Benefit Plan Setup Details

Business Scenario

Benefit plans, such as a Californian PPO (Preferred Provider Organization) medical plan, have a vendor code for the insurance provider and eligibility rules. The California PPO plan is defined on the Benefit Codes Table and is then split into benefit coverages, such as a California PPO Family Medical coverage option and a California PPO employee-only coverage, with separate costs and eligibility information on benefit cost code records defined on the Benefit Cost Codes Table.

Step-by-Step Benefits Setup

#	Organization-Level
1	Define the Vendor Code(s).
2	Verify the Coverage Codes and Benefit Eligibility Rules (not visible).
3	Add profile codes(benefit classes) as needed. At least one active profile code is required for benefit self-service. Define the Profile Setup for benefits after all benefit plans are defined. See Step 11.
4	Payroll Accumulator Setup is needed for benefit costs that calculate by a percentage, such as 401(k) by percentage contribution and any corresponding employer-match.

#	Per Plan
5	If the plan is a deferred compensation plan, then verify or add a Deferred Compensation Plan Code. Otherwise skip this step.
6	Add a Deduction Code.
7	Add an Earnings Codes. Not all plans require earnings.
8	Add a Benefit Code.
9	Add Benefit Cost Bands (optional).
10	Add Benefit Costs Codes.

#	Per Employee: Assign benefits to employees.
11	Define benefit profiles (works in conjunction with new hire processing).
12	Define open, new hire, and life change enrollments for Benefit Self Service. Open Enrollment (Plan) Selection Transaction routing on Employee Transaction Approvals records for the following types: 08, Benefit Open Enrollment; and 03, Employee Address Change. Confirm that the Supervisor Codes are valid and appropriate employees are assigned to each Supervisor Code.
13	Add Employee Benefit Details.
14	Assign dependents and beneficiaries. (Define employee contacts first.)