Adding a New Benefit Plan

Access the Plan Master form.

To add a new benefit plan:

1. Complete the Plan ID field.

2. In the unlabeled field to the right of the Plan ID field, enter the name of the plan.

3. On the General Info tab, complete the Provider/Trustee field.

4. Complete these optional fields or accept the default values:

   • From Date

   • Thru Date

   • Policy/Reference Number

   • Plan Type

   • Status Code

     Note: You need to assign the same benefit plan type to every plan within a benefit category. For example, all medical plans should be assigned to the medical plan type.

5. Select any of these options, if necessary:

   • Mandatory

   • Enter Amount/Rate

   • COBRA Plan (Consolidated Omnibus Budget Reconciliation Act)

6. In the Enrollment Rules group box, select an option for the enrollment start date.

7. Select one or both of these options:

   • Allow Enrollment at Plan Level

   • Flex Plan

8. Select one of these options in the Dependent/Beneficiary group box:

   • Requires Dependent

   • Requires Beneficiary

   • Does Not Require Dependent/Beneficiary

     The Dependent/Beneficiary options define whether a plan is designated as a dependent plan or a beneficiary plan.

9. Select one of these options in the Spending Account group box:

   • Not a Spending Account

   • Medical Spending Account

   • Non-Medical Spending Account

     You use the Spending Account options to associate the account with medical or other types of expenses.

10. Select the Calc./Eligibility (Calculation/Eligibility) tab and complete any of these DBA fields:

    • EE Payroll Deduction (Employee Payroll Deduction)

    • ER Paid Benefit (Employer Paid Benefit)

    • EE Flex Cost (Employee Flex Cost)

    • ER Flex Credits (Employer Flex Credits)

      If the plan is a flex plan, complete either the EE Flex Cost field or the EE Flex Credits field.

11. To enter a date-sensitive override amount or rate for the employee contribution, select Plan Rates from the Form menu.

12. On the PDBA Detail form, select the PDBA record for which you want to enter a rate, and then click Select.

    Note: The plan rate or amount that you enter on this form is a date-sensitive override to the rate that exists in the DBA field. You must complete the DBA field before you enter override amounts or rates. You cannot enter an amount or rate for a DBA field that is blank.Entering new rates does not change existing benefit plan information for employees. To recalculate the new premium costs, the employee must enroll in the plan again, or a human resources administrator must process batch enrollment.

13. On the Plan Master Rates Window form, complete any of these override fields, click OK, and then click Cancel.

    • Type

    • Beginning Date

    • Ending Date

    • Amount or Rate

14. On the Calc./Eligibility tab of the Plan Master form, complete these fields:

    • Init Elig Table (Initial Eligibility table)

    • Cont Elig Table (Continuing Eligibility table)

15. Complete the optional Prerequisite Plan field.

16. To enter information about the plan, select the Addl. Info (additional information) tab, and then enter the information.

17. To track additional data, select the Cat. Codes (category codes) tab and complete the relevant information.

18. If you use Self Service Benefits, select the Self Service tab and complete the Description field.

    If you do not enter a description, the plan description appears on self service forms. This description field enables you to enter a longer representation of the benefit plan.

19. Complete the Short Plan/Plan Option Description field.

    This description field provides only a short description that is used when benefit plans appear as column titles on self service forms.

20. Complete the Plan Grouping Code field.

    We recommend that you use the Plan Master Options program (P083202) instead of the plan grouping code.

    You can use plan grouping to associate benefit plans if you do not use benefit plan options. For example, if you create separate benefit plans for employee only, employee plus 1, employee plus family, and employee opt out, you can set up a plan grouping code in UDC 08/PG. You can then assign the plan grouping code to each plan master record.

    We recommend that you set up a nonparticipating plan for each benefit category so that employees can elect this plan to select no coverage.

21. To track the primary care physician number, select the Track Primary Care Physician (PCP) option to activate it.

22. If the purpose of the benefit plan is to indicate that an employee is declining coverage, select the Non-Participating Plan Flag option.

    The system displays this option only if the plan is set up as a nonparticipating plan.

    Note: We recommend that you set up a nonparticipating benefit plan for every benefit category.

    If the benefit plan is a dependent plan, the system displays a field at the bottom of the form where you can enter the number of dependents who can enroll in the plan.

23. If the plan is a dependent plan, specify the number of people to be covered (including the employee) by completing the Maximum Dependent field.

24. Select the Premium/Coverage tab and complete either of these fields to specify premium information:

    • Premium Payment

    • Age Rate Table

25. Complete these optional fields:

    • Per Coverage Dollars

    • Maximum Premium Amount

26. To enter coverage information, complete either of these fields:

    • Amount - Coverage

    • Salary Factor

27. Complete the optional Rounding Amount field.

28. Click OK to save the record.