1. Benefits Implementation Guide
  2. Understanding Enrollment Parameters

Understanding Enrollment Parameters

You can set up enrollment parameters to define which eligibility test and date code the system applies when you enroll employees using enrollment with eligibility or batch enrollment. Enrollment parameters define the action that the system takes when it tests for eligibility. The system compares the employee enrollment information with each enrollment parameter to determine which eligibility test and date code to use. The system then uses the eligibility test and the date code to calculate when to enroll an employee in a benefit plan or whether to terminate the employee's participation.

You can base each enrollment parameter on any combination of these search items:

  • Plan ID

  • Benefit status

  • Enrollment status

  • Valid plan

After you create enrollment parameters, the system searches the records in the Batch Enrollment Parameters table (F08392) based on level of detail. The least detailed parameter appears at the top of the table, and therefore, the system searches it last. The most detailed parameter appears at the bottom of the table, and therefore, the system searches it first. When you enroll an employee in benefits or test for continuing eligibility, the system first compares the employee's enrollment information with the most detailed enrollment parameter (the parameter at the bottom of the table). When the employee's enrollment information does not match the criteria of this enrollment parameter, the system searches for the second most-detailed parameter. The system continues searching, from the most detailed parameter to the least detailed parameter, until it identifies the parameter to use.

When the system locates a parameter that matches the enrollment information for which it is searching, it conducts the eligibility test or assigns the date code and status that is specified in that parameter.

If you do not set up enrollment parameters, the system will:

  • Test continuing eligibility in a plan, when an employee is enrolled in a benefit plan and has an eligible enrollment status as defined by the eligibility test.

  • Test initial eligibility for employees in all other cases.

If you set up parameters for a particular plan, you must also set up the basic parameters for initial and continuing eligibility.