Under Benefits
The Following Steps will Definitely Help you...
1) Define Benefit Areas
In this step, you define benefit areas. Benefit areas allow you to have separate administration of different benefit plan pools. This division is primarily for administrational purposes and would not normally be used for eligibility..
2) Assign Currency to Benefit Area
In this step, you specify the currency for the benefit area.
3) Define Benefit Providers
In this step, you enter the providers of the benefit plans you offer.
Example
This could be the Insurance company, or Health Maintenance Organization that receives the benefit plan costs.
4) Set Current Benefit Area
In this step, you set the relevant benefit area for your Customizing activities.
If you have more than one benefit area to set up, you must set up each separately. After you have set up all the plans in one area, you should switch the benefit area in this step and work through the IMG again, making settings for the new benefit area.
5) Define Benefit Plan Types
In this step, you enter the benefit plan types that you require for the plan categories predefined in the system. These categories are predefined because the system handles each differently. In order to reflect your own requirements regarding the categorization of plans, you define plan types within these categories.
Plan types are a control mechanism for enrollment, since the system does not allow an employee to enroll in more than one benefit plan per plan type. This allows you, for example, to offer a choice of regular health care from different providers under one plan type, without the risk of accidentally enrolling an employee in more than one of these benefit plans.
Within each plan category (for example, Insurance Plans) you should define one plan type for each sort of benefit plan that the employee is likely to elect (for example, Life Insurance, Spousal Life, Supplemental Life). Thus an employee can elect a plan from the Life Insurance as well as from the Spousal Life plan type.
6) Define Benefit Plan Status
In this step, you define the plan statuses that you require for benefits administration. You later assign these statuses as to your plans in their general data.
It is important that you assigning statuses in order to be able to control the availability of plans with a minimum of effort. For example, you can control whether or not employees can enroll in a plan simply by changing its status.
7) Define Employee Criteria Groups
In this section, you can define employee criteria groups to determine how plan-related amounts are to differ according to employee age, salary and/or seniority (or the age of the employee's spouse or domestic partner). These groups are later in the customizing of plans, in the definition of plan-related amounts.
You define employee criteria groups as follows:
1. Define parameter groups that will include individual criteria groups.
2. To each parameter group, assign the individual salary groups, age groups, and seniority groups that you require.
😎 Define Cost Groupings
In this step, you can define cost groupings and determine how employees are allocated to these groupings. You only need to do this if you want to differentiate between costs for employees using additional criteria to those available in the cost variant. For example, you may want to use geographical location, job classification, or marital status as criteria. You determine how employees are allocated to cost groupings using the feature CSTV1
9) Define Credit Groupings
In this step, you can define credit groupings and determine how employees are allocated to these groupings. You only need to do this if you want to differentiate between credits for employees using additional criteria to those available in the credit variant. For example, you may want to use geographical location, job classification, or marital status as criteria. You determine how employees are allocated to credit groupings using the feature CRDV1
10) Define Coverage Groupings
In this step, you can define coverage groupings and determine how employees are allocated to these groupings. You only need to do this if you want to differentiate between coverages for employees using additional criteria to those available in the coverage variant. For example, you may want to use geographical location, employment contract, or residence status as criteria. You determine how employees are allocated to coverage groupings using the feature COVGR
11) Define Employee Contribution Groupings
In this step, you can define employee contribution groupings and determine how employees are allocated to these groupings. You only need to do this if you want to differentiate between employee contributions for employees using additional criteria to those available in the employee contribution variant . For example, you may want to use geographical location, weekly hours, or residence status as criteria. You determine how employees are allocated to employee contribution groupings using the feature EECGR
12) Define Employer Contribution Groupings
In this step, you can define employer contribution groupings and determine how employees are allocated to these groupings. You only need to do this if you want to differentiate between employer contributions for employees using additional criteria to those available in the employer contribution rule variant . For example, you may want to use geographical location, weekly hours, or residence status as criteria. You determine how employees are allocated to employer contribution groupings using the feature ERCGR
SETTING UP OF PLANS(EG:HEALTH PLANS)
1) you define the details of your health plans. 2)You define different options within a health plan
3) possible dependent coverages for health plans.
4)You define how costs may vary for different employees depending on their personal data,
5) you define the actual costs for these various groups of employees.
6)The final step is to bring together in each health plan all the information you have defined separately in the preceeding steps.
7) Define Evidence of Insurability Conditions
For certain levels of coverage, employees may be required to provide evidence of their insurability. In this step, you define evidence of insurability (EOI) requirements in accordance with the policies of the plans that you offer.
Flexible Administration
1) Define Administrative Parameters
In this step, you enter parameters that apply to processing within an entire benefits area, including:
u2022 Open enrollment period dates
u2022 Default validity dates for adjustment/standard plan records
u2022 Advance availability of future plans
u2022 Dependent age limits
2) Define Prerequisite Plans
In this step, you define prerequisite plans.
In order to enroll in a plan for which another plan is required as a prerequisite, an employee must be participating in the prerequisite plan on the day before he starts participating in the new plan.
The system checks whether this condition is fulfilled during initial enrollment in the new plan only.
Example
An employee wants to participate in the Standard Dental plan. He must already be participating in the Standard Health plan or Deluxe Health plan on the day prior to the begin date of the Standard Dental plan.
3) Define Corequisite Plans
In this step, you define corequisite plans.
In order to enroll in a plan to which another plan is corequisite, an employee must be enrolled in the corequisite plan on the begin date of the new plan. Enrollment in the corequisite must be registered by the end of the enrollment procedure at the latest. It is therefore possible for an employee to enroll in a plan and its prerequisite simultaneously.
The corequisite condition is ongoing. The system checks whether it is fulfilled during enrollment and each time the benefits monitor is run.
Example
An employee wants to participate in the Standard Dental plan. She must already be enrolled in or have selected the Standard Health plan or Deluxe Health plan at the start of participation in the Standard Dental plan.
4) Benefits Adjustment Reasons
In this section, you determine how changes to benefit enrollments are to be controlled within your organization. You do this as follows:
1. If you want different permissions to apply to different groups of employees, you set up an adjustment grouping to do this.
2. You define adjustment reasons for which specific changes are permitted.
3. You define adjustment permissions to determine which adjustments are allowed per plan type, adjustment reason and, if required, adjustment grouping.
In enrollment, the list of adjustment reasons valid for an employee is displayed, and the clerk (using the standard enrollment transaction) or the employee (using Employee Self-Service) selects a reason for enrollment, according to which a benefits offer is to be generated. The system then creates an offer based on the adjustment permissions assigned to each plan.
5) Define First Program Grouping
In this step, you define first program groupings. Later, you define programs for a combination of first and second program groupings.
Identical attributes are available for the setup of both the first and second program groupings, and they are therefore interchangeable. The fact that you determine macro-eligibility for a program using two dimensions means that you are able to make finer distinctions between groups of employees.
Example
An organization offers one set of benefit plans for hourly-paid employees and a different set for salaried employees. Hourly-paid employees may enroll in medical, dental and life insurance plans after a four month waiting period. Salaried employees may enroll in medical, dental, life and vision plans after a one month waiting period.
6) Define Second Program Grouping
In this step, you define second program groupings . Later, you define programs for a combination of first and second program groupings.
Identical attributes are available for the setup of both the first and second program groupings, and they are therefore interchangeable. The fact that you determine macro-eligibility for a program using two dimensions means that you are able to make finer distinctions between groups of employees.
Example
An organization offers one set of benefit plans for full-time employees and a different set for part-time employees. Full-time employees may enroll in medical, dental and life insurance plans after a four month waiting period. Part-time employees may enroll in medical, dental, life and vision plans after a one month waiting period.
7) Employee Eligibility
In this step you define the criteria according to which you control eligibility for individual benefit plans within a benefits program (definition of micro-eligibility). You perform the following steps to set up eligibility requirements:
1. You define eligibility grouping to identify groups of employees for whom certain eligibility criteria apply.
2. You create eligibility variants , which you later use to link eligibility rules to programs.
3. If necessary, you define dynamic eligibility conditions relating specifically to actual hours worked/length of service, or zip codes.
4. You bring your definitions together in the eligibility rule, where you can also specify further conditions for enrollment.
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