How to Configure Grandfathered Benefits

Configure grandfathered eligibility to enable already enrolled participants to retain eligibility for a benefit that they would otherwise not be able to elect. For example, continue a benefit for only those employees of an acquired company who were already enrolled on the acquisition date.

The following are the steps to configure grandfathered benefits eligibility:

  1. Set the Grandfathered Benefit Group as the criterion for the Grandfathered Eligibility Profile.

  2. Associate the Grandfathered Eligibility Profile to the associated benefit offering.

  3. Assign the Grandfathered Benefit Group to the participants who are eligible for the associated benefit offering.

Creating and Assigning a Benefit Group

  1. In the Plan Configuration work area Tasks panel drawer, click Manage Benefit Groups to open the Manage Benefits Group page.

  2. Create a benefit group using a descriptive name, such as Grandfathered Eligibility with the name of the offering.

  3. Use one of the following tasks to assign the benefit group to workers who qualify for the benefit:

    Task

    Work Area

    Description

    Manage Person Habits and Benefit Groups

    Enrollment

    Search for individuals and assign the benefit group

    Manage Processes and Uploads

    Evaluation and Reporting

    Assign benefit groups using the Upload Person Benefit Groups integrated workbook

Creating and Using an Eligibility Profile

  1. In the Plan Configuration work area, use the Manage Eligibility Profiles task to create an eligibility profile using these criteria:

    Criteria Type

    Criteria Name

    Value

    Other

    Benefit Groups

    Select the grandfathered benefit group that you created.

  2. In the Plan Configuration work area, attach the eligibility profile to the benefit offering using these steps in the program or plan configuration guided process:

    1. After searching for the program or plan, select the appropriate offering in the hierarchy table on the Eligibility step of the guided process.

    2. In the Eligibility Profiles section, select the grandfathered eligibility profile that you created and set the Required value as appropriate.