Setting Up a Typical Eligibility Table

Enter a code that identifies the particular table of eligibility rules. The rules determine whether the employee is eligible for enrollment in a plan. Complete this field to name the table.

Enter AND or OR to designate whether the test parameters or criteria are based on an And condition or an Or condition.

Enter the minimum requirement that must be met to satisfy the eligibility requirements. The minimum is associated with the method that you use to calculate eligibility.

For defining the method as AE for ACA Eligibility, you must specify a value from the Special Handling field of the 08/SE UDC table, in this field. When the system determines an employee's eligibility for benefits for method AE, it checks the Min Amount or Status value against the ACA Eligibility Status codes that have that same value in the Special Handling column. Use these codes:

1: Not Eligible

2: Standard Eligibility

3: Unknown/To Be Determined

4: Excluded from Test

5: Eligible

Note: An employee who has an ACA Eligibility Status that has its special handling code equal to 5 is eligible for benefits enrollment.

See the Method field (data item MTHD) for more information.

Enter the code that the system uses to calculate eligibility. Use this field in conjunction with the Amount field (data item ELMH).

For example, if the eligibility criteria for a plan includes minimum age, you enter AM (minimum age) in this field and the specific age in the Amount field.

We provide codes for six of the most common methods. These codes are hard-coded and cannot be changed or deleted:

H: Hours of service

D: Days of service

M: Months of service

Y: Years of service

AM: Minimum age

AX: Maximum age

AE: ACA Eligibility

Note: When using the method AE for ACA Eligibility, you must specify the Special Handling value for the ACA Eligibility Status code from UDC 08/SE in the Min Amount or Status field.

Enter the status to be assigned to the enrollment record after the employee becomes eligible for a plan.

You can define this code using a UDC 08/ES. See Enrollment Status (data item XDFS) for restrictions on the allowed values for this field.

Enter a code that indicates the date that the employee's new enrollment record begins after the system determines that the employee is eligible for a plan. These codes are defined in the Define Date Codes table (F08395).

When basing eligibility on employee ACA Eligibility data, and when using the Look-Back Measurement method to determine an employee's full-time status, you can use a Date Code that indicates to the system to use the Stability Start Date from the employee's ACA Eligibility Status record as the benefits enrollment date. To use the Stability Start Date as the enrollment effective date, define the Date Code ST in the F08395 table.

Note: When you create the Date Code ST, you do not need to provide any other information on that record, and the system automatically references SPSD (Stability Start Date) column in the ACA Parameters History table (F0811629).

Enter the status that the system assigns to the enrollment record after it determines that an employee is ineligible for a plan.

You can define this code using UDC 08/ES. See Enrollment Status (data item XDFS) for restrictions on the allowed values for this field.

If the eligible or ineligible enrollment status code begins with an A, such as ACT or AC2, the system writes the DBA code from the Plan Master table to the Employee DBA Instructions table. When a begin enrollment status code begins with a letter other than A, no record is written to JD Edwards EnterpriseOne Payroll.

To indicate an ending status that does not result in a new enrollment, such as termination, you must define the code with an X in the first position in the Description 2 field of the General User-Defined Codes form.

Use a status that begins with an X as an ending status to indicate a mistaken enrollment. The system does not write instructions to the Employee DBA Instructions table when the status begins with X.

Enter a code that indicates the date that the employee's new enrollment record begins after the system determines that the employee is ineligible for a plan. These codes are defined in the Define Date Codes table (F08395).

Enter a code that defines the date from which eligibility is calculated. Complete this field if eligibility is not based on hours worked. The allowed codes correspond to the dates that appear on the Dates, Eligibility, and EEO form and that are defined in UDC 08/D1. If you do not enter a code in this field, the system uses the employee's hire date.

Enter a code that is used to calculate if a person has the minimum number of hours necessary to be eligible for a plan. Complete this field if eligibility is based on hours worked. Codes are:

W: Week (seven days prior to effective date)

M: Previous calendar month

Y: Year (previous year to effective date)

Enter the number of consecutive periods used to calculate eligibility. Complete this field if eligibility is based on hours worked.

Enter a code from UDC 08/TT that specifies the pay type table used to calculate the hours worked for plan eligibility. Complete this field if eligibility is based on hours worked.