Benefit Eligibility Rules Table

Overview

Fields on the Benefit Eligibility Rule Table

Code. Enter a unique code value of ten characters or less. Omit special characters, punctuation, and spaces.
Active? An active code has the Active checkbox selected, making the code available and keeping the code in effect as a valid choice. Verify that the Active indicator is selected if the code should be available to the system.
Description. Enter a description of thirty characters or less. Omit special characters and punctuation. Spaces are permitted.

Eligibility Information (Informational-Only)

Minimum Age Required. If a minimum age must be attained before the employee becomes eligible for the benefit, enter the Minimum Age Required.
Minimum Hours Worked. If employees are required to work a certain number of hours to be eligible under this eligibility rule, enter that number of hours as the minimum hours worked.
Minimum Annual Salary. If employees must earn a minimum salary to be eligible, enter the dollar amount as the minimum annual salary.
Maximum .Annual Salary If employees who earn above a set dollar amount become ineligible under this benefit rule, enter the maximum salary eligible as the maximum annual salary.

Require All of These Benefits

"Require All of These Benefits" is used to define multiple requirements where every listed plan and coverage combination is required for eligibility. Up to three Benefit codes and coverages can be defined as required to be eligible under a particular eligibility rule. For instance, if an employee must have a benefit code of MEDICAL and a coverage code of EE and a DENTAL benefit and EE coverage to be eligible for a life insurance, a separate eligibility rule can be defined with MEDICAL and a coverage code of EE and a DENTAL benefit and EE coverage selected in the "Require All of These Benefits" section

Require Any of These Benefits

"Require Any of These Benefits" is used to define benefit requirements that are for one or more plans and coverage. If any one of two or three Benefit codes and coverages are required for an employee to be eligible under a particular eligibility rule, define these in the section labeled, "Require Any of These Benefits". For instance, if an employee must have a benefit code of NYMEDICAL with a coverage code of EE or a NJMEDICAL benefit with EE coverage to be eligible for a life insurance, a separate eligibility rule can be defined with of NYMEDICAL with a coverage code of EE or a NJMEDICAL benefit with EE coverage selected in the "Require Any of These Benefits" section

Benefit Coverage Eligibility

Select which date to use as the basis for determining the term of service seen in the "Coverage Starts" section.
Use Original Hire Date (the date that the employee was first hired).
Use Adjusted Hire Date (may be recorded during new hire/re-hire).
Use Re-Hire Date (for employees who have been re-hired).
Use Benefit Service Date to use the employee's defined Benefit Service Date.

Coverage Starts

Define the rules for when the benefit coverage is available, specifically to define the term of service that is required for eligibility.
First Day Following Service of (days or months)
First Month Following Service of (days or months)
First Quarter Following Service of (days or months)
Select the Days or Months option to define the units for the character field on the left. The service requirement is either Days entered or Months entered.
Enter the numeral for the number of units. Service requirement are in days entered or months entered.

Payroll Processing Rule

Define the rules for when deduction/earning processing should begin for the benefit. The payroll processing rule applies in comparison with the Coverage start date.

Begin Payroll Processing. Identify the number of Days/Months before or after the coverage date that payroll processing should begin for benefits under this eligibility rule. For days before, enter a negative number. For days after, enter a number without any symbols.
Select the Days or Months option to define the units for the character field on the left. The service requirement is either Days entered or Months entered.
Days from Coverage Date (days or months)
Months from Coverage Date (days or months)