Benefits Administration Guide

Version: R2024.2.0

About This Guide
Getting Started
Benefits User Roles and Payroll Integration
Benefits Role Features
Benefits
Benefits Administration
Benefits in the People Feature
Benefits Intelligence
Benefits Setup
Data Export Setup for Benefits
PPACA
Assign Benefits Role Authorizations
Payroll Configuration for Benefits Integration
Payroll Earnings and Deductions
Payroll Deferred Compensation Plans
Pay Calendars
Benefits Setup
Plan Carriers
Add Plan Carriers
Benefits Data Export
XML/834 Exports
Add XML/834 Exports
COBRA and Initial Notice Exports
Add COBRA or Initial Notice Exports
Ongoing and Open Enrollment Exports
Ongoing Exports
Plan Year Dates for Ongoing Exports
Blackout Dates for Ongoing Exports
Open Enrollment Exports
Best Practices for Open Enrollment Exports
Add Single Ongoing and Open Enrollment Exports
Add Multi-Carrier Ongoing and Open Enrollment Exports
End Export Configurations
Eligibility Qualifiers
Simple Eligibility Qualifiers
Add Simple Eligibility Qualifiers
Complex Eligibility Qualifiers
Add Complex Eligibility Qualifiers
Test Eligibility
Flex Credit Benefits
Flex Credit Plans
Add Flex Credit Plans
Configure Flex Credit Plan Details
Flex Credit Plan Tiers
Add Tiers to Flex Credit Plans
Configure Flex Credit Amounts and Participant Rules
Flex Credit Order
Add Flex Credit Order
Plans and Options
Plan Attributes
Manage Plans and Options
Add Plans
Add Options
Delete Plans and Options
Waive Options
Health Plans
General Health Plan Settings
Add Managed Care Provider Information
General Health Option Settings
Best Practices for Domestic Partner Options
Life and Disability Plans
General Life and Disability Plan Settings
General Life and Disability Option Settings
Life and Disability Option Coverage Settings
Add Life and Disability Option Coverage
Life and Disability Option Guaranteed Amounts
Include in Recalculations Setting
Add Guaranteed Amounts
Coverage Expressions
The Benefits Expression Builder
Examples for Coverage Expressions
Test Coverage Expressions
Imputed Income
Imputed Income and Mid-Month Coverage Changes
Dependent Coverage and Imputed Income
Best Practices for Imputed Income Options
Best Practices for Voluntary Life Plans
Reimbursement Plans
General Reimbursement Plan Settings
General Reimbursement Option Settings
Reimbursement Option Contribution Settings
Configure Reimbursement Option Contributions
Retirement Plans
General Retirement Plan Settings
General Retirement Option Settings
Retirement Option Contribution Settings
Employee Deferral Settings
Employer Contribution Settings
Configure Retirement Option Contribution
Best Practices for State-Mandated Retirement Plans
Add Documents to Plans or Options
Coverage Period
Add Coverage Begin Rules
Add Coverage End Rules
Payroll Mappings
Health Plan Payroll Mappings
Example for Health Plan Payroll Mapping
Life and Disability Plan Payroll Mappings
Example for Life and Disability Plan Payroll Mapping
Reimbursement Plan Payroll Mappings
Retirement Plan Payroll Mappings
Monthly Contribution Payroll Mapping
Add Plan Payroll Mapping
Configure Tiers
Assign Eligibility Qualifiers
The Eligibility Test Tool
Test Plan and Option Eligibility
Option Rates
Rates Settings
Add Option Rates
Copy Option Rates
Delete Option Rates
Participant Definitions
Participant Definition Settings
Add Participants
Proration Rules
Full Month
Pay Period
Fixed Date
Relative Date
Validate Plan Configuration
Run the Benefits Plan Configuration Audit Report
Recalculate Benefits
Plan Option Groups
Add Plan Option Groups
Enrollment Events
Add Enrollment Events
Enrollments
Enrollments and Pre-Start Employees
HR Events and Pre-Start Employees
Load Enrollments
Add Enrollments
Enrollment Settings
Configure Open Enrollments
Configure New Hire Enrollments
Configure Life Event Enrollments
Configure Work Event Enrollments
Configure Periodic Enrollments
Configure PPACA Enrollments
Add Introduction Text
Include Profile Forms
Add Event Details
Add Events to Enrollments
Delete Events from Enrollments
Sections and Elections
Add Sections
Add Election Sets
Default Options During Enrollment
Best Practices: Auto Enroll Health Options
Add Comparison Categories to Election Sets
Add Options
Add Individual Options to Election Sets
Add Option Bundles to Election Sets
Add Comparison Information to Options
Copy Comparison Information
Change Individual Options in Election Sets
Copy Sections and Election Sets
Configure Enrollment Restrictions
Add Restrictions to Election Sets
Events and Restrictions in the Enrollment Process
Configure the Summary
Add Next Steps
Configure Eligibility
Test Enrollment Eligibility
Add a Logo or Signature
Publish Enrollments
Unpublish Enrollments
Update Communication Dates for Open Enrollments
Update Communication End Dates for Life Event Enrollments
Republish Enrollments
Edit Enrollments
Enrollment Setup Reports
Enrollment Restriction Definitions
Best Practices for Mobile and Web Enrollments
Best Practices for Sections and Elections
Benefits Decision Support
Benefits Decision Support Overview
Benefits Decision Support Coverage Categories
Benefits Decision Support Settings
Add Benefits Decision Support
Validate Benefits Decision Support Configurations
Enable Benefits Decision Support in Enrollments
Copy Benefits Decision Support Configurations
Delete Benefits Decision Support Configurations
Descriptions of Benefits Coverage Examples
Accumulation Method
Ambulatory Surgery Outpatient Facility
Ambulatory Surgery Outpatient Professional
Applicable Deductibles - Medical
Applicable Deductibles - Rx
Coinsurance
Combo
Copay
Emergency Department
Imaging Outpatient Facility
Imaging Outpatient Professional
Inpatient Facility
Lab Outpatient Facility
Lab Outpatient Professional Office
Medical Deductible
Mental Health Outpatient Facility
Mental Health Outpatient Professional
Occupational Therapy Outpatient Facility
Occupational Therapy Outpatient Professional
OOP Max
Preventive Services
Primary Care Office Visit
Referral Required
Rx Deductible
Rx Generic
Rx Non Preferred Brand
Rx OOP Max
Rx Preferred Brand
Rx Specialty High Cost
Skilled Nursing Facility
Specialist Office Visit
Speech Therapy Outpatient Facility
Speech Therapy Outpatient Professional
X-Rays All Other
X-Rays Primary
X-Rays Specialist
Benefits Overview
Add an Overview Page
Add Files to an Overview Page
Benefits Templates
Add Benefits Templates
Payroll Integration Methods
Set Payroll Integration Methods
Add Payroll Election Exceptions
Add Pay Group Exceptions
COBRA Event Reasons
Add and Edit COBRA Event Reasons
Localize COBRA Event Reasons
Copy COBRA Event Reasons
Delete COBRA Event Reasons
Benefit Properties
Add Benefit Properties
Benefit Plan Qualifier Library
Benefit Plan Option Dependency Qualifier
Dependent Qualifier
Employee Qualifier
Personal Information
Employment Information
Compensation Information
Job Information
Location Information
Date Comparison Information
Enrollment Event Qualifier
HR Event Qualifier
Payroll / Work Eligibility Qualifier
Payroll / Work Eligibility Qualifier Examples
Period of Time Qualifier
Period of Time Qualifier Examples
PPACA Status Qualifier
PPACA Status Qualifier Example
WFM Hours Qualifier
WFM Hours Qualifier Example
Cost Splitting Configuration
Add Cost Splitting Configurations
Test Cost Splitting Configurations
Benefits Notifications
Configure Dependent Age Out Notifications
Configure Dependent Verification Notifications
Configure RST and PST
Use Earnings and Deductions
Use Benefits Rates
Manage Dependent Verification
Benefits Intelligence
Periods and Plan Groups
Load Data in Benefits Intelligence
Best-Fit Plan Analysis
Forecasted Best-Fit Enrollment
What-If Analysis
Run the What-If Analysis
Benefits Administration
Benefits Administration Overview
Benefits Administration Filters
Filter Behavior
Filter Parameters
Set Filters and Manage Favorites
Review Benefit Election Details
Configure Column Display
Configure Column Sorting
Export Election Records
Review Employee Information
Run Benefit Recalculations
Manage Pending Recalculation Results
Re-Calculate Plans
Update Coverage and Rates
Run the Auto-Enrollment Option Process
Re-Calculate Imputed Income
Review Recalculation Results
Load Recalculation Results
Review Loaded Recalculation Results
Approve Recalculation Results
Unapprove Recalculation Results
Discard Recalculation Results
Commit Approved Recalculation Results
Export Recalculation Results
Manage COBRA Events
Review COBRA Event Statuses and Subscriber Information
Approve Auto-Assigned COBRA Event Records
Update Multiple COBRA Event Records with Mass Assign
Reset COBRA Event Records to Pending Status
Review the Benefit Election Summary
Benefits Administration Reporting
Edit Employee Benefit Records
Benefit Elections
View Election Details
View and Edit Health Plan Elections
View and Edit Life and Disability Plan Elections
Edit Requested Coverage Amounts
Edit Elected Amounts
Edit Coverage Multipliers
View and Edit Reimbursement Plan Elections
View and Edit Retirement Plan Elections
Add Benefit Elections
Copy Benefit Elections
End Benefit Elections
Delete Benefit Elections
Manage Evidence of Insurability
Approve EOI Requests
Adjust EOI Requests
Deny EOI Requests
Benefit Enrollments
Add Enrollments for Individual Employees
Edit Enrollments for Individual Employees
Delete Enrollments for Individual Employees
Reset Enrollments for Individual Employees
Benefit History
Benefit Properties
Add Benefit Properties for Employees
Edit Benefit Properties for Employees
Delete Benefit Properties for Employees
Benefit Recalculation Results
Approve and Unapprove Recalculation Results for Individual Employees
Commit Approved Recalculation Results for Individual Employees
Discard Recalculation Results for Individual Employees
COBRA Events
Approve Auto-Assigned COBRA Event Records for Individual Employees
Update Multiple COBRA Event Records with Mass Assign for Individual Employees
Manually Approve COBRA Event Records
Dependents and Beneficiaries
General Information
Confidential Information
Phone Number
Address
Coverage and Designation
Add and Delete Dependents or Beneficiaries
Health and Wellness Records
Add Health and Wellness Status Records
Edit Health and Wellness Status Records
Delete Health and Wellness Status Records
Spouse Coverage Verification
Add Spouse Coverage Verification Records
Edit Spouse Coverage Verification Records
Delete Spouse Coverage Verification Records
PPACA Setup
Get Started with PPACA
PPACA Calendars and Mid-Year Job Assignment Changes
Configure PPACA Calendars
Define Override Reasons
PPACA Administration
Load Periods
Assign Periods
Review Information in the Overview
Calculate Average Hours
Adjust Eligibility Records
Export PPACA Records
Approve Eligibility Records
End PPACA Coverage
Publish Enrollments
View Eligibility Record Details
Run PPACA Administration Reports
Filter Employee Records
PPACA Year End
Load a Calendar Year
PPACA Year End Overview Tab
PPACA Overview: 1095-C Forms (Employees)
PPACA Overview: 1094-C Forms (Employer)
Generate Records and Safe Harbor Codes
Auto-Fill Task Properties
The Plan Start Month Property
View Tasks
PPACA Year End Legal Entities
Add Internal Legal Entities
Merged Legal Entities
Add External Legal Entities
Configure 1094-C Form Details
PPACA State Filing Requirements
PPACA Year End Coverage Records
The Manage Offered Coverage Tab
Employees with Applied For Type Social Security Numbers
Add PPACA Year End Coverage Records
Edit Individual PPACA Year End Coverage Records
Group Edit PPACA Year End Coverage Records
Validate PPACA Year End Coverage Records
Complete PPACA Year End Coverage Records
Revert PPACA Year End Coverage Records to Incomplete
PPACA Year End Exports and Imports
Export PPACA Year End Records
Import PPACA Year End Records
PPACA Year End Employee Import File Columns
PPACA Year End Covered Individual Import File Columns
Example: Export, Update, and Import a PPACA Year End Import File
Lock and Send PPACA Year End Files
Reprint PPACA Year End Forms
PPACA Year End Reports
PPACA Year End Corrections
Start PPACA Year End Correction Filings
Corrected 1095-C Forms
Add Corrected 1095-C Forms
Freeze HR Data
Corrected 1094-C Forms
Add or Edit Corrected 1094-C Forms
Appendix: Benefits Background Jobs
Benefits Auto Enrollment Option Process
Benefits Carrier Export
Benefits Dependent Age Out Notification
Benefits Enrollment Reminder
Benefits HR Event Generator
Benefits Intelligence Data Preprocessing
Benefits PPACA Background Process
Benefits Re-Calculate Imputed Income
Benefits Re-Calculate Plans
Benefits Re-Calculate Plans - Specific Employee(s)
Benefits Update Coverage and Rates
Dayforce Link Benefits COBRA Initial Notice Export
Dayforce Link Benefits COBRA Qualified Event Export
Dayforce Link Benefits Ongoing Export
Dayforce Link Benefits Open Enrollment Export
Dayforce Link Benefits Multi-Carrier Ongoing Export
Dayforce Link Benefits Multi-Carrier Open Enrollment Export
Dependent Verification - Manage Expired/Denied Statuses
Appendix: Benefits Forms
Current Beneficiary Information Form
Current Dependent Information Form
Health and Wellness Form
Life Event Declaration Form
Operator Types and Values
Store Names
LoadIfEmpty Named Function
Values for the wfListName Parameter
Exceptions for the LoadIfEmpty Named Function
Expression Builder Examples
Life and Disability Plan Examples
Retirement Plan Examples
Pension Plan Examples
Vacation Accrual Examples
Insurance Premium Tax Rate Examples
Formatting Date and Number Fields
Template HR Events
Appendix: Open Enrollment
Payroll Setup
Employee Eligibility
Plan & Option Configurations
Plan Option Groups
Carrier Feeds
Enrollment
Rich Text Controls
Appendix: Benefits Glossary

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