Overview of Rates and Coverages

Benefits administrators and managers create and manage benefit rates and coverages using the tasks in the Plan Configuration work area.

Here's the list of tasks:

• Manage Benefit Rates

• Manage Benefit Plan Coverage

This topic covers key benefit terms related to rates and coverage:

• Rates

• Coverage

• Calculation methods

• Variable rates and coverage

• Final calculation

Rates

Rates determine costs for purchasing benefit coverage, such as life or health insurance. Rates usually determine an amount of monetary contributions paid by:

• The employee

• The employer

• A combination of both

Rates can also determine amounts distributed from the employer to the employee, such as for tuition reimbursement.

Coverage

Coverage defines monetary amounts available to enrolled participants in the event of a claim, such as for medical expenses.

Calculation Methods

You can calculate standard rates and coverage using a variety of delivered calculation methods, such as flat amount or multiple of coverage. Or, you can create a calculation formula.

Variable Rates and Coverage

To vary a rate or coverage by criteria, you can associate variable rate or coverage profiles that adjust or replace the standard rate or coverage calculation.

Example: You can adjust a rate based on criteria such as location, length of service, and participant's age.

Final Calculation

To derive the final calculation of the rate or coverage, you can apply limits and rounding rules.