Understanding Event Rules

You use event rules to:

• Take into account the type of event and your employees' benefit election history to determine which benefit options employees can choose.

• Determine how the system compensates when employees neglect to make certain benefit elections.

• Determine effective dates for coverage and premiums.

• Manage enrollments in and move them into Benefits Billing.

Event rules are not the same as eligibility rules. Eligibility rules help determine which benefit program and benefit plan options an employee can have. They tell the system that because of changes to employee data, employee X is no longer eligible for certain plan options, but is eligible for others.

Event rules determine which eligible options employee X can actually choose, based on the type of event that has occurred and when new coverage begins. The event rules also determine when the plans that employee X is now ineligible for will be terminated and which plan options employee X will be enrolled into if new enrollments are not specified.

Event rules are linked to a benefit program on the Benefit Program page. You can have a different event rule for each plan type in a benefit program.

To set up event rules:

1. Use the Action Reason table to link personal action and action reason combinations that affect benefits eligibility.

2. Use the Event Class table to assign the types or classes of events that you want the system to recognize, and to control how the system processes event classes.

3. Use the Event Rules table to define the specific behavior that the system takes for each event classification.