Options to Configure Certifications and Other Action Items

You can configure a certification requirement action item to include one or more required individual certifications that participants must provide to fulfill the requirement.

You define action items on the Plan Certifications and Plan Designation Requirements pages using the Manage Benefit Plan Details task in the Plan Configuration work area.

This topic explains considerations for the following:

• Determination rule

• Multiple certifications

• Required action items without certification

Determination Rule

If you select the Required check box when you add a certification, you also select the determination rule, which specifies the conditions in which the certification is required.

Examples of determination rule conditions requiring certifications:

• Only when a participant is enrolling for the first time

• Only if never produced in the past

• Only if a new dependent is designated

• For every life event

You can create a formula if the existing determination rules don't meet your business requirements.

Multiple Certifications

If you select multiple certifications, a participant must provide both of the following to fulfill the requirement:

• All required certifications

• At least one optional certification

Example: You require that the participant provide either a Marriage Certificate or a Domestic Partner Affidavit when designating a spouse dependent.

In this case, you:

• Select Required for the certification requirement action item

• Don't select Required for each of the individual certifications

Required Action Items Without Certifications

Selecting Required for other action items, such as designation of a beneficiary, dependent, or primary care physician:

• Doesn't affect processing

• Can be useful for tracking an action item in internal reports