15 Setting Up Workfiles for Benefits Self Service

This chapter contains the following topics:

15.1 Understanding Workfiles for Benefits Self Service

Your software uses workfiles to process employee self-service enrollments. The workfiles contain values for current enrollments and available employee benefit plans. Each of the workfiles must be set up before employees can use the benefits self-service programs.

15.2 Setting Up Dependent Selection Automatically

This section provides an overview of setting up dependent selection automatically and discusses how to:

  • Run the Automatically Setup SS Dependent Selection (R085505)

  • Set processing options for the Run the Automatically Set Up Dependent Min/Max program

15.2.1 Understanding Automatic Dependent Selection

The Automatically Set Up Dependent Min/Max program (R085505) builds tables that the system uses to automatically determine the minimum number of dependents that are appropriate for each benefit plan or plan option. This program also adds a value for allowed relationships in the Allowed Dependent Relations Per Plan table (F085500). A * is added to each benefit plan or benefit plan option record that does not already contain a specified value. Self-service benefits programs use these tables to select benefit plans based on covered dependents. The system uses these factors in determining the plans that are displayed as choices from which employees can choose:

  • Minimum number of dependents

  • Maximum number of dependents

  • Valid relationships per plan or plan option

Before running this program, ensure that benefit plans options are defined for each benefit plan or that benefit plans are set up with plan grouping. Also review your benefit plan setup to ensure that a maximum number of dependents has been defined for all benefit plans and benefit plan options.

When you run the program, you define plans or plan options to include. You normally run this program after adding a new set of benefit plans to the software and before building the benefit workfiles that use the new plans.

Include all benefit plan options within a benefit plan when you run the Automatically Set Up Dependent Min/Max program. Do not include only one benefit plan option. If you are using benefit plan grouping, then include all benefit plans within a benefit plan group when you run the program.

The system determination of the minimum number of dependents for each benefit plan option is an estimate that is based on the maximum number of dependents listed in the prior plan option and the number of dependents that are defined for a certain plan. For example, the minimum number of dependents for the EE + 1 benefit plan in the list below is 2. The estimate of 2 is based on the maximum number of dependents defined for the previous EE Only benefit plan and the plan maximum of 2 dependents that are defined for the EE +1 benefit plan.

The system calculates the minimum number of dependents as follows:

Medical Plan Options Number of Dependents Before Running the Program Maximum Number of Dependents After Running the Program Maximum
Medical Plan Options Minimum Maximum Minimum Maximum
EE + 1 1 2 2 2
EE + 3 1 4 3 4
EE + Family 1 99 5 99

Review the results to ensure that the dependent numbers reflect the needs of the organization.

15.2.2 Running the Automatically Setup SS Dependent Selection (R085505)

From the Employee Self Service General Management (G08BESS327), Automatically Set Up Dependent Min/Max.

15.2.3 Setting Processing Options for Automatically Setup SS Dependent Selection (R085505)

Processing options enable you to specify the default processing for programs and reports.

15.2.3.1 Defaults

Default the number of dependents

Prompt the system to automatically supply the minimum number of dependents. Values are:

1: Yes

0: No

Default the relationship if one is not found

Prompt the system to write a default value for allowed relationships if a value is not found. Values are:

1: Yes

0: No

15.3 Building the Current Coverage Workfile for Self Service

This section provides an overview of setting up dependent selection automatically and discusses how to:

  • Run the Current Enrollment Work File Build program.

  • Set Processing Options for Current Enrollment Work File Build (R085530).

15.3.1 Understanding the Current Coverage Workfile for Self Service

The Current Coverage Work File Build program (R085530) should be run prior to running these reports:

  • Available Plans Work File Build (R085520)

  • Build Current Dependent/Beneficiary Work File (R085537)

  • Personal Employee Information Workfile Build (R054101)

The Current Coverage Work File Build program creates the Employee Current/Pending Elections Work Table (F085530W) that contains current employee enrollment information. The system uses this workfile to display the benefits in which an employee is currently enrolled. When you build the Employee Current/Pending Elections Work Table, the system uses information from these tables:

  • Employee Master Information (F060116)

  • Employee Enrollment (F08330)

  • Categories Within Benefit Groups (F08350)

  • Plans Within Benefit Categories (F08351)

  • Benefits Plan Master (F08320)

  • Plan Additional Options (F083202)

You should run this report at these times:

  • Before employees use the benefits self-service programs to enter changes and new information

  • Before each open enrollment

  • Periodically, after employees enter benefit changes

    When employees re-enter self service after entering changes, they can view their updated information only after this report is run.

If the version number has been created for the Build Current Dependent/Beneficiary Work File program (R085537), and a processing option is set appropriately, the Current Coverage Work File Build program automatically launches the Build Current Dependent/Beneficiary Work File program.

15.3.2 Running the Current Enrollment Work File Build program

From the Current Coverage Work File Management (G08BESS321), Current Coverage Work File Build.

15.3.3 Setting Processing Options for Current Enrollment Work File Build (R085530)

Processing options enable you to specify the default processing for programs and reports.

15.3.3.1 Version

Use this processing option to specify a version of the Build Current Dependent/Beneficiary Work File program (R085537) and build the Current Dep/Ben X-Reference Work Table (F085537W)

1. R085537 Version:

Enter the version of the Build Current Dependent/Beneficiaries Work File UBE (R085537) to be run. If the field is left blank, the dependent/beneficiary enrollment information will not be generated. Verify that the data selection for R085537 is set up for the selected version before running. XJDE0001 is the standard version used. The Build Current Dependent/Beneficiary Work File program supplies current dependent and beneficiary enrollment data for the Current Dep/Ben X-Reference Work Table (F085537W)

15.4 Setting Up a Current Dependent and Beneficiary Workfile

This section provides an overview of the Current Dependent/Beneficiary Work File program and discusses how to:

  • Run the Build Current Dependent/Beneficiary Work File program.

  • Set processing options for the Build Current Dependent/Beneficiary Work File program.

15.4.1 Understanding the Current Dependent and Beneficiary Workfile

When you build the Current Dep/Ben X-Reference Work Table (F085537W), the system searches these tables:

  • Employee Master Information (F060116)

  • Employee Enrollment (F08330)

  • Dep/Ben to Employee Plan X-Reference (F08336)

  • Participant File (F08901)

  • Primary Care Physician Table (F08338)

  • Dep/Ben X-Reference Tag Table (F08336B)

  • Plan/Plan Option Tag Table (F08320B)

The system obtains employee dependent and beneficiary records that are associated with plans, and records that are not associated with plans. The system then saves this information in the Current Dep/Ben X-Reference Work Table. When employees use self service to change their benefits or update information, the system uses information from this file to display their current dependents and beneficiaries. You should run this program before employees use benefit self service features.

You can build the workfile for open enrollment or for a current enrollment event type. The workfile stores the records for both types of events. The program maintains the dependent and beneficiary records separately for each event type.

Running this program checks for active and inactive dependents and beneficiaries and saves the information in the workfile. All dependent and beneficiary information is saved in the workfile even if the dependent or beneficiary is not currently covered by employee benefit plans or benefit plan options so that an employee can re-enroll an inactive dependent.

Before building the workfile, if the system finds unprocessed dependent or beneficiary records for an employee, the system prints the record on an exception report without processing the employee and proceeds to the next employee. The system does not include participants who are deceased.

15.4.2 Running the Build Current Dependent/Beneficiary Work File Program

From the Dependent/Beneficiary Work File Management (G08BESS323), Dependent/Beneficiary Work File Build.

15.4.3 Setting Processing Options for Build Current Dependent/Beneficiary Work File (R085537)

Processing options enable you to specify the default processing for programs and reports.

15.4.3.1 Process

Use this processing option to specify the type of enrollment that you are preparing to offer.

1. Enrollment Event Type:

Specify the event type that the system uses when saving data in the Current Dep/Ben X-Reference Work Table (F085537W). Open enrollment indicates an event that occurs during a set date range, normally only once, during the year. Current enrollment indicates life events that can happen at any time during the year. Examples of current enrollment events are marriage, divorce, or the birth of a child. Values are:

1: Open enrollment

2: Current enrollment

15.5 Building the Available Plans Workfile for Self Service

This section provides an overview of the available plans workfile for self service and discusses how to:

  • Run the Available Plans Work File Build program.

  • Set processing options for the Available Plans Work File Build.

15.5.1 Understanding the Available Plans Workfile for Self Service

When you use the Available Plans Work File Build program (R085520) to build the Available Plans and Plan Options by Employee Work Table (F085520W), the system searches each employee benefit group for all active benefit plans and benefit plan options that are offered. It also calculates the new cost, as of the effective date, for each plan and plan option. The system obtains age and salary from the Benefit Self Service Constant table (F08505) and uses this information as of the point-in-time date to determine the cost for applicable annuity benefit plans. If the plan requires the employee to enter an amount or rate, the system calculates the costs or credits dynamically after the employee enters the amount and requests the calculation.

If the workfile contains unprocessed records, these instances are printed to an exception report.

To determine whether the current employee enrollment elections can be reused for open enrollment, the Available Plans/Plan Options by Emp Work Table Report (R08320) tracks whether the current elections are different from the available benefit plans and benefit plan options. For the system to reuse current enrollment information, these conditions must exist:

  • All current benefit plans and benefit plan options must be valid for the upcoming enrollment year.

  • All current benefit plans and benefit plan options must be set to enable reuse (defaulting).

If the employee's current enrollment is available for open enrollment, and a processing option is set appropriately in the Available Plans Work File Build program (R085520), the system supplies the current enrollment as the default enrollment. However, if a current plan is no longer available (for example, if you are changing insurance carriers), defaulting of all enrollment plans is not allowed.

You can build the Available Plans and Plan Options by Employee Work Table (F085520W) for either open enrollment or current enrollment. In open enrollment, available plans and plan options, as well as their costs, might change. In current enrollment, which is typically associated with new hire, rehire, life event, or special enrollment, the available plans and plan options remain the same. The effective date processing option is used to obtain the active plans and plan options, with their associated costs and credits, for the event type. If you do not set up an effective date in the processing options, the system date will be used.

You can build the workfile twice; once for open enrollment and once for current enrollment. The workfile stores the records for both types of enrollment at the same time.

You can set processing options to specify:

  • The effective date of the active benefit plans and benefit plan options

  • The event type (open enrollment or current enrollment)

  • Whether the system allows prior enrollment information to be automatically defaulted as the chosen benefit plans or benefit plan options

15.5.2 Prerequisites

Before you complete the tasks in this section:

15.5.3 Running the Available Plans Work File Build program

From the Available Plans Work File Management (G08BESS322), Available Plans Work File Build.

15.5.4 Setting the Processing Options for Available Plans Work File Build (R085520)

Processing options enable you to specify the default processing for programs and reports.

15.5.4.1 Date

Use this processing option to specify an effective date for active benefit plans and plan options.

1. Effective Date:

Specify the effective date that the system uses to determine active benefit plans and plan options. The system also uses this date to calculate costs and credits that are linked with benefit plans and plan options.

If the effective date is left blank, the system date is used.

15.5.4.2 Event Type

Use these processing options to specify the type of enrollment event that you are setting up.

1. Event Type:

Specify the event type that the system uses when saving data in the Available Plans and Plan Options by Employee Work Table (F085520W). Open enrollment indicates an event that occurs during a set date range, normally only once, during the year. Current enrollment indicates life events that can happen at any time during the year. Examples of current enrollment events are marriage, divorce, or the birth of a child. Values are:

1: Build available plans and plan options for open enrollment.

2: Build available plans and plan options for current enrollment.

2. Process Defaulting:

Specify whether the system checks to see if the current employee's enrollment can be defaulted during an open enrollment. This option is valid only when saving data in the Available Plans and Plan Options by Employee Work Table (F085520W) for an open enrollment event. Values are:

Blank: Do not save information for automatic defaulting. This is the default value.

During open enrollment, employees need to elect

each benefit plan or plan option.

1: Save information for automatic defaulting.

During open enrollment, the system displays the benefit plans and plan options in which each employee is currently enrolled and marks them as elected. Employees can normally change the current elections.

15.6 Excluding Benefit Plans or Categories From a Work File Build

This section provides an overview of the excluding benefit plans or categories from a work file build and discusses how to implement exclusions.

15.6.1 Understanding Benefit Plan or Category Exclusion from a Work File Build

You can use the Plans/Categories to Exclude From Work File program (P085501) to select either benefit plans or benefit group categories that you want to exclude when you are building the work files for benefits self service. If your organization has DBAs that use special-use benefit plans or benefit group categories that are set up for purposes other than regular employee benefits, then you might want to use this approach to exclude these plans or categories when you are preparing for benefits open enrollment or a benefits enrollment that is based on a life event. If you do not exclude these special-use benefit plans or benefit group categories, then the system displays them as employee self-service benefit options.

The Plans/Categories to Exclude From Work File program allows you to select an existing program version for either the Available Plans Work File Build (R085520) or the Current Enrollment Work File Build (R085530) and then specify a benefit plan or benefit group category identification to exclude from the work file build. To view exclusions that might exist, you can select Exclusions from the Form menu.

15.6.2 Forms Used to Exclude a Benefit Plan or Category

Form Name FormID Navigation Usage
Excluded Benefits W085501A Employee Self Service General Management (G08BESS327), Plans/Categories to Exclude From Work File Add a benefit plan or category that you want to exclude from the workfile build.

To view existing versions, select Version from the Form menu.

You normally select either a benefit plan or a benefit group category, but not both.


15.6.3 Exclude a Benefit Plan or Category

Access the Excluded Benefits form.

To exclude benefit plans or categories from a work file build:

  1. On Excluded Benefits, select one of these options:

    • R085520

    • R085530

  2. Enter an existing version identification in the Version field.

  3. To exclude a benefit plan, enter a plan identification in the Plan ID field.

  4. Click the adjacent Add button to add the benefit plan to the grid.

  5. To exclude a benefit group category, enter a benefit group category identification in the Benefit Group Category field.

  6. To save the exclusions to the current version, click OK.

    • R085520

      Select an option that allows you to select either the Available Plans Work File Build program (R085520) or the Current Enrollment Work File Build program (R085530). When you associate one of these choices with an existing version identification, you can specify benefit plans that you want to exclude from the work file build for self service.

    • R085530

      Select an option that allows you to select either the Available Plans Work File Build program (R085520) or the Current Enrollment Work File Build program (R085530). When you associate one of these choices with an existing version identification, you can specify benefit plans that you want to exclude from the work file build for self service.

15.7 Building the Personal Information Workfile

This section provides an overview of the Budget Worksheet report and discusses how to:

  • Run the Personal Employee Information Workfile Build report.

  • Set processing options for the Personal Employee Information Workfile Build report.

15.7.1 Understanding the Personal Information Workfile

You use the Personal Employee Information Workfile Build program (R054101) to create tables that contain employee, dependent, and beneficiary personal information. The report obtains information from these tables:

  • Employee Master Information (F060116)

  • Address Book - Contact Phone Number (F0115)

  • Address Book - Who's Who (F0111)

  • Disability and Veteran Status History (F085590)

The benefits self service programs use this information to display employee personal information. These tables provide a temporary location that the system uses to store data before writing it back to the originating tables.

The tables that this program updates are:

  • Employee Personal Profile Information Work Table (F054101W)

  • Employee Phone Number Work Table (F054115W)

  • Employee Emergency Contact Work Table (F054111W)

  • Disability Status Work Table (F085590W)

  • Veteran Status Work Table (F085605W)

15.7.2 Running the Personal Employee Information Workfile Build Report

From the Personal Information Work File Management (G08BESS324), Personal Information Work File Build.

15.7.3 Setting Processing Options for Personal Employee Information Workfile Build (R054101)

Processing options enable you to specify the default processing for programs and reports.

15.7.3.1 Process

Use these processing options to specify who is included in the work file-build and whether the system saves IRS Form W-4 information in a work file.

1. Write Personal Information for Employee, Dependent/Beneficiary, or Both:

Specify information that the Personal Employee Information Workfile Build program (R054101) saves in employee self-service work files. Values are:

1 or Blank: Employee only. This is the default value.

2: Dependents and beneficiaries (R085537) must be run first).

3: Employee, dependents, and beneficiaries (R085537) must be run first).

Note:

To create records for dependents and beneficiaries, you must run the Build Current Dependent/Beneficiary Work File program (R085537) before you run this program.
2. Build the I.R.S. W-4 Tax Form work table (F085303W)

Specify whether the system saves information in the IRS W-4 Form Work File table (F085303W). This table stores self-service information that employees can review or change. Values are:

0 or Blank: Do not build the IRS W-4 Form Work File table.

1: Build the IRS W-4 Form Work File.

15.8 Setting Up Steps and Rules for Director Process Flows

This section provides an overview of the Populate the F05402 and F05403 Files UBE and discusses how to Run the Populate Director Form Rules/Edits program.

15.8.1 Understanding Steps and Rules for Director Process Flows

When you run the Populate Director Form Rules/Edits program (R8985500), the system builds these files:

  • F05402 table

  • F05403 table

The system saves information about objects and applications that can be specified in a process flow in the F05402 table. The Self-Service Process Flow Setup program (P05400) uses information from this file to define process flows.

The system saves rules and functional parameters for self-service process flows in the F05403 table.

15.8.2 Running the Populate Director Form Rules/Edits Program

From the Employee Self Service General Management (G08BESS327), Populate Director Form Rules/Edits.