Eligibility Profiles

Create eligibility profiles to define criteria that determine whether a person qualifies for objects that you associate the profile with. You can associate eligibility profiles with objects in a variety of business processes.

The following are key aspects of working with eligibility profiles:

• Planning and prerequisites

• Specifying the profile type, usage, and assignment usage

• Defining eligibility criteria

• Excluding from eligibility

• Assigning sequence numbers

• Adding multiple criteria

• Viewing the criteria hierarchy

Planning and Prerequisites

Before you create an eligibility profile, consider the following:

• If an eligibility profile uses any of the following to establish eligibility, you must create them before you create the eligibility profile:

  • Derived factors

  • User-defined formulas

  • User-defined criteria

• Consider whether to combine criteria into one profile or create separate profiles depending on:

  • Whether the object for which you're creating eligibility accepts only one eligibility profile or more than one

  • Performance considerations

• Use names that identify the criteria being defined rather than the object with which the profile is associated, because eligibility profiles are reusable.

  Example: Use Age20-25+NonSmoker rather than Supplemental Life-Minimum Rate.

Specifying Profile Type, Usage, and Assignment Usage

This table describes the basic profile attributes that you specify when you create an eligibility profile:

Setting	Description
Profile Type	Use only dependent profiles for Benefits plans or plan types when determining eligibility of participants' spouses, family members, or other individuals who qualify as dependents. All other profiles are participant profiles.
Usage	Determines the type of objects the participant profile can be associated with, such as benefits offerings and rates, compensation plans, checklist tasks, goal plans or mass goal assignments, or performance documents. Selecting Global makes the profile available to multiple business process usages.
Assignment to Use	Determines the assignment that the eligibility process evaluates for the person Select Specific assignment when the usage is Compensation or Performance. Select a value that includes benefit relationship when the usage is Benefits. You select this value to restrict eligibility evaluation to active assignments that are associated with the benefits relationship of the person on a given date. If you select other values, then you might need to include eligibility criteria to exclude inactive assignments. Select one of the following values for all other usages, such as total compensation statements: Any assignment - enterprise Employee assignment only - enterprise Primary employee assignment only - enterprise

Defining Eligibility Criteria

Here's the list of eligibility criteria that you can use to configure benefit offerings:

Category	Description
Personal	Gender Person Type Disabled Uses Tobacco Service Areas Home Location Postal Code Ranges Leave of Absence Termination Reason Qualification Competency Marital Status Religion
Employment	Assignment Status Hourly or Salaried Assignment Category Grade Job Position Payroll Salary Basis Department Legal Entities Performance Rating Quartile in Range Work Location Range of Scheduled Hours People Manager Job Function Job Family Hire Date Probation Period Business Unit
Derived factors	Age Length of Service Compensation Hours Worked Full-Time Equivalent Combined Age and Length of Service Benefit Groups Health Coverage Selected Participation in Another Plan Formula User-Defined Criteria
Other	Benefit Groups Health Coverage Selected Participation in Another Plan Formula User-Defined Criteria
Related coverage	Covered by Another Plan Covered by Another Plan in Program Covered by Another Plan Type in Program Covered by Another Program Dependent Eligible for Another Plan Type in Program Eligible for Another Plan Eligible for Another Plan Type in Program Enrolled in Another Option in Plan Enrolled in Another Plan Enrolled in Another Plan in Program Enrolled in Another Plan Type in Program Enrolled in Another Program Other Coverage
Labor Relations	Bargaining Unit Labor Union Member Union Collective Agreement

Some criteria, such as gender, provide a fixed set of choices. The choices for other criteria, such as person type, are based on values defined in tables. You can define multiple criteria for a given criteria type.

Excluding from Eligibility

For each eligibility criterion that you add to a profile, you can indicate whether persons who meet the criterion are considered eligible or are excluded from eligibility. For example, an age factor can include persons between 20 and 25 years old or exclude persons over 65.

If you:

• Exclude certain age bands, then all age bands not explicitly excluded are automatically included.

• Include certain age bands, then all age bands not explicitly included are automatically excluded.

Assigning Sequence Numbers

You must assign a sequence number to each criterion. The sequence determines the order in which the criterion is evaluated relative to other criteria of the same type.

Adding Multiple Criteria

If you define multiple values for the same criteria type, such as two postal code ranges, a person must satisfy at least one of the criteria to be considered eligible. For example, a person who resides in either postal range is eligible.

If you include multiple criteria of different types, such as gender and age, a person must meet at least one criterion defined for each criteria type.

Viewing the Criteria Hierarchy

Select the View Hierarchy tab to see a list of all criteria that you have saved for this profile. The list is arranged by criteria type.