1. Benefits Implementation Guide
  2. Understanding Eligibility Tables

Understanding Eligibility Tables

Some benefit plans require that employees meet specified eligibility requirements before they qualify for or maintain enrollment in a benefit plan. If a benefit plan requires eligibility rules, you enter the name of the eligibility table on the plan master for the benefit.

You must set up an eligibility table to define each of the requirements that you use to determine eligibility. You can use the same table for more than one benefit plan if the eligibility requirements are the same for both. For example, an organization might require that employees be employed full time for six months and have worked a minimum of 40 hours in the past week before they qualify for medical insurance and dental insurance. In this case, you could set up an eligibility table and associate that table with both plans.

You can also set up an eligibility table to verify employees' continuing eligibility in a plan. For example, an organization might require that employees continue to work at least 35 hours per week to participate in the organization's medical plan.

After you have set up an eligibility table and included it in the plan master for a benefit, the system can test an employee's eligibility for enrollment in a benefit plan. When the system tests for eligibility, there is one of two outcomes:

  • When an employee passes the eligibility test, the system assigns a status to the enrollment record to indicate eligibility and a beginning enrollment status date based on the date code.

    When the enrollment status begins with an A (for active), the system passes the DBA code to the JD Edwards EnterpriseOne Payroll system so that the system can make the necessary deductions or contributions. The system also assigns a participation date and an eligibility date.

  • When an employee does not pass the eligibility test, the system assigns a status to the enrollment record to indicate ineligibility and a beginning enrollment status date based on the date code.

    The system does not pass the DBA code to the JD Edwards EnterpriseOne Payroll system. In this case, the system does not assign eligibility and participation dates.

In addition, set up an eligibility table that you use to indicate that a plan has no eligibility requirements. Use this eligibility table for all benefit plans that do not require employees to meet or maintain eligibility requirements to participate in the plans.