BENEFIT PLAN SETUP

Use this screen to set up actual insurance benefits for your company and define rules for eligibility, coverage, and enrollment. You can also use this screen to establish benefit cost and assign coverage options and deduction codes.

You must set up this screen before you can establish benefit packages or benefit package defaults. However, you can add to this table at any time, and you can establish an unlimited number of benefit plans.

Benefit Plan Code

Enter up to 12 alphanumeric characters to uniquely identify this benefit plan. This is a required field.

Description

Enter up to 30 alphanumeric characters to describe this benefit plan. This field is required.

Provider

Enter, or use Lookup to select, the code for the provider that is associated with this benefit plan. The provider is the company or agency that provides the insurance policy associated with this benefit plan. The provider code is validated against the Provider table, which is set up in the Providers screen. This is a required field. The name of the provider is displayed in the field to the right.

System Benefit Type

Use the drop-down box to select the type of system benefit. Drop-down values include "Life Insurance," "Health Care Insurance," "Vision Insurance," "Dental Insurance," and "Long Term Disability." These codes are used by various benefits reports; this is a required field.

User Benefit Type

Enter, or use Lookup to select, the user benefit type code that is associated with this benefit plan. These codes are established in Benefit Types screen and are used only for internal tracking purposes. User benefits types are defined by the user and differ from the standard system benefit types listed above. The benefit type code is validated against the Benefit Types table. This is an optional field.

Plan Info URL

Enter the web location for information about this benefit plan for Employee Self Service exactly as you would type it in a web browser (e.g., http://www.(websitename).com). Employee Self Service is an add-on product for Costpoint that allows employees to view their benefits information online.

Plan Status

Use the selections in this group box to make this benefit plan active or inactive.

Active

Select this radio button to make the benefit plan active.

Inactive

Select this radio button to make the benefit plan inactive.

Eligibility Rules

Use this group box to define who is eligible for enrollment in this benefit plan based on the employee status in the Salary Info and History screen. You will also define age requirements, if there is a waiting period, and how that waiting period is defined, if applicable.

Employee Class

Select this checkbox to sort by employee class.

If you select this checkbox, enter, or use Lookup to select, the employee class code by which you wish to sort in the adjacent unlabeled field. If you selected the Employee Class checkbox, this is a required field.

Hourly/Salary

Note: The checkbox that you select in this group box must match your selection in the Hourly/Salary column in the Employee Class screen in Costpoint Employee.

Use the selections in this group box to define who is eligible for this benefit plan based on the value in the Hourly/Salary field in the Salary Info and History screen in Costpoint Employee.

Hourly

Select this checkbox if hourly employees qualify for this plan.

Salary

Select this checkbox if salaried employees qualify for this plan.

Fluctuating

Select this checkbox if fluctuating hour employees qualify for this plan.

Employee Type

Use the selections in this group box to define who is eligible for this benefit plan based on the value in the Empl Type field in the Salary Info and History screen in Costpoint Employee.

Regular

Select this checkbox if regular employees qualify for this plan.

Part time

Select this checkbox if part-time employees qualify for this plan.

Temporary

Select this checkbox if temporary employees qualify for this plan.

Minimum Age

Enter up to three digits for the minimum age an employee must attain before becoming eligible for this plan. This is an optional field.

Dependent Maximum Age

Enter up to two digits for the maximum age at which a non-student dependent can still be covered under this plan. Spouses are excluded from this age editing. This is a required field if you select the Dependents Eligible checkbox in the Coverage Rules group box.

Student Maximum Age

Enter up to two digits for the maximum age at which a student dependent can still be covered under this plan. Spouses are excluded from this age editing. This is a required field if you select the Dependents Eligible checkbox in the Coverage Rules group box.

Minimum Hours Worked

Enter up to four digits to indicate the minimum number of hours an employee must work before becoming eligible for this plan. This is an optional field.

Waiting Period Months

Enter up to three digits to indicate the number of months an employee must wait before becoming eligible for this plan. This is an optional field.

First of Month After Waiting Period

Select this checkbox if this benefit is not available until the first of the month after the end of the waiting period. If you do not select this checkbox, this benefit is available immediately upon completion of the waiting period.

Rehires Eligible on Rehire Date

Select this checkbox if a rehired employee's benefit start date should be his rehire date. If you do not select this checkbox, a rehired employee’s benefit start date will be based on your selections in the Eligibility Rules group box.

Home Address

Note: This group box will display only if you are using Employee Self Service 3.0.

Use this group box to specify whether the Benefit Plan should default and be validated based on the employee's postal code or state.

Note: If the employee has an additional address type of "HOME," the system will use that address to determine the employee's postal code or state.  Otherwise, the employee's mailing address is used.

Postal Code

If you select this radio button, the Benefit Plan will default and be validated based on an employee's postal code.  Selecting this radio button enables the Valid Postal Codes pushbutton and disables the Valid States pushbutton

State/Province

If you select this radio button, the Benefit Plan will default and be validated based on an employee's state.  Selecting this radio button enables the Valid States pushbutton and disables the Valid Postal Codes pushbutton.

Neither

If you select this radio button, the Benefit Plan will default and be validated based on an employee's postal code or state.  Selecting this radio button disables the Valid States and Valid Postal Codes pushbuttons.

Coverage Rules

Use the selections in this group box to define additional rules for this plan.

Core Benefit

Select this checkbox if this benefit is automatically granted to an employee, unless specifically waived.

Eligible for COBRA

Select this checkbox to indicate that this benefit needs to be offered as a part of COBRA continuation. This is for information only.

Dependents Eligible

Select this checkbox if dependents can be covered under this plan. If you do not select this checkbox, you cannot assign employee dependents to this benefit plan.

Dependent Spouse or Child

Select this checkbox if only the spouse or child of the employee are the only dependents eligible for this plan. This will be used when assigning dependents to plans.

Beneficiaries Required

Select this checkbox if you selected "Life Insurance" in the System Benefit Type field and you require beneficiaries to be assigned to life insurance plans. This checkbox is for information only.

Disability Exclusion

Select this checkbox if disabled persons are excluded from this benefit plan. This checkbox is for information only.

Requires Approval

Select this checkbox if the plan requires approval before it is effective.

Require PCP Name and Number

Note: This checkbox will display only if you are using Employee Self Service 3.0.

If you select this checkbox, employees will be required to specify the Primary Care Physician (PCP) name and number when the benefit plan is elected in ESS or when the benefit plan is assigned to the employee in Costpoint.

Enrollment Rules

Use this group box to define the open enrollment period and which events allow for different times of enrollment. This group box is for information only.

Any Time

Select this checkbox if there is no time restriction on enrollment for this benefit plan. If you select this checkbox, the remaining checkboxes and fields in this group box are disabled.

On Hire

Select this checkbox if an employee should be enrolled in this plan upon being hired. Your entry in the Grace Period Days field will be used to define the grace period for enrolling after the hire date.

On Qualifying Life Event

Select this checkbox if the enrollment can be changed because of a qualifying life event.

Open Enrollment Period

Select this checkbox to if you want to define a period during which employees may enroll for this benefit. If you selected this checkbox, both the Open Enroll Date and Grace Period Days fields are enabled and required.

Note: You must select either the Any Time checkbox or one of the following checkboxes:  On Hire, On Qualifying Life Event, and/or Open Enrollment Period.

Open Enroll Date

Enter the date, in MM/DD format, on which open enrollment in this benefit plan begins. This field is required only if you selected the Open Enrollment Period checkbox.

Grace Period Days

If you selected the Open Enrollment Period checkbox, you must enter up to three digits for the number of days an employee has beyond the open enrollment date to enroll in this benefit plan. If you selected the On Hire checkbox, you must enter up to three digits for the number of days an employee has to enroll.

ESS Visibility

Exclude from Current Elections

Select this checkbox to exclude the benefit plan from ESS Current Elections.

Exclude from Benefit Options

Select this checkbox to exclude the benefit plan from ESS Benefit Options

Coverage Detail

Use this pushbutton to open the Coverage Detail subtask, where you can enter additional information about this benefit plan

Coverage Options

Use this pushbutton to open the Coverage Options subtask, where you can set up an unlimited number of coverage options for this plan. You can enter coverage and premium amounts either by specifying the rate/coverage table or by entering the actual amount.

Valid Postal Codes

Note: This pushbutton will be available only if you are using Employee Self Service 3.0.

Select this pushbutton to access the Postal Codes subtask, where you can enter valid postal codes for the benefit plan. Use this subtask to enter the Postal Code ranges that are eligible for the Benefit Plan in this subtask. Employee Self Service will use these ranges to default the Benefit Plan for the employee and also to validate the Benefit Plan for the employee.

Valid States

Note: This pushbutton will be available only if you are using Employee Self Service 3.0.

Select this pushbutton to access the Valid States subtask, where you can enter valid states and/or provinces for the benefit plan. Use this subtask to enter the States/Provinces that are eligible for the benefit plan. Employee Self Service will use these ranges to default the Benefit Plan for the employee and also to validate the Benefit Plan for the employee.

Table Information

Changes to this screen update the following tables:

Benefit Plan Header - HB_BEN_PLAN_HDR

Benefit Plan Line - HB_BEN_PLAN_LN

Benefit Plan CoPay - HB_BEN_PLAN_COPAY

Deductions - DED_CD

Coverage Amounts by Age - HB_AGE_CVG

Coverage Rates by Age - HB_ABE_RT

Benefit Types - HB_BEN_TYPE

Coverage Options - HB_COV_OPT

Employee Package Elections - HB_EMPL_PKG_ELEC

Providers - HB_PROVIDER

Coverage Amounts By Salary - HB_SAL_CVG

Coverage Rates by Salary - HB_SAL_RT

Pay Types - PAY_TYPE