This chapter provides overviews of Benefits Billing and the Billing Calculation process and discusses how to:
Enroll participants.
Calculate charges.
Review charges.
Generate Benefits Billing statements.
Process payments.
Adjust charges and payments.
Review charge and payment history.
You use Benefits Billing to process billing for employees and dependents who are charged directly for benefit plan elections instead of paying through payroll deductions. You can use Benefits Billing for either regular benefits or COBRA benefits.
Before you begin using the Benefits Billing feature, set up the rules for benefits billing.
See Also
Setting Up Base Benefits Core Tables
The Billing Calculation process creates billing charge records for a selected billing calendar. Each billing charge record contains charge information for an individual plan type and billing period combination.
The system queries the Manage Base Benefits business process tables to determine the coverage that is in effect for the plan type as of the end date of the billing calendar. It passes the coverage code and other relevant data to the Deduction Calculation (DedCalc) programs. The DedCalc programs calculate the billing amount using normal rules, which the billing system then modifies based on the rate qualifier.
Rerunning the Billing Calculation Process
Just as with PeopleSoft Enterprise Payroll for North America, you can rerun billing calculations repeatedly for a given billing calendar until you print billing statements for that calendar. The system backs out any previously calculated charges as well as any open credit that it applied previously to the charges.
The system cannot reprocess charges for a billing calendar if you have made adjustments to the charges or have applied payments.
When retroactive processing is called for, the Billing Calculation process compares:
Billing calendar dates.
The date that billing begins for the plan type.
The dates of any charge records for the plan type.
The system then generates retroactive billing charge records for all previous billing periods that:
Have passed since the billing begin date.
Do not have billing charge records.
Billing Calculation Limitations
The Billing Calculation process calculates payments based on employee enrollments in the Manage Base Benefits business process tables and the rates that are specified in benefit programs. The Billing Calculation process does not:
Include any offset from credits when calculating deductions.
You enter flat amounts into Billing Enrollment records to simulate the use of credits.
Calculate imputed income or any other taxable or nontaxable benefit calculations.
The process calculates before-tax and after-tax deduction classifications only.
Bill benefit programs, leave plans, and vacation buy and sell plans (plan types 01, 5x, and 9x).
Update any deduction or other payroll balances.
You have to do this manually. Not making these adjustments can affect imputed income reporting, savings plan limit testing, and flexible savings plan (FSA) claims processing.
Check group limits on life and AD/D insurance plans.
The Billing Calculation process bills only flat-dollar amounts for savings plans, FSA plans, retirement plans, and pension plans (plan types 4x, 6x, 7x, and 8x).
This section discusses how to:
Locate eligible participants.
Enroll participants automatically.
Enroll participants manually.
Override Benefits Billing parameters for individual enrollees.
Page Name |
Definition Name |
Navigation |
Usage |
BILL_ENROLL |
Benefits, Benefits Billing, Manage Acct Status and Balance, Enroll in Billing, Enroll in Billing |
Enroll participants manually into the Benefits Billing system and update previous enrollments. |
|
BILL_EMPL_PARM |
Benefits, Benefits Billing, Manage Acct Status and Balance, Request Hold/Alternate Address, Request Hold/Alternate Address |
Override Benefits Billing parameters at the individual enrollee level. Set up comments, designate an alternate address, or hold statements for an individual enrollee. |
A typical Benefits Billing population might include:
Employees on leave without pay.
Employees on reduced schedules who do not earn enough to pay for coverage.
Retirees who continue company-sponsored coverage.
Terminated employees who are enrolled in COBRA.
Dependents of employees who are enrolled in COBRA.
Survivors of deceased employees and retirees.
Note. Dependents of active employees cannot be billed through Benefits Billing. Only dependents who have been given a nonemployee status through COBRA processing or some other means can be enrolled in Benefits Billing.
If you currently implement PeopleSoft Enterprise Benefits Administration, you can use Event Maintenance processes to locate employees and dependents who are eligible for Benefits Billing and enroll them into the Benefits Billing system.
You can also use COBRA Administration processes to locate and enroll COBRA participants who are eligible for Benefits Billing.
See Also
Access the Enroll in Billing page (Benefits, Benefits Billing, Manage Acc Status and Balance, Enroll in Billing, Enroll in Billing).
ID |
When you first enter the Enroll in Billing page, you are prompted for the ID of the employee whom you want to enroll or update. You cannot create Benefits Billing enrollment records that cover all of an employee's multiple jobs at once. |
Plan Type |
You can enter multiple plan types, including:
|
COBRA Event ID |
This value is automatically assigned by the COBRA batch process, but can also be entered. The value is 0 for non-COBRA billing. |
Effective Date |
You can have multiple effective-dated billing records for COBRA and non-COBRA events. |
Event Identification |
Indicates whether the record was created through Event Maintenance or Open Enrollment. This field is for records created through Benefits Administration processes only. |
Billing Status |
Controls billing calculations for each plan type. Values are: Active: You are billing the employee for this plan type. Hold Billing: Charges are not calculated for this plan type. If you change the status to Active after Hold Billing has been in effect, the system retroactively calculates charges the next time that you run the Benefits Billing calculation process. While Hold Billing is selected for a particular plan type, the system continues to bill for other plan types and continues to produce statements. Inactive: You are no longer billing for this plan type. |
Billing Reason |
Identifies the source of the billing entry and the reason that the employee is being billed; for reference only. Values are: Manual: Indicates that you are entering the billing enrollment record manually. Arrears: Indicates that the participant cannot gross enough to cover deductions. If the system has automatically enrolled the employee or dependent into Benefits Billing through Benefits Administration or COBRA batch processes, the system selects either Benefits Administration or COBRA to identify the process by which this enrollment record was entered into the system. |
Percent Calculation and Flat Amount |
Determine how to modify the deduction calculation for billing purposes. Select Percent Calculation to use the system deduction calculation routines with either the normal Employee Rate or the Total Rate to calculate the amount that is owed for each billing period. The system then multiplies the calculated value by the percentage that is entered. The percentage can be more than 100 percent. Select Flat Amount to add a dollar amount to the amount calculated by the Percent Calculation settings. If the Percent Calculation check box is deselected, the system bills the employee the flat amount for each billing period. The amount can be a negative number. |
See Also
Access the Request Hold/Alternate Address page (Benefits, Benefits Billing, Manage Acc Status and Balance, Request Hold/Alternate Address, Request Hold/Alternate Address).
Effective Date |
You can enter more than one set of override parameters per employee and order them by effective date. |
Hold Billing |
Select to halt billing for all plan types. When you hold billing and run the Benefits Billing calculation process, the system retroactively calculates charges that occurred during the period that the hold was in effect. |
Hold Statements |
Select to stop printing billing statements for this employee. |
Comments |
Enter comments that are to be printed on upcoming billing statements for this employee. |
This section discusses how to:
Calculate charges automatically.
Calculate charges manually for individual participants.
Page Name |
Definition Name |
Navigation |
Usage |
BILL_RUNCTL |
Benefits, Benefits Billing, Calculate and Review Charges, Calculate Periodic Charges, Calculate Periodic Charges |
Calculate charges automatically and create billing charge records for a selected billing calendar. |
|
BILL_CHRG_ADD |
Benefits, Benefits Billing, Calculate and Review Charges, Enter Manual Charges, Enter Manual Charges |
Manually post new billing charge records to the system. |
Access the Calculate Periodic Charges page (Benefits, Benefits Billing, Calculate and Review Charges, Calculate Periodic Charges, Calculate Periodic Charges).
Billing Period |
Select the period that indicates the billing calendar for which you want to calculate benefits billing charges. Note. You can rerun the Billing Calculation process until you run the Statement Print process for that billing period. |
Payment Due and COBRA Payment Due |
Automatically populated with the dates that were defined for this billing calendar. These fields can be modified if necessary. |
Access the Enter Manual Charges page (Benefits, Benefits Billing, Calculate and Review Charges, Enter Manual Charges, Enter Manual Charges).
You can use this page to enter a partial charge for an employee's first billing period and start automatic billing for that employee in the next billing period. You can also use this page to enter a partial month billing for the last billing period.
If you enter a Billing Charge record manually for an employee, the Billing Calculation process does not automatically calculate the same billing period's charges for that employee. The Billing Calculation process never deletes manual charge entries, even when the process is rerun for a particular billing period.
Empl ID (employee ID) |
Enter the ID of the employee who is to be billed. |
Billing Period |
Select the billing period from the billing calendar. |
Plan Type |
Determine the plan type. |
(CAN) Sales Tax |
Canadian users can enter charges that represent various Canadian sales taxes that are associated with another benefits charge. For example, a billing charge for a medical plan may have a Canadian sales tax associated with it. You enter this tax as a separate charge and identify the type of sales tax here. This field can be used for the Goods and Services Tax (GST), the Provincial Sales Tax (PST), the Provincial Premium Tax (PPT), the Provincial Sales Tax on Insurance (PSTI), and the Harmonized Sales Tax (HST). Note. You always enter sales tax as a separate charge, because this is the only way that the system can track it. On all Benefits Billing pages dealing with benefits charges, sales tax charges are identified with their sales tax type. |
Charge |
Enter the total charge for this employee and billing period. |
Note. After you save a charge entry record, you cannot directly change the amount of that charge. Any changes must be made through the Adjust Charges page.
This section discusses how to:
Review individual charge records.
Review charge details.
Review charges by billing period.
Review charges by plan type.
Access the Charge page (Benefits, Benefits Billing, Calculate and Review Charges, Review Charge Details, Charge).
Charge ID |
A system-generated number that ensures the uniqueness of Billing Charge records. |
CBR Evt ID (COBRA event ID) |
If this coverage is calculated under COBRA, provides a link to the COBRA event. |
Benefit Program, Coverage Code, Benefit Plan, and Deduction Code |
Obtained from the participant's Manage Base Benefits business process records. These fields can be used to trace back to the rate tables and calculation rules that created the charge. |
(CAN) Sales Tax |
Appears if the charge is for Canadian sales tax associated with another benefits charge. |
Date Due and Date Overdue |
You can modify these dates. |
Print Period |
Indicates the begin and end dates of the billing calendar during which the statement for this charge was sent. |
Charge |
The original charge calculated by the batch calculation process or entered in the Charge Entry page. |
Charge Adjustments |
From the Adjust Charges page. |
Payment Adjustments |
From the Adjust Payments page. |
Note. Participants who are billed for more than one billing period, or who are billed for more than one plan type, employee record number, or COBRA event within a particular billing period, have multiple billing charge records.
Access the Charge Detail page (Benefits, Benefits Billing, Calculate and Review Charges, Review Charge Details, Charge Detail).
Posting Date |
Displays the dates on which actions were entered into the system. For detail records with an action type of Charge, the posting date is the last day of the billing cycle. |
Action Type |
Possible actions include Charge, Charge Adjustment, Payment, and Payment Adjustment. |
Charge |
The amount of the original charge. If the charge is associated with a Canadian sales tax, the sales tax type (GST, PST, PSTI, and so on) is indicated as well. |
Access the Rvw Charge Smry by Bill Period page (Benefits, Benefits Billing, Calculate and Review Charges, Rvw Charge Smry by Bill Period, Rvw Charge Smry by Bill Period).
(CAN) If the charge is associated with a Canadian sales tax, the sales tax type (GST, PST, PSTI, and so on) is indicated before the Charge column.
Access the Rvw Charge Smry by Plan Type page (Benefits, Benefits Billing, Calculate and Review Charges, Rvw Charge Smry by Plan Type, Rvw Charge Smry by Plan Type).
(CAN) If the charge is associated with a Canadian sales tax, the system displays the sales tax type (GST, PST, PSTI, and so on) of the charge to the left of the charge amount.
This section discusses how to:
Print and reprint billing statements.
Establish print IDs for reprinting statements.
Page Name |
Definition Name |
Navigation |
Usage |
RUNCTL_BEN040 |
Benefits, Benefits Billing, Create Statements, Print Billing Statement, Print Billing Statement |
Print and reprint billing statements. |
|
BILL_PRINT |
Benefits, Benefits Billing, Create Statements, Reprint Statement, Reprint Statement |
Set up print IDs and select employees for reprinting billing statements. |
Access the Print Billing Statement page (Benefits, Benefits Billing, Create Statements, Print Billing Statement, Print Billing Statement).
Billing Period |
Select from the billing calendar. |
Statement Date and Date for determining Past Due |
Used to determine which charges are overdue. The system totals charges with due dates prior to the as of date and prints the total as the amount overdue. This date has been kept separate because some organizations bill in advance for benefits. |
Reprint and Print ID |
If you want to reprint statements, select the Reprint check box and enter a print ID. You define reprint report print IDs in the Reprint Statement page, which is explained in the following section. |
The printed statements include all plan types that are being billed. They do not differentiate between COBRA and non-COBRA charges, and they don't itemize the charges by an employee's different employee record numbers (if the employee has multiple jobs). The inclusion of a due date on each item allows for separate due dates for COBRA coverage.
Billing statements can also include statement comments. You can use the Billing Parameter page to create global comments that appear on the statements of all employees who are participating in a given billing calendar, and you can use the Employee Override page to compose a statement comment that appears on an individual employee's billing statement.
Note. The system produces statements only for individuals who have active billing enrollments or outstanding balances in the Benefits Billing system. The system does not print statements for employees who are inactive with a zero balance or who have Hold Statements selected in the Employee Override page. If a charge that is displayed on the statement is subject to a Canadian sales tax, the system displays the charge's sales tax type (GST, PST, PSTI, and so on) to the left of the charge amount.
Access the Reprint Statement page (Benefits, Benefits Billing, Create Statements, Reprint Statement, Reprint Statement).
Billing Period |
Select from the billing calendar. |
Empl ID (employee ID) |
Select the employees for whom Billing Statements need to be reprinted. |
This section discusses how to:
Log payments.
Review payment history.
Page Name |
Definition Name |
Navigation |
Usage |
BILL_PAYMENT |
Benefits, Benefits Billing, Apply Payments, Allocate Payments to Charges, Allocate Payments to Charges |
Log individual payments from a participant and allocate those payments to separate charges. |
|
BILL_PAYMENT_VW |
Benefits, Benefits Billing, Apply Payments, Review Payments/Details, Review Payments/Details |
Examine charge payment history for a selected participant. |
|
BILL_PSUM_BY_PTDT |
Benefits, Benefits Billing, Apply Payments, Review Summary by Post Date, Review Summary by Post Date |
Review payments for a specific participant, arranged by posting date. |
Access the Allocate Payments to Charges page (Benefits, Benefits Billing, Apply Payments, Allocate Payments to Charges, Allocate Payments to Charges).
Posting Sequence |
Provided by the system. Enables you to enter multiple payments on the same day. |
Form of Payment |
You can enter either Check or Cash, but the interface value can be set automatically only by the Billing Calculation batch process. |
Payment |
Enter the total payment that the employee provides. The system automatically allocates this payment to the oldest charges. You can redistribute the payment among the participant's various charges manually in the Allocations group box. |
Allocation Details |
This group box enables you to manually distribute the payment to the various open charges. When a charge is paid in full, it is closed by the system and does not appear the next time that you access the Allocate Payments to Charges page. If, after allocation of the payment, a charge is not paid in full, it remains open for the next payment. |
Applied to Open Credit |
If payment exceeds the total amount owed, the system posts the excess payment here. Note. The system does not allow participants to have payments applied to open credit as long as they have unpaid charges. |
Note. Any changes to saved payment entries must be made through the Adjust Payments page.
Access the Review Payments/Details page (Benefits, Benefits Billing, Apply Payments, Review Payments/Details, Review Payments/Details).
Posting Date |
The date when the payment was actually applied to the charges. |
Entry Date |
The date when you entered the payment record into the system. |
Print Period |
The billing period during which information about this payment appeared on the participant's billing statement. |
Payment |
The payment amount that was originally entered. |
Payment Adjustments |
Adjustments made on the Adjust Payments page. |
Actual Payment |
The amount of the payment that was actually applied against charges. This value is identical to either the Payment or Payment Adjustments value, except in cases in which overpayments were applied to open credit. |
This section discusses how to:
Make adjustments to charges.
Make adjustments to payments.
Page Name |
Definition Name |
Navigation |
Usage |
BILL_CHRG_ADJUST |
Benefits, Benefits Billing, Make Adjustments, Adjust Charges, Adjust Charges |
Adjust charges on existing Billing Charge records. |
|
BILL_PAY_ADJUST |
Benefits, Benefits Billing, Make Adjustments, Adjust Payments, Adjust Payments |
Adjust payments to existing Billing Payment records. |
|
BILL_ADJ_SMRY |
Benefits, Benefits Billing, Make Adjustments, Review Adjustment Summary, Review Adjustment Summary |
View a summary of all adjustments for a participant. |
Access the Adjust Charges page (Benefits, Benefits Billing, Make Adjustments, Adjust Charges, Adjust Charges).
Note. You can apply only one charge adjustment at a time.
Post Date |
Automatically set to today's date, but you can change it. |
Post Seq (post sequence) |
Assigned by the system. Enables you to schedule more than one charge adjustment for a particular post period. |
Adj Amt (adjustment amount) |
Enter the amount of the adjustment. If you increase the charge, the system checks to determine whether the participant has any overpayments allocated to open credits. It applies open credits to the increase in the charge, updates the charge balance, and inserts detail rows showing the allocation of the open credits to the charge. If you reduce a charge that has already been paid, you end up with an overpayment. The system checks to determine whether the employee has other open charges. If open charges exist, the system requests that you make a payment adjustment. If no open charges exist, the system selects a payment that is allocated to the charge that is being adjusted and automatically creates a payment adjustment that reduces the payment. The system then increases the open credit balance by the amount by which the payment was reduced. |
Adjustment Description |
Enter the reason for the adjustment. |
Access the Adjust Payments page (Benefits, Benefits Billing, Make Adjustments, Adjust Payments, Adjust Payments).
Payment Adjustments |
Distribute the total adjustment among the charges. |
Post Date |
Automatically set to today's date, but you can change it. |
Post Seq (post sequence) |
Assigned by the system. Enables you to schedule more than one charge adjustment for a particular post period. |
Payment Change |
Enter the total adjustment. |
Net Adjustment |
The net adjustment is equal to the payment change if the adjustment increases the payment or if no open credit is associated with the payment. If the payment adjustment reduces the payment or an open credit exists, the Net Adjustment field represents the amount that is left over when the open credit has been used up, which then has to be subtracted from charges. The system requires that the value in the Net Adjustment field equal the value in the Net Adjustment Allocated field, except when the total adjustment exceeds the total due on charges. In this case, as with payments, the system requires that all the charges are paid off, and it applies the remainder to open credit. |
Adjustment Distribution |
You can redistribute the payment to other charges through the adjustment. |
You can view a history of all payments, charges, and remaining balances for an employee.
This section discusses how to review employee billing history.
Page Name |
Definition Name |
Navigation |
Usage |
BILL_BLNC_SMRY |
Benefits, Benefits Billing, Manage Acct Status and Balance, Review Employee Balances, Review Employee Balances |
View charges, payments, and grand totals that are associated with an individual employee. |
Access the Review Employee Balances page (Benefits, Benefits Billing, Manage Acct Status and Balance, Review Employee Balances, Review Employee Balances).
The charge and payment values that appear are accounted for in all adjustments previously posted against them. The Net column displays the balance that is still outstanding for each charge and payment combination.
Note. Canadian sales tax types (GST, PST, PSTI, and so on) appear to the left of the charge listing when appropriate.
The Grand Total field adds the Total Charge, Total Payment, and Net columns.