Single or Multiple Eligibility Profiles
You can define multiple criteria in an eligibility profile or create separate profiles for individual criterion.
To determine the best approach, consider the following:
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Does the object for which you are defining eligibility allow multiple eligibility profiles?
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What is the best approach in terms of efficiency and performance?
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Are your criteria both inclusive and exclusive?
Allowable Number of Eligibility Profiles
If an object permits only one eligibility profile, you must include all criteria in a single profile.
The following table shows which objects permit only one profile and which permit more.
Only One Profile |
One or More Profiles |
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Efficiency and Performance in the Benefits Hierarchy
For optimum performance and efficiency, attach profiles at the highest possible level in the benefits object hierarchy and avoid duplicating criteria at lower levels. For example, to be eligible for a plan type, a person must satisfy eligibility profiles defined at the program and plan type in program levels.
The following objects inherit the eligibility criteria associated with the program:
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Plan types in program
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Plans in program
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Plans
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Options in plans that are in programs
However, it's sometimes more efficient to create more than one profile and attach the profiles at various levels in the hierarchy. The following table illustrates applying successively restrictive exclusion criteria at different levels in the hierarchy:
Level |
Eligibility Profile Criteria |
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Program |
Exclude employees who do not have an active assignment. |
Plan type in program |
Exclude employees who do not have a full-time assignment. |
Plan |
Exclude employees whose primary address is not within a defined service area. |
Using Both Inclusive and Exclusive Criteria
Eligibility criteria can be used to include or exclude persons from eligibility. Sequencing of criteria is more complicated when you mix included and excluded criteria in the same profile. For ease of implementation, keep excluded criteria in a separate eligibility profile.