US Benefit - Health plans (dependent coverage) - URGENT, any link?

[Former Member]

Hi experts,

I have an issue below:--

Employee can have their children covered under the medical and dental plans until they are the age of 19 or 23 if children are in school full time.

But situation arises if an employee has medical coverage and elections one of the options but picks employee + 1 and has a child as a dependant that is age 23. When the child turns 24, the benefits automatically end for the child and this appears to be the case on SAP.

Question though is the benefit election should also change to EMPLOYEE only......

Is this something that we can get SAP to do?

Waiting for reply...

Saurabh Garg

[Former Member · Accepted solution]

Use the Participation Monitor( HRBEN0003 ) for this purpose. Typically Partcipation Monitor report is scheduled to run on daily basis.. Report points out any body who currently enrolled in Benefit plan are not eligible anymore ( like one of the reason which you have specified about the crossing over the Max Age limit ).

When one run the above report, it will let the enduser to delimit the existing Option and create the plan with new option ( EE only ) ..

Hope this helps.

[Former Member · Accepted solution]

Hi,

This is just a report but practically it is not possible to monitor for all the employees' data and change them manually.

Is there any other means where system can track this problem and resolve?

Thanks in advance

Saurabh

[Former Member · Accepted solution]

Hi Friend,

Appreciate if you can rephrase your question Please...?

To my understanding, the process would be this....

1. Run the standard eligibility check program.

2. Identify the dependents whose age eligibility criteria has affected the termination of their benefits.

3. Maintain the Adjustment reason (IT0378).

4. When it calls for the Enrollment program, make necessary changes.

These steps are must to make Changes if there is any adjustment reason and is not specific to dependents.

And as regards changing the election from "Employee+1" to "Employee"; above mentioned process is the only way.. SAP system CANNOT automatically do it...

Thanks & Regards

Kumarpal Jain.

Edited by: Kumarpal Jain on Sep 18, 2008 1:08 AM

[Former Member · Accepted solution]

The situation is - all the employees have eligible dependents for different health plan to a certain age i.e. 19 yrs, now once the dependent crosses the age of 19, he/she becomes ineligible dependent.

Now my question is, do we have something in SAP that checks automatically the eligible dependent and if all the dependent become ineligible, change employee's coverage option to EMPLOYEE ONLY?

One solution is write a ABAP program but is there any other way?

[Former Member · Accepted solution]

you may go ahead with ABAP because in SAP Std it is not there...