Overview of setup

You must complete the required set up within the Benefits application and in other specified applications before you can begin enrolling employees. This table shows the order in which to perform these steps.

Set up Required action Section title
Benefits Organization

Define a benefit organization.

If HIPAA 834 transactions will be used for any plan, then to set up a benefits organization you must have Benefit Reasons. These are in the Benefit Preliminaries section.

Creating benefits organizations
Benefit Groups Define benefit groups that correspond to custom groups that define the employees, retirees, and COBRA participants that are included in benefits processes. Creating benefit groups
Benefit Preliminaries

Define the settings that all of your benefit plans can use.

  • Reasons

  • Coverage options

  • Annual limits

  • Providers

  • Group life rate tables

  • Rate tables

  • Vesting schedule

  • Payroll Codes

    • Deduction codes

    • Pay codes

    • Pay classes

    • Pay summary groups

    • Pay summary group relations

    • Payment schedules

  • Frequency tables

  • Benefit categories

  • Dependent relationships

  • Primary care physician codes

Setting up benefits preliminaries
Templates Defining email and document templates Types of email templates
Entry Rules Benefit plans and flex plans require plan entry rules for employee enrollment in benefit plans. This includes waiting period rules and change rules. Benefit entry rules
Termination Rules Termination Rules are used by the mass update action when an employee is no longer eligible for a benefit plan. Termination rules
Flex Plans If your company provides flex benefits or reserved spending accounts, you must define your Flex Plans before you define your organization's overall benefits Flex plans setup
Benefit Plans When defining benefit plan parameters, you are structuring the plan. Creating basic benefit plans
Plan Coverage In each plan, you can define unique coverage for different groups of employees. You can also define the default coverage type for a plan. If you defined your coverage type as No coverage, the information in this chapter does not apply. Benefit plan coverage setup
Plan Contributions Plan contributions define how the employee's contributions are calculated. Before this can be defined, the benefit group and rate tables must be configured. This is also bound by a coverage date. Benefit plan contribution setup
Coverage Limits across plans Limits defined for plans with coverage amounts. Plans must be of the same type. Before the coverage limits are defined, Benefit Group and Benefit Plans must be configured. This is also bound by a coverage date. If a coverage limit has been defined, the guarantee issue limit in a benefit plan should not be defined and vice versa. Creating coverage limits across plans
Enrollment Groups This is a library of headers that are presented to the employee to choose from for various enrollment events, for example, Health, Dental, 401k, Vision, Life, etc. Creating enrollment groups
Organization Enrollment Rules This defines how the organization will show current benefit-related information to the employee including whether email notifications are used at the organization level when changes occur in employee benefits. Creating organization rules
Enrollment Events

The Benefits application requires plan enrollment rules for initial and subsequent employee enrollment in benefit plans.

These are the definitions for open enrollment and life events.

Enrollment events