Examples of Enforcing Benefits Restrictions

Some benefits provide options for different levels of coverage, such as life insurance offerings with coverage in multiples of a participant's annual salary.

You can define sequence restrictions to limit the number of levels of increase either:

  • From one enrollment period to the next

  • Due to occurrence of a life event

You can also set the minimum and maximum sequence levels that workers can select with and without certification. You define sequence number restrictions on the Benefit Certifications tab, General Configuration subtab of the Plan Certifications page.

Sequence Number Increase Restriction

Scenario: A life insurance plan has options for 10k USD, 20k USD, 30k USD, 40k USD, and 50k USD, associated respectively, with sequence numbers 1 through 5. A participant with existing coverage of 10k USD can only jump:

  • One level, up to 20k USD, without certification

  • Two levels, to 30k USD, with certification of good health or evidence of insurability

Setup:

  1. In the Restriction Type field, select Plan or option sequence.

  2. In the Plan or Option Sequence Restriction section, set the sequence restriction values as shown in the following table:

    Field

    Value

    Maximum Sequence Number Increase

    1

    Maximum Sequence Number Increase with Certification

    2

Maximum Sequence Number Restriction

Scenario: A supplemental life insurance plan has four coverage options with sequence numbers 1 through 4. You want to restrict the highest level of coverage, sequence number 4, to only those participants who provide certification.

Setup:

  1. In the Restriction Type field, select Plan or option sequence.

  2. In the Plan or Option Sequence Restriction section, set the sequence restriction values as shown in the following table:

    Field

    Value

    Maximum Sequence Number

    3

    Maximum Sequence Number with Certification

    4