's people group in the Group field.
Select a Job, Position, and Grade.
Select a payroll.
Note: US and Canadian users must select a payroll with a monthly periodicity.
Save your work.
Choose the Entries button if you want to add, purge, or end element entries for this assignment.
You cannot manually enter or edit entries for elements attached to an activity base rate. These entries are updated by the system when you make an election change or enrollment override.
To delete a benefits assignment
Query the person's benefits assignment and choose the Delete icon from the toolbar. You can choose to purge or end-date the record.
Note: Deleting a benefits assignment does not affect the employee assignment.
You can update activity rates for currently enrolled participants based on plan design changes--such as yearly rate increases--or after a salary review period. You can also recalculate rates if you change the Value Passed to Payroll. For selected persons, you run the Recalculate Participant Values process to calculate:
Participant rates
Coverages
Actual premiums
Imputed income rates (US)
The process provides for a participant to continue coverage in their current benefits elections without the need for re-enrollment or a manual change in rates.
By running the Recalculate Participant Values process close to when plan design changes take effect, you can minimize the impact on currently enrolling participants. Most often, a system administrator schedules the process to run after the end of an annual enrollment period.
As a prerequisite to running the process you should:
Update your plan design (defining the new rate calculations)
Ensure that person records are current
Run the Maintain Participant Eligibility process to update eligibility records and derived factors such as age and length of service
See: Running the Maintain Participant Eligibility Process
See: Running the Recalculate Participant Values process
Note: You can use Total Compensation Setup Wizard to update multiple standard and variable activity rates simultaneously.
When activity rates change between plan years, follow these steps to ensure that your rates are updated without any interruption to current enrollments.
Use the Standard Rates window to update activity rates. You can also use Total Compensation Setup Wizard to update multiple rates simultaneously.
To update activity rates from year-to-year
Set your effective date to the date and year in which the new rate becomes effective.
Make any changes that you require, such as updating the calculation to establish a new rate.
Important: Occasionally, you may want to change the element and input value of a standard rate for business purposes. If so, set the effective date to the date you want the element to begin for participants that you process. The effective date must be later than the existing element entry start date for a person currently enrolled in a compensation object that uses the rate.
Save your work.
When you process an enrollment or run the Recalculate Participant Values Process, the application calculates the rate according to your changes.
The Recalculate Participant Values process updates activity rates based on changes to plan design.
You run processes from the Submit Requests window.
See: Recalculate Participant Values Overview (Standard Benefits)
To run the Recalculate Participant Values process
Select the Recalculate Participant Values process in the Name field.
Enter the Parameters field to open the Parameters window.
You can select from a variety of criteria to limit the participants for whom you are re-calculating activity rates.
Select an individual in the Person Name field to run the process for a single person.
Select a Person Type if you want to calculate rates only for a particular person type (such as employee) within the compensation objects you select.
Select a compensation object--such as a plan or program--for which you are calculating rates.
If special circumstances apply, select a Compensation Object Selection Rule or a Person Selection Rule you have defined to limit the application of the rate re-calculation. For example, you can write a rule to restrict person selection to those employees with a recent salary change.
Choose the OK button.
Complete the batch process request and choose Submit.
If you run this process in error, you can resubmit the process at a date that is prior to the effective date of the previous run. This will recalculate results using the earlier effective date and remove all future changes.
Note: Anytime you run this process it will remove any future enrollment changes.
Run the Premium Reconciliation Report to support the monthly benefits billing reconciliation process. This report compares monthly premium amounts to standard rates and element entries by pay period, for all participants enrolled during the reporting period.
Use this report as an error check for employees with no rates, rates that differ from element entries, and rates and element entries that do not equal monthly premium amounts. In addition, you can use this report as an account of monthly premium payments by sending it to the benefits provider.
You run reports from the Submit Requests window.
To run the Premium Reconciliation Report
Select Reconciliation of Premium Contributions to Element Entries in the Name field.
In the Parameters window, enter the Reporting Start Date and the Reporting End Date to limit the premium reconciliation to this pay period.
Note: If you select dates beyond the pay period, the report result will not display the reconciliation details.
Select other criteria to limit the report results to a particular employee, such as:
Employee Name
National Identifier
Employee Name Format: this limits the report result to the selected employee.
Note: The default format is the default Employee Name Format you configured during implementation. If you select Japanese, the report result displays the participant details in the full name format as per Japanese legislation requirements.
Program: this limits the report to the specific program.
Note: The list of values contains all active programs in the business group.
Select the Plan to limit the report results to data elements contained in the plan.
Note: If you select a healthcare plan, the report displays details of healthcare options. Similarly, if you select an insurance plan, the report displays details of coverage options.
You can also select other criteria to limit the results of the report, such as:
Person Selection Rule
Organization
Location
Benefits Group
Reporting Group
Payroll
Premium Type
The default value for Output Type is Text. Select Comma Separated Values if you have many premium, rate, and element entry values.
Indicate if you want to view report results, such as:
Note: The default value for the following is Yes:
Display Plan Reconciliation Report: provides total participant monthly premiums, standard rates, element entries, and discrepancy amounts for each payroll frequency in the reporting period.
Display Plan Discrepancies Report: lists all participant records with a discrepancy due to monthly premiums, standard rates, or element entries per pay period.
Display Life Event Report: lists all participants whose life event caused a change to plan premiums in the reporting period. If there are no such participants, the report result does not display this section.
Display Plan Participant Details Report: lists all the participants enrolled in the plan including option/coverage, monthly premium, and coverage start and end date.
Display Participant Details: displays the Plan Reconciliation and Plan Discrepancies sections of the report.
Choose OK.
In the Submit Request window, verify the parameters you selected, set the schedule and the options for running the report.
Choose the Submit button.
Close the Submit Requests window.
Open the Find Requests window.
Click Find.
Select your Request ID and click View Output.
The Discrepancy column highlights the amounts that do not reconcile for a person. The following codes indicate the reason for the discrepancy:
S = Element entries (per pay period) for total contributions subtracted from the standard rate pay period total do not equal zero.
P = Element entries (per pay period) for total contribution subtracted from the participant monthly premium do not equal zero.
SP = Both standard rates and the participant monthly premium do not reconcile with element entries for the period.
You use the Monthly Plan or Option Premium window to view the plans and options for which you have defined a premium calculation.
Use this form if you need to manually adjust the premium result for a plan or an option in plan or if you need to enter or update the costing segment against which the premium is applied.
To view or adjust a monthly premium for a plan or option in plan
Query the Plan or Option for which you want to view premium information.
Select the premium associated with this plan or option in the Premium Name field.
The system displays the following read-only premium information in the General tabbed region:
The premium Type
The premium Payer
The Supplier of the coverage
The Calculation method used to derive the premium.
The system displays premium calculation results in the Monthly Activity tabbed region. The following information is read-only:
Premium unit of measure
the Premium Manually Adjusted field appears checked if you manually adjusted the premium
Enter the new premium in the Value field to manually adjust the result of the premium calculation.
If necessary, change the month or year for which you are manually adjusting the premium.
Enter the Number of Participants included in this premium.
Enter or updates the Costing segment against which to apply the premium for this plan or option in plan.
Save your work.
You use the Monthly Participant Premium window to view the plans and options in which a participant is enrolled that have an associated premium. Use this form if you need to manually adjust a participant's premium or if you need to enter or update the costing segment against which the participant's premium is applied.
To view or adjust a monthly premium for a participant
Query the Person for whom you want to view premium information.
Select the premium associated with this plan or option in the Premium Name field.
The system displays the following read-only premium information in the General tabbed region:
The Plan or Option associated with the premium
The premium Type
The premium Payer
The Calculation method used to derive the premium
The Supplier of the coverage
The Standard Value and Unit of Measure of the premium
The system displays premium calculation results for the selected person in the Monthly Activity tabbed region. The following information is read-only:
Premium unit of measure
Total credits
Net premium (the premium paid minus the total credits applied to the premium)
the Allocated Value field appears checked if this is an allocated premium
the Premium Manually Adjusted field appears checked if you manually adjusted the premium
the Credits Manually Adjusted field appears checked if you manually adjusted the credits applied to this premium
Enter the new premium in the Value field to manually adjust the result of the premium calculation.
If necessary, change the month or year for which you are manually adjusting the premium.
Enter or update the Costing segment against which to apply the premium for this person.
Save your work.
You define a person benefit balance using the Person Benefits Balances window by associating a person with a benefit balance you have defined.
To define a person benefit balance
Select a Person for whom you are defining a benefit balance.
Select a Benefit Balance that you defined in the Benefit Balances window.
Enter a Value for the balance.
Save your work.
You use the Reimbursement Requests window to date-effectively record a request for reimbursement when the participant incurs a cost that is covered by a plan for which you have defined reimbursable goods and services, such as a spending account plan.
To record a reimbursement request
Query the name of the person who is submitting the reimbursement request.
In the From and To fields, record the date range over which the cost was incurred. The Expense Incurred Date defaults to the effective date.
Note: The application saves future-dated reimbursement requests with a status of Pending and does not create an element entry.
Select the Plan against which the submitter is making the reimbursement request.
Request Details Tab
Choose the Request Details tab.
In the For field, select the name of the person receiving the reimbursement.
This person can be the primary participant or a person of a valid relationship type to the primary participant as defined for the reimbursement plan.
Select the Status of the reimbursement request.
Enter the request Amount and select the Currency type of the expense.
Enter the name of the good or service Provider and the Provider's Tax ID.
Check the Adjustment field if this reimbursement request is an adjustment to an existing request.
Optionally, enter an Approved Amount.
Save your work.
When you save the request, the application automatically:
Assigns the request a Request Number
Records the effective date as the Submitted Date of the request
Assigns the request a status of Goods and Services Required
Indicates the Annual Coverage Elected for the current and previous years as well as the previous year's Claims Paid (for spending account plans)
In the Total Claims Submitted field, calculates and displays the total amount of the requests this year for this person for this plan
Goods or Services Tab
Note: As a prerequisite, you must define goods and services during your plan design in order to process a reimbursement request.
Choose the Goods or Services tab.
Select the Good or Service provided.
The Certification Required field appears checked if you indicated this certification was required during your implementation.
Choose the Certification button to open the Reimbursement Certifications window.
Record the Received Date or Denied Date of the certification.
Save your work.
Changing the Status of a Request
You can change the status of a reimbursement request.
To change the status of a request
Choose the Status Tracking tab.
The application populates the Status field with the request status you selected in Step 6 above.
In the Request block:
Select a Reason for this request status.
You can add to the list of Status Reason types by using the Lookup Type BEN_STAT_RSN in the Application Utilities Lookups window.
Check the Overridden field if you override the status of this request for some reason.
Note: This field is reserved for future use.
Select a Reason for the request override.
Note: This field is reserved for future use.
Select the Prior Status of the request before you selected the overriding request status.
Note: This field is reserved for future use.
In the Approved for Payment block:
Select the status of the approved payment in the Current field.
You can add to the list of Approved Payment Status types by using the Lookup Type BEN_APRVD_PYMT_STAT in the Application Utilities Lookups window.
Select an approved payment status Reason.
You can add to the list of Approved Payment Status Reasons by using the Lookup Type BEN_APRVD_PYMT_RSN in the Application Utilities Lookups window.
Check the Overridden field if you override the status of this approved payment for some reason.
Note: This field is reserved for future use.
Select a Reason for this approved payment override.
Note: This field is reserved for future use.
Select the Prior Status of the approved payment request before you selected the overriding status.
Note: This field is reserved for future use.
Save your work.
Entering a Reimbursement Payment
When you save an approved request, the application writes the approved amount to the Reimbursement Payment window and updates the standard distribution rate for the reimbursement. If you link an element to the distribution rate, the process updates the element entry.
You can change the approved amount, provided that the new amount is not for a higher value and that your payroll system has not processed the payment.
To enter a reimbursement payment
Choose the Payment button.
Modify the Approved Payment amount.
Select a payment status and a status reason.
Check the Adjustment check box if you are adjusting the approved amount.
Save your work.
Run the Process Forfeitures concurrent request to calculate and record the total forfeited amount for each participant in a reimbursement plan at the end of a plan year.
Note: As a prerequisite, update the balances to make sure that contribution and distribution totals are current and accurate.
See: Setting Up Reimbursement Plans for Forfeitures (Advanced Benefits)
You run processes from the Submit Requests window.
To run the Process Forfeitures concurrent request
Select Process Forfeitures in the Name field.
Enter the Parameters field to open the Parameters window.
Enter the Effective Date of the process.
In the Commit field, select whether you want to commit or rollback the results of the process.
Select the reimbursement plan for which you are processing forfeitures in the Plan Name field.
Choose the OK button.
Complete the batch process request and choose Submit.
Run the Process Forfeitures Audit Log process or the Process Forfeitures Summary Report for information about errors and process totals.
To view forfeiture results for a participant, open the View Enrollment Results window. Query a person, then choose the Rates button.
To view total forfeitures for the plan, open the Forfeited Values window. Query a plan. Select the Forfeitures tab, then choose the Forfeiture Values button.
You use the Determine Communications batch process to generate communications that are not automatically generated based on the rules of your plan design.
You can generate a batch communication for just one person or for all the people who meet your selection criteria. You select the parameters of the batch process to limit the people who receive a communication.
You can generate a batch communication by selecting one of four different kinds of triggers types. A trigger is a primary parameter that determines the kind of communication that is delivered. Choose one of the following triggers:
Enrollment Reminder Letters
Action Item Reminder Letters
Emerging Event Literature
Targeted Mass Mailing
The parameters available for your use vary according to the trigger that you select.
When you select more than one parameter, the system only generates communications for those persons who meet the criteria of all the parameters you select.
Important: If you do not select a communication type as one your parameters, the batch process generates all communications defined for the trigger type you select.
See: Running the Determine Communications Batch Process
You select this trigger to generate one or more batch communications for all participants who:
Have an open life event (life event status equals Started)
Have not made an election as of the effective date of the batch process
Meet the criteria of all the parameters that you select
For example, you could send an enrollment reminder letter to all persons eligible for a benefit who have not made an election by a certain date.
You select this trigger to generate one or more batch communications for all participants who:
Have an open action item as of the effective date of the batch process
Meet the criteria of all the parameters that you select
You select this trigger to generate one or more batch communications for all participants who:
Will experience a life event based on the temporal factors of age, length of service, or combination age and length of service as of the date you select
Meet the criteria of all the parameters that you select
Note: For emerging event communications, the selection of a compensation object as a batch process parameter is optional. If no compensation object is specified, none will be used. For other batch processes, if you do not select a compensation object all compensation objects are included as a parameter.
You select this trigger to generate one or more batch communications for all participants who:
Are either eligible for a benefit or enrolled in a benefit that you select
Meet the criteria of all the parameters that you select
You select batch communication parameters to determine the criteria that a person must meet in order to receive a communication.
When you select more than one parameter, the system generates communications for those persons who meet the criteria of all the parameters you select.
The available parameters vary according to the trigger type that you select.
A listing of all possible runtime parameters follows.
Action Type Select an action type to specify that the system process persons who have an open action item effecting their enrollment as of the effective date of the batch process run.
Age Factor Select an age factor to specify that the system process persons who meet the criteria of this derived factor.
Combination Age and Length of Service Select a combination age and length of service factor to specify that the system process persons who meet the criteria of this derived factor.
Comp Object Select Rule Select a user-defined rule to limit the compensation objects that are processed in the batch run.
Eligible or EnrolledSelect this parameter to indicate if the system should process persons who are eligible for a benefit or enrolled in a benefit.
Enrollment PeriodSelect an enrollment period.
From Date Select the date from when the derived factor is computed if you use age, length of service, or combination age and length of service as a parameter.
Length of Service Factor Select a length of service factor to specify that the system process persons who meet the criteria of this derived factor.
Life Event Select a life event to specify that the system process persons experiencing this life event.
Location Select a location to specify that the system process all employees assigned to that location.
Maximum Age Enter a maximum age to use as a selection criteria instead of an age factor.
Maximum Combination Age and Length of Service Enter a maximum combination age and length of service to use as a selection criteria instead of a combination age and length of service factor.
Maximum Length of ServiceEnter a maximum length of service to use as a selection criteria instead of a length of service factor.
Minimum Age Enter a minimum age to use as a selection criteria instead of an age factor.
Minimum Combination Age and Length of Service Enter a minimum combination age and length of service to use as a selection criteria instead of a combination age and length of service factor.
Minimum Length of Service Enter a minimum length of service to use as a selection criteria instead of a length of service factor.
Mode Select Initial if you are submitting this communication batch process for the first time, or select Resend if you are re-submitting this batch process.
Organization Select an organization to specify that the system process all employees whose primary assignment is to the organization.
Person Name Select one person for processing.
Person Selection Rule Select a user-defined rule designed to limit which persons are processed by the batch run. The Person Selection Rule and the Person Name parameters are mutually exclusive.
Person Type Select one person type for processing.
Plans Not in Programs Select Yes to specify that the system process all persons for all plans not in program.
Program Select a program to specify that the system process persons enrolled in or eligible for any plans or options in this program.
Trigger Type This is the main parameter that determines the kind of communication to be sent.
You use the Person Communications window to date effectively maintain information about the communications that are sent to a participant. You can define communications so that they are automatically sent to a participant after a qualifying life event, or you can send communications at the participant's request.
To maintain communications for a person
Query the person for whom you want to maintain communications information.
Select the Type of communication you are sending.
Note: The communications listed in the Type field are those defined with a communication trigger type of Online Participant Based Request or Online PSR Based Request.
The system displays the following read-only information based on the communication you select:
The life event triggering this communication
The date sent, if this communication has been sent
The short name for the communication, if one was defined
The To Be Sent date code, communication usage, and recipient type
Modify the To Be Sent date, if necessary.
Check the Inspect field if this mailing requires inspection.
Check the Requested field if this mailing does not require inspection, but inspection is requested.
Select the Address to which the communication should be delivered.
Change the delivery method or media, if necessary.
You maintain a person's preferred delivery method and media on the People window.
Enter any Instructions about the delivery or processing of this communication.
Choose the Usages button to navigate to the Communications Usages window where you can associate the communication type to a program, plan, action, or enrollment period.
Choose the Resend button to send this communication.
Save your work.
You run the Communications Batch Process from the Submit Requests window. Select runtime parameters as needed.
To run the Communications Batch Process
Check the Single Request field.
Select the Determine Communications batch process in the Request Name field.
Select one or more runtime parameters in the resulting Parameters window to limit the group of persons the system processes during the batch run.
Note: The system determines the available parameters based on the trigger type you select. Further system edits prevent the selection of incompatible parameters.
Choose the Submit Request button to submit this batch run for system processing.
This workbook enables you to identify a person's outstanding enrollment action items if any. It also enables you to decide whether to unsuspend elections or consider the life events as complete.
This workbook has the following worksheets:
Action Items
Certifications
You must supply values for the following parameters of the worksheet:
Employee Name
Employee Number
National Identifier
This worksheet enables you to display the following details for each person:
Life event causing the action item
Program name
Plan type name
Plan and option names
Action type name and description
Action item required
Action item due and completed dates
Enrollment suspended or not suspended
What open action items exist for the employees' enrollment?
This worksheet enables you to identify the certifications that the participant provides in a plan to satisfy the enrollment certification requirements. It enables you to identify the following details for each person:
Life event name
Program name
Plan name and type
Option name
Details about enrollment certification, such as the certification type, required or optional, required and received dates, and denied certification information
What certifications have the employees provided for their enrollment?
This workbook enables you to identify the persons or organizations that benefits participants designate as their beneficiaries or dependents.
This workbook has the following worksheets:
Dependent Designations
Beneficiary Designations
You must supply values for the following parameters of the worksheet:
Employee Name
Employee Number
National Identifier
This worksheet enables you to identify the persons that participants designate as dependents. This worksheet displays the following details for each person:
Life name
Program name
Plan name and type
Option name
Dependent name and relationship to participant
Dependent coverage rates
Certification details such as the type, dates, and requirement status
Who have the employees designated as their dependents?
This worksheet enables you to identify the persons or organizations that participants designate in a plan as beneficiaries of plan benefits. It displays the following details for each person:
Life event name
Program name
Plan name and type
Option name
Beneficiary name and type
Coverage percentage and amount
Designation dates
Trustee details
Additional instructions if any
Certification details, such as the type, dates, and requirement
Who have the employees designated as their beneficiaries?
This workbook enables you to identify the following information:
Standard rates
Total flex credits
Imputed income for a person enrolled in a plan or option in plan
Premium values
This workbook has the following worksheets:
Enrollment Rates
Premiums
You must supply values for the following parameters of the worksheet:
Employee Name
Employee Number
National Identifier
This worksheet displays the following details for each program:
The participants and the plans or options in which they are enrolled
Corresponding standard rates and rate types
Defined, communicated, and annual amounts
What are the enrollment rates for the employees' programs?
This worksheet displays the participant details, such as the plans or options in which they have enrolled, the corresponding premium amount, currency, and activity period.
What are the premium rates for the employees' programs?
This workbook enables you to identify the existing health plans for a person.
This workbook has the following worksheets:
Plan
Person
You must supply a value for the Program Name parameter for these worksheets.
Note: You need an Advanced Benefits licence to obtain meaningful data in these two worksheets.
The Plan worksheet enables you to report on the defined, annual, and communicated amounts for each plan. It provides the sum total of the entire plan and option combinations. For each plan/option combination, the worksheet displays the calculation result in a matrix format.
What are the cost details for the medical plans in which employees have enrolled?
This worksheet displays the details of participants enrolled in each plan. It enables you to report on the defined, annual, and communicated amounts for each plan. You can also report the total amount of the plan or option for each individual employee.
How many employees have enrolled in a specific plan?
This workbook enables you to identify the existing life events for a person. You can also identify the potential life events and the ones currently in progress.
This workbook has the following worksheets:
Person Life Events
Potential Life Events
You must specify values for the start and end date parameters for both these worksheets.
Note: You need an Advanced Benefits licence to obtain meaningful data in these two worksheets.
This worksheet enables you to report on the total number of processed life events with the following statuses:
Processed
Started
Backed-out
Voided
This report uses calculations with the following statuses:
Backed out
Processed
Started
Voided
Total
What are this person's life events? What is the status of those events?
This worksheet enables you to report on the total number of processed life events with the following statuses:
Detected
Manual override
Processed
Unprocessed
Voided
Total
What are the potential life events and what is their status?
This workbook enables you to identify the details of the processed and potential life events for a person.
This workbook has the following worksheets:
Processed Life Events
Potential Life Events
You must specify values for the start date, end date, and life event name parameters for both these worksheets.
Note: You need an Advanced Benefits licence to obtain meaningful data in these two worksheets.
This worksheet enables you to display the details of persons with the following life event information:
Selected life event
Date of occurrence
Status
Organization
Job
Grade
Position
Location
Bargaining unit
e-mail address
What are the processed life events for an employee? What are the employee details and life event status?
This worksheet enables you to report on the following:
Life event name and status
Persons with the selected life event
Life event occurrence and processed dates
Void/manual override dates when applicable
What are the potential life events for an employee? What are the employee details and life event status?