2 Maintain Benefits Enrollments

This chapter contains the following:

Maintain Benefits Enrollments: Overview

Managing Person Benefit Groups in the Integrated Workbook: Explained

Managing Person Benefit Balances in the Integrated Workbook: Explained

Managing Person Habits in the Integrated Workbook: Explained

Configuring Default Benefits Relationships: Critical Choices

Benefits Relationships: How They Affect Benefits Processing

Entering Contact Start Date for Benefits Designation Purposes: Examples

Managing Benefit Enrollments in the Integrated Workbook: Explained

Benefit Enrollments Integrated Workbook

Action Items: How They Are Processed

FAQs for Maintain Benefits Enrollments

Maintain Benefits Enrollments: Overview

Centrally coordinate and manage day to day benefits enrollment activities for participants. Enrollments generate action items that help administer certification requirements, such as proof of student status or proof of good health, and designation requirements, such as dependents, beneficiaries, and primary care physicians.

Benefits professionals can:

To maintain benefits enrollments, select Navigator - Enrollment.

Managing Person Benefit Groups in the Integrated Workbook: Explained

You can download person benefit group information to the integrated Microsoft Excel workbook. You use the integrated workbook to view and edit person benefit group assignments for multiple persons and groups. Then, you upload your changes back into the application database. Repeat these steps as many times as required to accommodate revisions.

The basic process for managing person benefit groups using the workbook is:

  1. Generate and populate the workbook.

  2. Edit, add, and delete person benefit groups in the workbook.

  3. Upload edits.

  4. Resolve errors.

Generating and Populating the Workbook

On the Plan Configuration work area:

  1. In the Tasks pane, click Manage Benefit Groups.

  2. In the Search Results section, click Upload Person Benefit Groups.

  3. In the Upload Person Benefit Groups dialog box, enter a session effective date and click Prepare in Workbook.

Editing, Adding, and Deleting Person Benefit Groups in the Workbook

After the download is complete, you can view, edit, add, and delete existing person benefit group assignments.

Editing person benefit group assignments: You can edit the Benefits Group column; edits in other columns are not uploaded.

Restriction

You cannot edit or enter the effective date in the workbook. To change the effective date, you must generate a new workbook with the new session effective date. You can also edit the date directly in the application using the Manage Benefit Groups task in Plan Configuration work area.

Adding person benefit group assignments: You can insert a row to add a new person benefit group assignment. The workbook automatically adjusts the symbol in the Changed cell to mark the rows that you edit or add.

Deleting person benefit group assignments: To delete records from the application database, you double-click the Mark for Deletion cell in the workbook rows that you want to delete. When you are ready, click Delete Selected Rows.

Warning

Deleted data cannot be retrieved.

Uploading Edits

When you are ready, click Upload in the workbook.

The rows that are marked as changed are uploaded into the application database. The session effective date that you set when generating the workbook becomes the start date for any edits or new group assignments that you entered in the workbook. Prior group assignments for each edited row are end dated as of the previous day and the history is retained.

For each row marked for deletion in the workbook, the application permanently deletes all of the related effective-dated records from the application database.

Resolving Errors

As the application processes the upload request, it updates the Status cell in each workbook row. If there are errors for a row, the process rolls back the change and sets the row status to Upload Failed. Then, it continues to the next row in the workbook. You double-click Update Failed to view the errors. Fix any data issues in the workbook and upload again.

Managing Person Benefit Balances in the Integrated Workbook: Explained

You can download person benefit balance information to the integrated Microsoft Excel workbook. Use the integrated workbook to view and edit the benefit balance value, primary assignment, and benefits relationship entries for multiple persons. Also add and delete person benefit balances. Then, upload your changes back into the application database tables. Repeat these steps as many times as required to accommodate revisions.

The basic process for managing person benefit balances using the workbook is:

  1. Generate and populate the workbook.

  2. Edit, add, and delete person benefit balances in the workbook.

  3. Upload edits.

  4. Resolve errors.

Generating and Populating the Workbook

On the Plan Configuration work area:

  1. In the Tasks pane, click Manage Benefit Balances.

  2. In the Search Results section, click Prepare in Workbook.

  3. In the Upload Person Benefit Balances dialog box, enter a session effective date and click Prepare in Workbook.

Editing, Adding, and Deleting Person Benefit Balances in the Workbook

After the download completes, you can view, edit, add, and delete person benefit balances.

Restriction

You cannot edit or enter the effective date in the workbook. To change the effective date, you must generate a new workbook with the new session effective date. You can also edit the date directly in the application, by searching for the person in the Enrollment work area, then going to the Manage Person Benefit Balances task.

Editing person balances: You may edit the Value, Primary Assignment, and Benefits Relationship columns; edits in any other columns are not uploaded.

Adding person balances: You can insert a row to add a new person balance. For each new balance, you must enter a value in either the Primary Assignment or Benefits Relationship cell, but not both. The workbook automatically adjusts the symbol in the Changed cell to mark the rows that you edit or add.

Deleting person balances: To delete records from the application database tables, double-click the Mark for Deletion cell in the workbook rows that you want to delete. When you are ready, click Delete Selected Rows.

Warning

Data deleted as part of the upload cannot be retrieved.

Uploading Edits

When you are ready, in the workbook click Upload.

The rows that are marked as changed are uploaded into the application database. The session effective date that you set when you generated the workbook becomes the start date for any edits or new person benefit balances that you entered in the workbook. Prior balances for each edited row are end dated as of the previous day and the history is retained.

For each row marked for deletion in the workbook, the application permanently deletes all of the related effective-dated records from the application database.

Resolving Errors

As the application processes the upload request, it updates the Status cell in each workbook row. If there are errors for a row, the process rolls back the change and sets the row status to Upload Failed. Then, it continues to the next row in the workbook. Double-click Update Failed to view the errors. Fix any data issues in the workbook and upload again.

Generate a new workbook after the successful upload to verify your edits.

Managing Person Habits in the Integrated Workbook: Explained

You can download person habit information to the integrated Microsoft Excel workbook. You use the integrated workbook to view and edit student and disability status, disability type, tobacco usage, and other plan coverage details for multiple persons. After you edit, add, or delete person habits data in the workbook, you upload your changes into the application tables. Repeat these steps as many times as required to accommodate revisions.

The basic process for managing person habits data using the workbook is:

  1. Generate and populate the workbook.

  2. Edit, add, and delete person habits in the workbook.

  3. Upload edits.

  4. Resolve errors

Generating and Populating the Workbook

On the Person Data Uploads tab on the Overview page in the Evaluation and Reporting work area, click Prepare Person Habits in Workbook.

  1. In the generated workbook, enter the session effective date.

  2. Click Download to retrieve the records that are effective starting on the date that you entered in step 1.

Editing, Adding, and Deleting Person Habits in the Workbook

After the download is complete, you can view, edit, add, and delete existing person habits data.

Editing person habits data: You can edit the Student Status, Disability Status, Disability Type, Tobacco Use, Covered in Another Plan, and Plan columns only; edits in other columns are not uploaded.

Restriction

You cannot edit or enter the effective date in the workbook. To change the effective date, you must generate a new workbook with the new session effective date. You can also edit the date directly in the application by searching for the person in the Enrollment work area and, then opening the Manage Contacts page.

You can verify disability status and tobacco usage for only participants in the application user interface. To verify disability status and tobacco usage for dependents, you must generate the integrated workbook and download the person habit information for the relevant dependents.

Adding person habits data: You can insert a row to add habit data for a new person. The workbook automatically adjusts the symbol in the Changed cell to mark the rows that you edit or add. To identify the person, you must enter either the person number or these three values, in their respective fields: first name, last name, and date of birth. As denoted in the column header, person type is required for each new row.

Deleting person habits data: To delete records from the application database, you double-click the Mark for Deletion cell in the workbook rows that you want to delete. When you are ready, click Delete Selected Rows.

Warning

Deleted data cannot be retrieved.

Uploading Edits

When you are ready, click Upload in the workbook.

The rows that are marked as changed are uploaded into the application database. The session effective date that you set when you generated the workbook becomes the start date for any edits or new records that you entered in the workbook. For each edited row, the prior data row is end dated as of the previous day and the history is retained.

For each row marked for deletion in the workbook, the application permanently deletes all of the related effective-dated records from the application database.

Resolving Errors

As the application processes the upload, it updates the Status cell in each workbook row. If there are errors for a row, the process rolls back the change and sets the row status to Upload Failed. Then, it continues to the next row in the workbook. You double-click the Update Failed button to view the errors. Fix any data issues in the workbook and upload again.

Configuring Default Benefits Relationships: Critical Choices

Configure how benefits relationships are associated by default when you hire a worker or add additional assignments. Benefits professionals group worker assignments for benefits enrollment and processing. You must make the following choices for each combination of legal entity and benefits usage, such as unrestricted or life events:

If you enable multiple assignment processing for benefits, you must also specify the pattern to associate additional worker assignments with benefits relationships by default. Benefits professionals can update or modify the default relationships for individual workers.

Specifying the Default Benefits Relationship

Every worker has at least one benefits relationship. Specify the default benefits relationship at the legal entity level for different usages, such as unrestricted or life events, within the enterprise for the initial worker assignment when a worker is hired.

Specifying Multiple Assignment Processing

Initially, you must make one choice between two mutually exclusive options for each combination of usage and legal entity within the enterprise:

Disabling Multiple Assignment Processing for Benefits Processing

If you do not enable multiple assignment processing for benefits processing, then all worker assignments are associated with the default benefits relationship that you select for the combination of usage and legal entity. In this configuration, benefits professionals cannot select alternative benefits relationships because each worker has only one benefits relationship. Consequently, you cannot configure other options for multiple assignment processing for benefits for the usage and legal entity combination.

Enabling and Configuring Multiple Assignment Processing for Benefits Processing

If you enable multiple assignment processing for benefits processing, configure the default pattern of associating the benefits relationships with additional worker assignments for each legal entity and usage.

Select one default option for new assignments from among these choices:

Additionally, if the newly created assignment can be included in a benefits relationship, configure whether or not it becomes the primary assignment in the benefits relationship when another assignment is already designated as the primary assignment.

Note

When you enable multiple assignment processing for benefits processing for a usage and legal entity combination, benefit relationship-related processing options and user interface fields are displayed on the user interface. User interface pages in benefits service center that display the option to select a benefits relationship for a worker include participant benefits summary, override enrollment, manage person life events, process open enrollment, and process life event.

Benefits Relationships: How They Affect Benefits Processing

Benefits relationships control how a worker's benefits are grouped for processing. A worker might have different sets of benefits attached to different benefits relationships.

Benefits entities that are affected by benefits relationships include:

Settings That Affect Benefits Relationship Assignments

A default benefits relationship is configured for each legal entity and usage of benefits processing within the enterprise. It is automatically associated with new hires and workers with only one assignment. If multiple assignment processing is enabled for benefits processing, the pattern of benefits relationships associated with additional worker assignments by default is configured for each legal entity and usage. Benefits professionals can change the configuration of benefits relationships associated with individual workers and can change the work assignments associated with the worker's benefits relationships.

How Benefits Relationship Assignments Affect Benefits Processing

A worker might have assignments that are associated with different benefits relationships. The following six examples list different ways that worker assignments might be structured within an organization and how the benefits relationships would be associated. The configuration table for each example lists the legal entities, work relationships, employment terms, assignments, and benefits relationships. Each scenario lists the impact that each structure has on life events, electable choices or enrollment options, and benefits eligibility.

Example 1: Single Legal Entity, Work Relationship, Employment Terms, Assignment and Benefits Relationship

Configuration: Only one assignment and one benefits relationship exist.


Legal Entity

Work Relationship

Employment Terms

Assignment

Benefits Relationship

Galaxy UK

1

Architect

Architect

A (default)

Processing: Life events, electable choices or enrollment options, and benefits eligibility are evaluated based on the assignment in this benefits relationship.

Example 2: Work Relationships in Two Different Legal Entities

Configuration: Two sets of work relationships, employment terms and assignments exist, one for each legal entity. The person has two sets of benefits, one for each legal entity. Each assignment is associated with a different benefits relationship.


Legal Entity

Work Relationship

Employment Terms

Assignment

Benefits Relationship

Galaxy UK

1

Architect

Architect

A (default for the legal entity)

Galaxy US

2

Consultant

Consultant

B (default for the legal entity)

Processing: This table shows the basis for benefits evaluation and processing for each data type:


Data Type

Benefits Evaluation Processing Basis

Life events

Primary assignment from each legal entity

Electable choices or enrollment options

One set of data for each legal entity

Eligibility

Use eligibility to provide benefits from the appropriate legal entity. Eligibility criteria are defined at the legal entity level or globally.

Example 3: Multiple Assignments in a Single Legal Entity

Configuration: One benefits relationship is associated with different employment terms and assignments.


Legal Entity

Work Relationship

Employment Terms

Assignment

Benefits Relationship

Galaxy US

1

Architect

Architect

A (default)

Galaxy US

1

Consultant

Consultant

A

Processing: This table shows the basis for benefits evaluation and processing for each data type:


Data Type

Benefits Evaluation Processing Basis

Life events

Primary assignment

Electable choices or enrollment options

One set of data for each life event

Eligibility

Attributes defined at global person level are used for both life events. Assignment-level attributes are used in the respective life events.

Example 4: Multiple Assignments in a Single Legal Entity - One Benefits Relationship for Each Assignment

Configuration: Separate benefits relationships are associated with each assignment.


Legal Entity

Work Relationship

Employment Terms

Assignment

Benefits Relationship

Galaxy US

1

Architect

Architect

A (default)

Galaxy US

1

Consultant

Consultant

B

Processing: This table shows the basis for benefits evaluation and processing for each data type:


Data Type

Benefits Evaluation Processing Basis

Life events

Separate life events created for Architect and Consultant assignments

Electable choices or enrollment options

One set of data for each life event

Eligibility

Attributes defined at global person level are used for both life events. Assignment-level attributes are used in the respective life events.

Example 5: Multiple Assignments in a Single Legal Entity - One Benefits Relationship Has Two Assignments, Another Has Remaining Assignments

Configuration: Two assignments are associated with one benefits relationship, and another assignment with a second benefits relationship.


Legal Entity

Work Relationship

Employment Terms

Assignment

Benefits Relationship

Galaxy US

1

Architect

Architect

A (default)

Galaxy US

1

Product Manager

Product Manager

A

Galaxy US

1

Consultant

Consultant

B

Processing: This table shows the basis for benefits evaluation and processing for each data type:


Data Type

Benefits Evaluation Processing Basis

Life events

Separate life events are created for the assignments in benefits relationships A and B

Electable choices or enrollment options

One set of data for each life event

Eligibility

Attributes defined at the global person level and assignment level are used for life events.

Example 6: Complex Multiple Benefits Relationships

Configuration: Many assignments are associated with one or more benefits relationships.


Legal Entity

Work Relationship

Employment Terms

Assignment

Benefits Relationship

Galaxy US

1

Product Manager

Orlando

A

Galaxy US

1

Product Manager

Dallas

A

Galaxy US

1

Product Manager

Atlanta

B

Galaxy US

1

Consultant

San Francisco

C

Galaxy US

1

Consultant

Los Angeles

D

Processing: This table shows the basis for benefits evaluation and processing for each data type:


Data Type

Benefits Evaluation Processing Basis

Life events

Separate life events created for the assignments in each benefits relationship

Electable choices or enrollment options

One set of data for each life event

Eligibility

Attributes defined at global person level are used for all life events. Assignment-level attributes are used in the respective life events.

Entering Contact Start Date for Benefits Designation Purposes: Examples

Use these examples to decide the best effective start date to use for dependents that you want to add as contacts so that they qualify for benefits.

Adding Your Newborn

Your hire date is January 1, 2013. Your child was born on January 15, 2013. When you add your newborn as a dependent, you enter the birth date as the effective start date. In another example, if your child was born on December 15, 2012 and your hire date is January 1, 2013, then you enter your hire date as the effective start date.

Updating a Contact's Relationship

Your hire date is January 1, 2013. On February 1, 2013, you married Jane Smith whose relationship is listed currently as a friend on your contacts page. When you update this relationship, you enter the marriage date as the effective start date so that your spouse qualifies for appropriate benefits.

Updating the Effective Start Date Because of an Event

Your hire date is January 1, 2013. You relocated to a new house on February 28, 2013. When you update your address details on the contact page, you enter the date you relocated to the new address as the effective start date. However, if your relocation date was earlier than your hire date, then you enter your hire date as the effective start date.

Managing Benefit Enrollments in the Integrated Workbook: Explained

You can enroll participants in various programs, plans, and options using the integrated Microsoft Excel workbook. Also, you can designate dependents and beneficiaries in participant-enrolled plans. You upload your changes to an interim database and then run the Upload Benefit Enrollments batch process. The participant enrollment portion of this batch process creates a potential life event, processes this life event, creates enrollments, and populates rates and coverage amounts. It also closes life events. You can process multiple life events by entering rows in the integrated workbook that are effective-dated to handle successive historical changes for an individual. This preserves and uploads legacy historical data.

You must verify that the relevant plan and program configuration is set up and working correctly before uploading enrollment data using the workbook. The basic process for managing benefit enrollments using the workbook is:

  1. Generate the workbook.

  2. Create a new batch of enrollment data in the workbook.

  3. Upload the workbook data into the interim database table.

  4. Resolve errors with workbook data.

  5. Run the Upload Benefit Enrollments batch process.

  6. Download the processing results and fix any errors.

  7. Review the results and reprocess.

Generating the Workbook

To generate the workbook:

  1. On to the Evaluation and Reporting work area Overview page, Enrollment Uploads tab, click Prepare Enrollment Batch in Workbook.

  2. Enter a name for the enrollment batch in the Batch Name cell.

  3. Enter the batch lines.

Creating a New Batch of Enrollment Data in the Workbook

Before you enter data in the workbook, note the following guidelines:

To delete records from the application database tables, you double-click the Mark for Deletion cell in the workbook rows that you want to delete. When you are ready, click Delete Selected Rows.

Uploading the Workbook Enrollment Data

After you are done in the workbook, click the Batch Name cell, click another cell, and then click Upload.

If the batch does not exist, the application creates a new batch. If the batch already exists, batch lines are updated in the existing batch. Only the rows that are marked as changed are uploaded into the interim database table.

For each row marked for deletion in the workbook, the application permanently deletes all of the related effective-dated records from the interim database table. This makes the deleted records unavailable for processing.

Resolving Errors in Workbook Data

As the application processes the upload request, it updates the Status cell in each workbook row. If there are errors for a row, the process rolls back the change and sets the row status to Upload Failed. Then, it continues to the next row in the workbook. You double-click Update Failed to view the errors. Fix any data issues in the workbook and upload again.

Running the Upload Benefit Enrollments Batch Process

After the batch lines are uploaded:

  1. Go to the Evaluation and Reporting work area Overview page, Processes tab Election Processes region to process the job.

  2. In the Upload Benefit Enrollments row, click Submit.

  3. In the Parameters section Batch Name field, select the name that corresponds to the name that you entered in your workbook.

  4. Click Submit.

    Note the request number in the Confirmation dialog box when the request completes processing to review log files for details.

The Upload Benefit Enrollments batch process completes all participant enrollments for a single participant before moving on to that participant's dependent designations, followed by beneficiary designations. If there are any errors that require review, the process rolls back and continues to the next participant, dependent, or beneficiary. If a participant enrollment fails, the batch process skips the associated designations, since they may be dependent on the participant enrollment completing without issues.

Reviewing the Results and Reprocessing

To view any data issues with the batch lines and the rows that show errors in the Row Batch Status cells, you download the batch details into the workbook.

  1. Generate the workbook.

  2. Enter the name of the existing batch that you want to review.

  3. Click Download.

    The workbook downloads all of the batch rows, not just the rows with errors.

  4. View messages in the Message column. Each message generally has a line ID indicating the row that is causing issues.

  5. Fix the issue with each specified row and upload the batch again for reprocessing.

In the Audit Log field, if you select Yes when uploading the batch data, the upload process adds any error or information messages for each line to the audit log.

Benefit Enrollments Integrated Workbook

This topic details the information required when you enter batch records in the integrated Microsoft Excel workbook for benefit enrollments. After completing the integrated workbook, you upload the rows to an interim batch table. When all of the rows in the workbook are uploaded without errors, you run the Upload Benefit Enrollments batch process in the Evaluation and Reporting work area.

Workbook Column Explanations

Required fields are marked with an asterisk, *, and you must enter a value for them.

Important

Values that you enter in name fields must exactly match the values already in the application. This applies to names of participants, programs, plans, options, dependents, beneficiaries, and life events.


Column

Description

Changed

Automatically marked by the application when you edit or add a row in the workbook. Only the rows that are marked as changed are uploaded to the interim batch table.

Mark for Deletion

Double-click this cell to mark the row for deletion. When you click Delete Selected Rows, the upload deletes the data from the interim batch tables so that it is not available for the batch process.

Status

Automatically provided by the application for each row after the application uploads its data into the interim batch table. For rows with errors, click Upload Error to see the details.

*Enrollment Type

Enter this value based on the person for whom you are entering the data. The person might be the participant enrolled in the benefit program or plan, or the participant's dependent or beneficiary. Valid values are Participant Enrollment, Dependent Designation, and Beneficiary Designation.

*Effective Date

The application uses this value when fetching person details, validating dependents, and processing participant life events. Enter the date in your standard local format.

*Person Number

PARTICIPANT_PERSON_NUMBER, a unique numeric identifier for the participant, for whom the processing is done.

Additional Person Identifier

Reserved for the application, do not use.

Program Name

Must be valid as of the effective date.

Plan Name

Must be valid as of the effective date.

Plan Disenrolled From

Reserved for the application, do not use.

Option

Must be valid as of the effective date.

Option Disenrolled From

Reserved for the application, do not use.

*Life Event

Must be valid as of the effective date.

*Life Event Occurred Date

Application processing derives the existence of a started life event based on the combination of this date and the specified life event reason. Enter the date in your standard local format.

Original Participant Enrollment Date

Does not affect processing. The field is updated for the participant enrollment record. Enter the date in your standard local format.

Create Potential Life Event

Yes: The process determines whether the participant has a potential life event for the combination of the life event name, life event occurred date, and benefit relationship. If there is no valid potential life event, a new one is created and processed.

No: The process does not create the potential or process life events automatically. You must manually add the life event using the Potential Life Event tab.

*Benefit Relationship

Must be valid for the participant as of the effective date. Benefits processing derives a valid started life event for the participant based on this value.

Rate Amount

If you enter a rate amount, ensure that there is no value in coverage amount.

Coverage Amount

If you enter a coverage amount, ensure that there is no value in rate amount.

Disenrolled Coverage Amount

Reserved for the application, do not use.

Date of Birth

Dependent's or beneficiary's date of birth. Enter the date in your standard local format.

Beneficiary Organizations and Trusts

Enter the name of the existing beneficiary organization or trust. If the beneficiary organization or trust does not exist as of the effective date, the beneficiary designation process fails.

To create the organization or trust, which you can then use in the workbook, you use the Manage Beneficiary Organizations task in the Benefits Service Center.

Primary Beneficiary Percentage

If you enter a percentage amount, ensure that there is no value in beneficiary amount.

Contingent Beneficiary Percentage

If you enter a percentage amount, ensure that there is no value in beneficiary amount.

Beneficiary Amount

If you enter a beneficiary amount, ensure that there is no value in beneficiary percentage.

Close Life Event Date

The date on which you want to close the life event. Enter the date in your standard local format.

*Close Life Event

Yes: The process attempts to close the life event that it is processing, which is useful if multiple life events are being processed for the same participant, dependent, or beneficiary.

No: The process does not close the life event, leaving it in the started state.

Suspended results or pending action items do not allow the life event to close. In such cases, it is left unchanged and you must close this event before attempting to process the next event.

Batch Line ID

Do not modify. Uniquely identifies the batch line, which is referenced in error messages.

Message

Do not modify. Describes any errors that occurred during the Upload Benefits Enrollments batch process. Reprocess the batch after correcting the errors.

Row Batch Status

Do not modify. Indicates the Upload Benefits Enrollments batch processing status for the row, such as COMPLETE or ERROR.

Key

Do not modify. Internal value used for Upload Benefits Enrollments batch processing.

Action Items: How They Are Processed

The configuration of action items determines what happens during enrollment processing. For example, failure to provide required action items can result in suspended enrollment or simply cause delinquent items to appear in benefits administration reports.

Settings That Affect Action Item Processing

The following action item settings affect processing:


Setting

Description

Suspend Enrollment

When enabled, notifies participant of pending action item during enrollment and causes suspension of enrollment until the item is completed.

Determination Rule

Determines when the item is required, such as always or only for initial enrollment.

Due Date

Determines when the item begins appearing on audit and error reports generated by enrollment processing.

Interim coverage setup also affects enrollment processing, as described in the next section. Interim coverage is defined for a plan or option on the Edit Plan Enrollment page in the Plan Configuration work area.

How Action Items Are Processed

If enrollment is suspended due to incomplete action items, then interim coverage, if configured, applies and no further life event processing takes place until the action items are completed.

Note

Incomplete or past-due action items for one benefits relationship do not stop processing of events for another benefits relationship for the same person.

Reporting of pending action items and certificates occurs as part of enrollment processing. Benefits administrators can use these reports to follow up as needed.


Process

Reporting

Close enrollment action items

Any past-due required action items appear in the audit log, as well as any incomplete action items that are configured to suspend enrollment.

Close enrollment

Any past-due required action items appear in the audit log, as well as any incomplete action items that are configured to suspend enrollment.

Participation evaluation

Any incomplete action items that are configured to suspend enrollment for a person appear in the error report.

The following scenarios illustrate how subsequent life events are processed for a participant with an open action item.

Suspension Results in No Further Life Event Processing

Scenario: Life Event A is processed on 1/15/2010. An outstanding action item exists with a due date of 1/30/2010, and it is configured for suspension. Enrollment is suspended, and interim coverage exists. On 1/28/2010, the benefits administrator attempts to process Life Event B, which has an occurred date of 1/20/2010.

Result: Life Event B cannot be processed until the suspension is resolved for Life Event A. The action item associated with Life Event A appears on the audit report after action item processing, and the participant's name appears on the error report after participation evaluation processing. Contact the participant and attempt to resolve the action item. Once the action item is complete, enrollment for Life Event A is completed and Life Event B can be processed.

Suspension of Beneficiary Designee Only

Scenario: Life Event A is processed on 1/15/2010. An outstanding action item for beneficiary designation exists, and suspended enrollment is configured for the beneficiary designee only, not for the benefits offering itself.

Result: Enrollment is suspended only for the beneficiary, not for the entire offering. Future life events can be processed for the participant.

Suspension with No Interim Coverage

Scenario: Life Event A is processed on 1/15/2010. An outstanding action item exists with a due date of 1/30/2010, and it is configured for suspension. Enrollment is suspended, but no interim coverage exists. On 1/28/2010, the Benefits Administrator attempts to process Life Event B.

Result: Life Event B cannot be processed because the participant is not currently enrolled.

Subsequent Life Event Processing Causes Previous Life Event to be Backed Out

Scenario: Life Event A is processed on 1/15/2010. An outstanding action item exists with a due date of 1/30/2010, and it is configured for suspension. Enrollment is suspended, and interim coverage exists. On 1/25/2010, Life Event B is processed with an occurred date of 1/1/2010.

Result: Life Event A is backed out, along with any pending action items. Life Event B is processed (unless the Timeliness setup for the Life Event prevents life events from being backed out in this situation).

FAQs for Maintain Benefits Enrollments

How can a participant make elections without using a computer?

On the Manage Person Life Events page in the Benefits Service Center, click the Manage Enrollment Document button to view and print an enrollment document that you can mail or send electronically to the participant. The document lists electable enrollment options or changes based on the active life event, and configured default enrollments, if any. The participant selects or changes enrollment options and returns the document. Use the completed, returned form to edit enrollment information for the participant.

Can I upload benefit group assignments for multiple persons at one time?

Yes. Use the integrated Microsoft Excel workbook to view and edit person benefit group assignments for multiple persons and groups. Then, upload your changes back into the application database. To generate the integrated workbook, start on the Plan Configuration work area, Manage Benefit Groups page. In the Search Results section, click Prepare the Workbook.

Can I upload benefit balances for multiple persons at one time?

Yes. Use the integrated workbook to view and edit the benefit balance value, primary assignment, and benefits relationship entries for multiple persons. Also, add and delete person benefit balances. Then, upload your changes back into the application database. To generate the workbook, start on the Plan Configuration work area, Manage Benefit Balances page. In the Search Results section, click Prepare in Workbook.

Can I upload student and disability status for multiple persons at one time?

Yes. Use the integrated workbook to view and edit student and disability status, disability type, tobacco usage, and other plan coverage details for multiple persons. After editing, adding, or deleting person habits data in the workbook, upload your changes into the application database. To generate the integrated workbook, on the Evaluation and Reporting work area Overview page, Person Data Uploads tab, click Prepare Person Habits in Workbook

Can I upload enrollment data in a batch?

Yes. Enroll participants in various programs, plans, and options using the integrated Microsoft Excel workbook. Also, designate dependents and beneficiaries in participant-enrolled plans. Upload your changes into an interim database. Then, run the Upload Benefit Enrollments batch process. To generate the integrated workbook, on the Evaluation and Reporting work area Overview page, Enrollment Uploads tab, click Prepare Enrollment Batch in Workbook.

How can I unprocess a life event that was processed in error?

In the Benefits Service Center, select the event on the Life Events tab of the Manage Person Life Events page, and select Back Out Event in the Actions menu. Specify Voided as the life event status.

To delete the voided life event, select Show Voided Potential Life Events in the Actions menu on the Potential Life Events tab. Select the voided potential life event and delete it.

Note

A potential life event that is automatically triggered by an HR data change, such as marital status change, is not automatically backed out if the HR data change is backed out. If the triggering HR data change is invalid, you must manually back out the life event, as described in this topic.

How can I diagnose any issues with a person's benefits enrollments?

When you need details of a person's event, eligibility, and enrollment data, you can run the Person Benefits Diagnostic Test if you have access to the Diagnostic Dashboard. Select Run Diagnostic Tests from the Setting and Actions menu in the global area.

Why can't I see or edit a benefit participant's contacts?

First, check whether the contact is future dated as contacts are not visible until the contact's effective start date is reached. If that is not the issue, then your data role might not include access to related contact information for participants. Your application administrator must provide you with the proper data role and person security profile so that you can access related contact information for participants. The application administrator grants you access by following the steps provided in the Configuring Security for Manage Contacts Page for Benefits: Worked Example topic.