Coverage/Premium Rules

Use the Coverage Detail subtask to enter additional information about this benefit plan.

Because this subtask is primarily a continuation of the Manage Benefit Plans screen, you must enter coverage detail information before you can establish benefit packages or benefit package defaults. Entering information on this screen is part of the first step in setting up any new benefit package.

Coverage Calculation Rules

Use this group box to define how an employee's age is calculated when the Premium Rates by Age and Coverage Amounts by Age tables (set up in the Premium and Coverage Tables menu) are used during the Compute Payroll process.

Field	Description
Coverage Calculation Method	Use this drop-down list to determine the method by which coverage amounts are calculated. Amount: Select this option if you want the amount entered in the Coverage Factor/Amount column to be used as the actual amount. When you select this option, the Table group box and the Coverage Table column is disabled. This is the system default. Factor: Select this option if you want the value entered in the Coverage Factor/Amount column to be multiplied by the employee's salary to determine coverage. When you select this option, the Table group box and the Coverage Table column are disabled. Coverage Table: Select this option if you want to use the Coverage Amounts by Age or Coverage Amounts by Salary tables to calculate coverage. If you select this option, the Table group box is enabled, and the Coverage Factor/Amount column is disabled. None: Select this option if coverage amounts do not apply. This will be common for health insurance benefits.
Coverage Table	Use this drop-down list to indicate which table to use for calculating coverages. This group box will be enabled only if you selected the Coverage Table option in the Coverage Calculation Method group box. Salary: Select this option to use the Coverage Amounts by Salary table for calculating coverage. You can then assign the applicable coverage table code to all coverage options. Age: Select this option to use the Coverage Amounts by Age table for calculating rates. You can then assign the applicable coverage table code to all coverage options. None: Select this option to use no coverage tables. The actual amount or a factor will be entered for each coverage option. This option is automatically set as the default if you select any option other than Coverage Table in the Coverage Calculation Method group box.
Rounding Criteria	Use this drop-down list to control how coverage amounts are rounded. 1: Select this option to round coverage amounts up to the next whole dollar. This is the system default. 10: Select this option to round coverage amounts up to the next $10. 100: Select this option to round coverage amounts up to the next $100. 500: Select this option to round coverage amounts up to the next $500. 1,000: Select this option to round coverage amounts up to the next $1,000. 10,000: Select this option to round coverage amounts up to the next $10,000.
Coverage Limit	Enter the coverage limit for the plan. If the field is enabled, the application automatically sets the value in this field to 999,999,999,999,999.00. This field is enabled if the Coverage Calculation Method is Factor or Coverage Table; Coverage Table is Salary; and the System Benefit Type is one of the following: Life Insurance AD&D Insurance Long Term Disability Short Term Disability Supplemental Life Insurance Supplemental AD&D Insurance Dependent Life Insurance Spouse Life Insurance Spouse AD&D Insurance Other You can update the Coverage Limit if needed. This field is disabled if the Coverage Calculation Method is Amount or Coverage Table and the Coverage Table is Age . When disabled, the value in this field is set to 999,999,999,999,999.00. To enable the Coverage Limit field and related conditions, ensure that the ESS Version drop-down list on the Configure Global Settings screen is set to Deltek ESS 10+. Versions earlier than 10 do not support this functionality.

Premium Calculation Rules

Field	Description
Premium Calculation Method	Use this drop-down list to determine whether premium amounts will be calculated using an amount, factor, or coverage table, and how the premium will be calculated if using an amount, factor, or coverage table. Amount: Select this option if you want the amount entered in the Premium column to be used as the actual monthly amount. Selecting this button will disable the Premium Table group box and enable the Premium, Company Amount, and Employee Amount fields in the table. Cost Per $1,000: Select this option if you want the amount entered in the Premium column to be used as the cost per $1,000 amount. Selecting this button disables the Table group box and enables the Premium, Company Amount, and Employee Amount fields in the table. Rate Table: Select this option to use the Premium Amounts by Age table or Premium Amounts by Salary table to calculate rates. Selecting this button  enables the Table group box and the Rate Table column. In addition, the Premium, Company Amount, and Employee Amount fields in the table window are disabled.
Premium Table	Use this drop-down list to indicate which table to use for calculating rates. This group box is enabled only when you select the Rate Table option in the Premium Calculation Method group box. Salary: Select this option to use the Premium Amount by Salary table for calculating rates. You can then assign the applicable salary rate code to all coverage options. Age: Select this option to use the Premium Rates by Age table for calculating rates. You can then assign the applicable age rate code to all coverage options. None: If you select this option, no rate table is used. The actual amount will be entered for each coverage option. This is the system default.
Cash Out Pay Type	Enter, or click to select, the code for the pay type to be used for the cash out option for this benefit plan, if a cash out option is available. If an employee elects a cash out option, this pay type is used to add the cash out amount to the employee's paycheck. This must be a Benefit Reimbursement pay type, and it will be treated as fully taxable, unless otherwise indicated on the Configure Pay Type Taxability screen. This field is required if this benefit plan has a cash out option.

Age and Salary Calculation Methods

Field	Description
Age Based On	Select the basis for age calculation: Employee: Select this option to base the age calculation on the employee's age. Spouse: Select this option to base the age calculation on the age of the spouse.
Age Calculation Method	Use this drop-down list to define which date should be used to determine an employee's age. Options are: Start of Year: Select this option to use the employee's age at the beginning of the calendar year when computing payroll. This is the system default. End of Year: Select this option to use the employee's age at the end of the year when computing payroll. Start of Pay Period: Select this option to use the employee's age at the beginning of the pay period when computing payroll. The pay period date is determined on the Manage Pay Periods screen. End of Pay Period: Select this option to use the employee's age at the end of the pay period when computing payroll. The pay period end date is determined on the Manage Pay Periods screen. Policy Date: Select this option to use employee's age at the provider's policy start date when computing payroll. The provider's policy start date is determined on the Manage Benefit Providers screen. System Date: Select this option to use employee's age as of the system (current) date when computing payroll. Coverage Start Date: Select this option to use the employee's age at the coverage start date when computing payroll. Hire Date: Select this option to use the employee's age at his or her hiring date year when computing payroll.
Salary Calculation Method	Use this drop-down list to control how an employee's salary is calculated when the Coverage Amounts by Salary table or the Premium Amounts by Salary table are used during the Compute Payroll process. End of Prior Year: Select this option if you want the rate calculated on the employee's salary at the end of the prior year. The system determines the prior year by subtracting one year from the pay period end date in the Manage Pay Periods screen. This is the system default. Start of Pay Period: Select this option to use the employee's salary at the beginning of the pay period. The start date of the pay period is determined on the Manage Pay Periods screen. End of Pay Period: Select this option to use the employee's salary at the end of the pay period. The end date of the pay period is determined on the Manage Pay Periods screen. System Date: Select this option to use the employee's salary as of the system (current) date.