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Benefit Eligibility Rules

Details

Define the qualifications for receiving a specific benefit according to an organization's benefit plan rules.

The benefit eligibility rules are used for reporting and to limit plan availability through employee self-service benefit enrollments.

Two standard Benefit Eligibility Rules impact the Employee New Hire Wizard's Benefit Service Date and Probation Date.

• BENEFITSVC, Benefit Service Date, controls the calculation used to auto-populate the Benefit Service Date in the Employee New Hire Wizard.
• PROBATION, Probation Date, controls the calculation used to auto-populate the Probation Date in the Employee New Hire Wizard.

You may need the assistance of your system administrator to add additional Benefit Eligibility Rules or change the benefit eligibility rules.

Business Scenario

The Benefit Eligibility Rules codes table defines sets of eligibility requirements for benefits for reporting and auto-calculating payroll effective dates base on coverage effective dates. For instance, a benefit might require that an employee be at least 21 years old. The Benefit Start Date can be set to the Adjusted Hire, Original Hire, or the Eligibility Date.

• Benefit plans assigned directly on the Employee Benefits Detail are not restricted based on benefit eligibility rules. The auto-calculation of the Payroll Effective Date is based on the applicable Benefit Eligibility Rule, the Coverage Effective Date, and the pay schedule for the employee.  
• Benefit plans available through employee self-service Open Benefit Enrollment are restricted based on applicable Benefit Eligibility Rules and Benefit Profiles. The benefit eligibility rules also contribute to payroll date calculations based on coverage effective dates.

Note: Benefit plans assignments directly on the Employee Benefits Detail are not restricted based on benefit eligibility rules.