Benefit Setup

Introduction

Benefit plans are defined on the Benefit Setup page under EO Administration, Settings. Data used here is dependent upon data in EO Settings, Benefits.

All Benefit Code and Benefit Type entries matching those in HR Benefit Definitions (HRTBBE) are considered for use in Benefit Enrollment. If benefits in HRTBBE do not have associated Benefit Categories but their Benefit Code and Benefit Type do match entries here, they will appear in the Benefit Enrollment Wizard. Caution must be used to ensure benefit setup in EO and HR is correct.

The setup involves both the benefit plan display within the EO Benefits page and the configuration for the Open Enrollment process. These definitions are stored to the hr_eobemstr table.

When saving a record, the Benefit Code and Benefit Type are concatenated and compared to entries in HRTBBE. If there are no records with that same concatenation, regardless of the Category, an error will display and the entry blocked.

Entity

Benefit Card

Benefit Code: The Benefit Code from the Benefit plan associated with the benefit. Validates to HRTBBE, Benefit Codes, where the entities match.

Benefit Type: The Benefit Type from the Benefit plan associated with the benefit. Validates to HR Entity Specific Misc HR Codes (HRTBCE), where the entities match.

EO Group: There are four possible benefit groups: INS (insurance), REIM (reimbursements), RETI (retirement), OTH (other). Groupings are arbitrary. It is not necessary to use them all. Entries in other groups will be determined by how a site's benefits are organized.

Plan Type: A site-defined value used to create subgroups within an EO Group. A plan type should be defined for each type of benefit, which EO will allow a user to see. For example, a site that has three different dental plans would define three different entries with EO Group set to INS and Plan Type set to DENTAL. Benefit Plan Types are set up on the EO Settings page, Benefits Settings card, Benefits section. Use the Exclusive in Type, Required in Open Enrollment, and Secondary Plan Type check boxes to further define the Benefit Plan Type. Exclusive in Plan Type indicates that an employee may only have one of the possibilities, at a given time, defined in the Plan Type.

Target Record: The name of the target HR table that Employee Online will use for the benefit. Valid targets are BENEFIT ASSIGNMENT (hr_beneinfo table) and CDH ASSIGNMENT (hr_cdhassgn table).
Further restrictions exist when CDHASSGN is the target. These restrictions are because benefit plan codes are not stored in the HR table (hr_cdhassgn).

The CDH Number of the CDHASSGN must map back to a single Benefit Plan on HRTBBE. It cannot use the same CDH in different benefit plan definitions.
The HRTBBE Benefit Plan record must only have a single CDH Number and it must be in the C/D row of fields (Contribution or Deduction).
If a CDHASSGN target occurs within a Plan Type with multiple records then all members of that Plan Type must map to CDHASSGN.

Allow Close: A blank check box indicates the employee is not allowed to close the benefit. If the check box is marked, the employee will be able to close the benefit assignment using the trash can button which will appear in the Benefit Enrollment page, Summary card, Current Plan Info section.

New Hire Period: If a benefit can only be added within a certain number of days from the hire date, enter the number of days. Leave blank if the employee can add the benefit at any time. A negative value in the field indicates that the employee is not allowed to add the benefit through Employee Online. Mid-Year Changes and Open Enrollment dates take precedence over the minus sign.

Mid-Year Changes: The following rules apply outside the open enrollment dates. A NO or blank means no change is allowed; the benefit will display in the Current Plan Info section if the employee already has it assigned but will not appear in the Select Primary Plan section. A 125 means change requests must meet section 125 criteria and a Change Reason is required by the employee. OK means change is allowed at any time.

If Open Enrollment Dates exist as well as this field having 125 or OK, the current pay period date logic overrules the Open Enrollment Payroll Begin date. For example, say today is 05/01, we are in open enrollment, and the record Payroll Begin is 08/01. An employee on monthly pay cycle elects benefit plan. The assignment begin date will be 05/01 this year instead of 08/01 because of the pay period logic. To have Open Enrollment dates prevail, clear this field or set it to NO.

Display Order: The sort order used when displaying the benefit. Typically, this field will be numbered so that related Plan Types are shown together and in a certain order.

Read Only: A checkmark indicates the benefit cannot be modified. The benefit will display on the Summary section if already assigned to the employee, but it will not display in the Benefit Wizard on the Benefit Enrollment page.

Forms and Coverage Information

Form Required: A checkmark indicates a form is required for benefit changes to be effective. A Required Form label along with the form name will appear in the Benefit Wizard. The employee goes to the Forms menu, downloads the form, completes and submits it.

After checking marking the box, enter the file name for the form associated with the benefit. Forms are uploaded on the Form Upload card on the Upload Settings page, and can be viewed by employees via the Forms link.

Dependent Info: A checkmark indicates the system needs to track dependents and submit information to HR. If checked, when the benefit is selected from the Benefit Enrollment wizard, the employee's dependents will display and be able to be selected.

Beneficiary Info: When the check box is marked, a benefit in the Benefit Enrollment wizard will contain an Eligible Beneficiaries panel. HRPYBE, Dependent/Beneficiary tab will display records where the Action <> EOC. Filtering based on the benefit category is not applied.

Coverage Info: Coverage Info is used for benefits that require a coverage amount selection. In the benefit wizard, when the plan is selected, a Coverage Amount drop-down menu will appear. Note that the user must type in at least three digits before matching coverage amounts appear in the drop-down. The minimum and maximum coverage amounts are determined using the HRTBBE Cap/Amt/Cov 1 and Cap/Amt/Cov 2 fields. An error will display in the benefit wizard if an amount is not entered. After check marking the box, the following fields will display:

Special Code Box: Denotes the special code box on the HR assignment that will record the coverage amount.
Units: Denotes the units of the coverage amount factored into the calculation to determine the coverage amount value. For instance, if employee selects $90,000 in coverage and Units are 10,000 then the value sent to the HR assignment Special Code Box is 9 (i.e., 90,000 / 10,000).
Increment Amount: Denotes the increment between coverage steps in the Coverage Amount drop-down menu. It should only be used if the increment is consistent between all steps.
Multiplier: Reserved for future use.

Deduction Info: A checkmark indicates the employee can set a deduction amount for the benefit. There must be a deduction number associated with a benefit plan for this option to be set. An error will display in the benefit wizard if an amount is not entered.

Amount Type: Identifies what type of amount the system is expecting the employee to enter. Options are Flat Amount, Flat Amount or Percent, and Percent. In the benefit wizard, the Amount Type is displayed to the employee so they know what type of value they are to enter. If the employee can choose Amount or Percent then a radio button will display and they are to select one of the options. Amount and Flat Amount or Percent options cause the Min Amount and Max Amount fields to display in setup. Min Amount and Max Amount ONLY apply to flat amounts though, not percentages.
Min Amount: If Flat Amount or Flat Amount or Percent is selected, specify a minimum amount for per period employee-entered deductions (example: HSA plans).
Max Amount: If Flat Amount or Flat Amount or Percent is selected, specify a maximum amount for per period employee-entered deductions (example: HSA plans).

Open Enrollment Period 1 / 2

Period Begin 1 or 2: The MM/DD part of the begin date for the first open enrollment period for the benefit. If open enrollment does not apply then leave blank.

Period End 1 or 2: The MM/DD part of the end date for the first open enrollment period for the benefit. If open enrollment does not apply then leave blank.

Payroll Begin 1 or 2: The MM/DD part of the date on which the first open enrollment requests are to become effective.

Payroll End 1 or 2: The MM/DD part of the date on which the first open enrollment requests are to end. If left blank then the end date will be 12/31/2050.

Payroll Begin and End Year Interpretation

The software will interpret the Benefit Assignment Begin and End year values based on the Open Enrollment Period and Payroll Begin/End values. The following scenarios are covered:

When the Payroll Begin is BEFORE the Period Begin, the assignment year is interpreted as next year.
- For example: Period Begin is 11/01. Payroll Begin is 01/01. The month 01 (January) is before the month 11 (November) so the year assigned is next year. If the current year is 2023, the benefit assignment begin and end year will be next year, 2024. CDH assignment dates will be 01/01/2024 - 12/31/2024.
When the Payroll Begin is AFTER the Period Begin, the year is interpreted as the current year.
- For example: Period Begin is 11/01. Payroll Begin is 12/01 and Payroll End is 12/31. The month 12 (December) is after the month 11 (November) so the year assigned is the current year. If the current year is 2023, the assignment begin and end year is 2023. CDH assignment dates will be 12/01/2023 - 12/31/2023.
The same is true for the situation where there is an overlap from one year to the next for payroll begin/end.
- For example: Period Begin is 11/01. Payroll Begin is 12/01 and Payroll End is 06/30. The month 12 (December) is after the month 11 (November) so the assignment begin year is this year. Payroll End is 06/30 and month 06 (June) is before month 11 (November). If the current year is 2023, the assignment end date is next year, 2024. CDH assignment dates will be 12/01/2023 - 06/30/2024.

Coverage Rules

This section will determine which employees will be able to see which plan options based on employee master values.

Use the "(“, “Column”, “Operator”, “Value”, “)”, and And/Or fields to set coverage rules. When using brackets, make sure an opening bracket is matched by a closing bracket.
If entering a date in the Value field, enter it in mm/dd/yyyy format.
If entering a percentage in the Value field, enter it in x.xx format (for example 0.50).

Secondary Plans

Benefit Plan: Select a secondary benefit plan, if appropriate, from the drop-down menu. Available options are defined on the Employee Online Settings page, Benefits sub-card, Benefit Plan Types, Secondary Plan Type column. If the Plan Type for the primary benefit is already a secondary plan, this field will not display.