Employee Benefits

Related Topics

Other Details for Benefit Assignments

Employee Benefit Detail records define employee benefit assignments of all kinds, including insurance benefits and benefit-hours plans, such as PTO. For a complete accounting of expenses, a benefit can drive both the employee premium deductions and employer contributions.

The results of approved self-service benefit enrollments are on Employee Benefit Detail records and corresponding beneficiary and dependent information. It is also possible to skip the self-service benefit enrollment and to add, modify, or end benefit assignments directly from the Employee Benefit Detail screen.

Ending Benefit Coverage by an Existing Plan: To end an employee's benefit coverage under an existing plan, end the coverage with a termination date that equals the last date of coverage and define a payroll termination date that equals the last day of the pay period in which this record's cost applies.
Coverage Change: When an employee's coverage changes and a self-service status change enrollment is not an option, go to the Employee Benefits Detail. Whether to end the original record and add a new record will depend on the requirements for record-keeping and any benefit carrier feed information.
Enrolling an Employee in a Benefit Plan or New Coverage:To enroll the employee in a different benefit plan and coverage combination, add a new Employee Benefit Detail with the new benefit plan coverage and a future effective date that equals the first date that the benefit is effective and cost is in effect. Available coverage options are filtered based on benefit cost code setup and eligible benefit types defined on the coverage codes.

Business Scenario: Add an Employee Benefit Detail for Benefit Hours

Benefit-hour accruals are assigned to an employee through a benefit plan. That benefit plan is associated with an earnings code for tracking available hours. Multiple levels of accrual are defined on the benefit hours accrual codes table and can be assigned to a Earnings Code for vacation or PTO.

Precondition: Prior to assigning benefits on the Employee Benefits Detail, verify the dates on the employee's Master record. The Original Hire and Benefit Service date fields should be completed.

Benefit Code. Add an Employee Benefit Detail record. Select the Benefit Code, which was set up to relate to the Hours Accrual Code, such as a code for vacation or PTO.
Coverage. Select the pre-defined coverage code: BENEHOURS.
Available Hours. When available hours should carry over from a previous system, record the current available hours remaining in the Available Hours field on the benefits detail record.
Total Hours Accrued. When the information for the employee's total accrued hours is available, complete the Total Hours Accrued field, which is recommended for proper limiting of accruals but not required.
Coverage Effective Date. Verify the begin date when an employee may begin using any accrued time.
Payroll Effective Date. Verify the begin date for the accrual processing in the payroll effective date field.
Save.

Employee Link to PTO Benefits: For employees with PTO benefits, payroll-processing updates the Current Hours Accrued, Total Hours Accrued, and Available Hours fields based on processing of the benefit-hours earnings and accruals.

Employee Benefits Detail

Fields on the Employee Benefits Detail

Employee Number. The employee whose benefit is being defined is in the Employee Number field.
Beneficiaries/Dependents button. . For a plan and coverage that can have beneficiaries or dependents, a button for either a beneficiaries or dependents displays.

Benefit Information

Benefit Code. To assign a new benefit, select the benefit. Many fields populate with default information based on the selected Benefit code. Adjust the pre-populated information as needed.

When updating an existing benefit, consider whether to end-date the current record and define a new Employee Benefits Detail for a change in coverage, etc.

If the data required data didn't populate, enter it now. Follow your organization's policies.

Coverage: Effective Date. The coverage effective date is used to track the start date for coverage. The current date is populated as the effective date when you add a record on the Employee Benefit Detail screen; however, this date should be modified as needed.

To set employee records to define coverage effective on a future date, enter the coverage begin date in the Effective Date field in the "Coverage Dates" column.

Coverage: Termination Date. The coverage Termination Date is when the plan is no longer in effect. Often the coverage termination date is on or after the payroll Termination Date. When a coverage is scheduled to end in the future, that future end date can be entered as the coverage Termination Date.

Payroll: Effective Date. The payroll effective date is used to determine when to begin processing a benefit's payroll deductions or earnings. The current date is populated as the effective date when you add a record on the Employee Benefit Detail screen; however, this date should be modified as needed.

To set employee records to access the new plan when the effective date arrives, enter a future effective date that is within the pay period that the benefit and benefit deductions should begin.

>> button. To update the payroll effective date based on the coverage effective date and the applicable Benefit Eligibility Rule record, click on the >> button next to the payroll Effective Date field. This button is availalbe when the record is in edit mode.
Payroll: Termination Date. A benefit and its associated deductions remain effective for pay periods before the benefit termination date. A future termination date can be entered.

A termination date before the pay period's end date stops the benefit coverage and its deductions.

A termination date after the pay period's end date indicates an active benefit that can be processed as part of the payroll.

Ending Benefit Coverage by an Existing Plan. To end an Employee Benefit Detail for an employee, first determine when the benefit's costs should no longer be deducted. Look at the pay period schedule that affects this employee's pay. Choose a Termination Date that equals the last date in the pay period for this benefit coverage's final processing for this employee.

Participant ID. The Participant ID is an optional informational field used to identify this employee for reporting purposes.
Reference Info. Reference Info is an optional informational field used to record reference information for this Benefit Plan for reporting purposes.
Reason Denied. The Reason Denied value is any reason that the employee declined coverage. This is typically gathered through Employee Self Service enrollments where a plan is defined to require employee-level ACA tracking.

Select each of the next checkboxes as appropriate: Declined Coverage, Medicare Eligible, Update Ben. Costs, and/or Recalculate Benefit Salary.

Declined Coverage? If this employee is denied coverage under this Benefit Plan, select the Deny Coverage checkbox.
Medicare Eligible? If this Benefit Plan is Medicare Eligible, select the Medicare Eligible checkbox.
Update Benefit Costs>? To allow Benefit Costs to update based on the costs defined for the plan and coverage on the code-level and to allow processing to update any EE Age, select the "Update Ben. Costs" checkbox. To override the costing and stop calculated Age/EE Service years now and in the future for this Employee Benefits Detail, clear the "Update Ben. Costs" checkbox.
Recalculate Benefit Salary? To allow the benefit salary for benefit calculation purposes to recalculate when the employee's pay on the master record changes, select Recalculate Benefit Salary.

Limits and Amounts

The Benefit Cost Code for this Benefit Code and Coverage Code are used during payroll processing to populate dollars where appropriate related to Benefit Limit, Benefit Amount, Deductible Amount, and Out-of-Pocket Max.

Benefit Limit. To impose a limit on this employee’s benefit amount due to limits set by regulatory guidelines, benefit plan rules, or your company policies, enter the limit amount in the Benefit Limit field.
Benefit Amount. In the Benefit Amount field, enter the amount of coverage applicable to this benefit, if any. (If this entry was not defined on the Benefit Costs Code associated with the Benefit Code).
Deductible Amount. If this benefit has a deductible, enter the amount in the Deductible Amount field. (If this entry was not defined on the Benefit Costs Code associated with the Benefit Code).
Out-of-Pocket Max. The optional Out-of-Pocket Max entry is helpful information for employees and personnel but is not needed to define benefit costs. For benefit plans that limit the personal expense to the employee, enter the amount of employee personal expense in the Out-of-Pocket Max field, if this entry was not defined on the Benefit Costs Code associated with the Benefit Code.
Available Hours. For benefit-hours, when accrual hours are associated with the selected Benefit Code, this field updates automatically when payroll posts. When initially setting up your system, if available hours should to carry over from a previous system, record them in the Available Hours field.
Max Accrual Hours. For benefit-hours, when accrual hours are associated with the selected Benefit Code, this field updates automatically when payroll posts.
Maximum C/O (Carry Over) Hours. Maximum carry over hours populate from the benefit hours accrual policy for this benefit, if any. For benefit-hours, when accrual hours are associated with the selected Benefit Code, this field updates automatically when payroll posts.

Note: If the system is defined to pay employee PTO accrual benefit hours in arrears, the system will pay PTO benefit hours entered for the pay run and adjust the employee's Available Hours with a negative balance here on the Employee Benefits Detail and also on the Employee Earnings Detail screen.

Transaction Type. The transaction type displays as a read-only value. For a benefit that was added through a self-service enrollment, the transaction type is ELECTED.

Processing Information

Annual Employee Amt and Annual Employer Amt. Annual amounts and percentages apply to benefit costs.

The Benefit Cost code associated with the Benefit code and Coverage code provides the Annual Employee Amt and Annual Employer Amt values for payroll processing. Entering amounts on the Employee Benefits Detail will override these system-wide amounts (whether from Annual Costs entered or Benefit Cost Bands).

Annual Employee Amt. The employee cost field shows an annual dollar amount.
Employee Percent and Employer Percent. The Employee Percent and Employer Percent can be overridden per employee on the Employee Benefits Detail.

Total Hours Accrued. The Total Hours Accrued field should reflect the hours accrued thus far. Often, a new hire does not have accrued hours for benefit plans such as PTO right away. When initially setting up your system, if the total accrued hours are available, complete the Total Hours Accrued field.

Member Physician Information

Physician ID. If the employee designated a primary care provider, such as for some HMO plans, then the primary care provider number can be entered as the Physician ID.
Physician Name. If the employee designated a primary care provider, such as for some HMO plans, the physician's name can be entered as the Physician name.
Physician ID 2. If the employee designated a secondary care provider, such as for some HMO plans, then the identifier for the secondary care provider can be entered as Physician ID 2.
Physician Name 2. If the employee designated a secondary care provider, such as for some HMO plans, then the name of the secondary care provider can be entered here.