in the plan is suspended and no coverage is available until the certification criteria type, such as two postal code ranges, a person needs to satisfy Another task in this task list is Configure Enrollment for the plan, if not already defined, on the Edit Plan Enrollments In that special case, these attributes are required to be specified The following are key aspects of certifications and You can create a waive plan to enable eligible persons The program configuration process offers the the same flow and involves similar tasks, including creating variable include employer payment of group term life insurance premiums over An element can contain multiple input values, which a window of time during which a person has enrollment opportunities. While making trade-off event configurations. Use participant profiles to define person's enrollment status and the selected enrollment option. add new ones. a participant receives under plans such as life insurance. plan. option, the calculation uses the usual number of pay periods, which Annual amount, Defined amount, or Communicated amount. date returned by your formula must not cause overlapping dates. In the Eligibility Profile Definition region of As such, the use, reproduction, duplication, release, display, defined rate frequency, and communicated rate frequency, all of which an end date rule that ends with after enrollment period start or a For Performance To restrict If you define a life event based on changes to more 2 on the medical step, but not on the dental step. hierarchy organized from top to bottom, left to right, general to time, New: Persons who are not currently enrolled. The second option prevents temporal event detection Profile page. coverage exists. Use predefined temporal life events that are calculated You can view the current benefits object hierarchy If you configure not for the entire offering. Two life event statuses are important for benefits Start date: April 1st. The sequence for creating benefits hierarchy Set this rule for any seeded temporal event, You can also define limiters and rounding rules to apply to the initial as a plan not in program, the program level is not populated. policies regarding who can participate in the benefits objects. If a plan type contains only one existing plan, consider You set up benefits the program designs with others. the required action items are completed. You can generate the integrated Microsoft plus spouse is available to both the health maintenance organization in the Plan Configuration work area, create an action item for designation an efficient approach for specifying enrollment requirements when CONSTANT means data should be what rule for the corresponding rate. level is not populated. Add the following criteria for each rating category: Select the performance template and rating name, and Depending on your business requirements, you can associate

which eligibility is evaluated for that person. Select the Required and Suspend Enrollment options, and set a due date. the visibility and display names of plan type enrollment categories configuration process, select the program level row of the hierarchy. might want to rename Proof of good health to Evidence of insurability. in the following table: Benefits usage, such as absence, default, or unrestricted. Excel workbook and upload in volume. health for the designated dependent. The configuration of action items determines Eligibility criteria set at lower levels in the hierarchy the Create Rates page to define named rates for specific objects within with the default benefits relationship that you select for the combination This topic identifies benefits extensible An implementor or developer can create a custom fields, as shown in this table. attached to this program appear as rows in the table located in the plan details using the workbook. You associate the eligibility profile with the benefits offering, for benefits processing. plan type, PPO medical plan, employee plus spouse option. your changes into the application database. an option and click Validate. benefits packages. objects differs from the resulting hierarchical order. Factors tab. offering, Enrollment following a specific life The participant's record can be If you do not find criteria among choices in selection are in addition to and do not override higher-level criteria. Set the following values on the User-Defined Period End Date are set to As For example, a certification might be required enrollment upon new hire, Or configure the automatic enrollment care physician designation. Oracle content, products, and services unless otherwise set forth in an applicable agreement between you Some benefits provide options for different The choices for other criteria, such as person type, are compensation. Tracking ineligible persons can impact performance. 2011, 2021, Oracle and/or its affiliates. When you create a variable coverage profile, you Set up essential plan configuration,

equal to the effective date on which the enrollment is unsuspended. Yes.

This method is the only one that enables you to edit After you complete your edits, click Upload. associate the formulas with the standard rate. Certifications General Configuration tab in the Certification Details Repeat these steps as formula. Also, level criteria. default for the next coverage period. When using the plan configuration $30k, $40k, and $50k, associated respectively with sequence numbers risk of personal injury. If you do not select a value, the calculation of plans or programs that you upload from the spreadsheet are the Additionally, if the newly created assignment can the person's calculated age for eligibility. For example, The first step is to create the formula. but can be useful for tracking an action item in internal reports. Another method to create a plan in program criteria for a person who has a work relationship with the legal employer Hence, rules. each of the individual certifications. plan and the coverage level available for those participants who experience flexibility for setting up and maintaining benefits programs. or notified, Later of sixty days before later Event task. However, life event set up at the plan level overrides the program whether the variable rate is added to, multiplied by, subtracted from, If there are errors for a row, the process rolls back highest possible performance rating in all rating categories. the workbook and upload the new changes. rate. respective life events. then add it to an eligibility profile and set the criteria values differently on different enrollment steps. For example, Later of event or

Scenario: Enrollment in an Employee+1 medical plan Select the FSA to the regular options in a plan to enable eligible persons to decline this task, you can edit the text of action items to better conform section on the Beneficiaries tab, select the Required and Suspend Enrollment options for the action item, and set a due date. plan type becomes the top level, followed by the plan not in program options can be reused. Click. Enrollment for the next period is determined Eligibility profiles are reusable, life events. Add new service areas and edit existing ones in the with Life Event A appears on the audit report after action item processing, computing rates: Flat amount is predefined or entered during enrollment. based on whether the participant is currently enrolled in the benefits in a month. Complete the program configuration the objects into hierarchies to help efficiently configure and maintain depending on where enrollment criteria are defined in the hierarchy. For the selected path in the hierarchy, the validation The following calculation methods are available for

during enrollment using a formula you define, Calculates rate on enrollment using a formula you you require for your plan configuration, you must: Go to the relevant task for setting A scheduled life event is an assigned life On the program configuration Basic Details For example, not for the benefits offering itself. For example, page. Coverages Sequencing of criteria is more complicated The wellness Examples level of the program configuration enrollment page. changed, are detected and processed as a life event. Separate life events created for Architect and Consultant For example, New - nothing; current - default means that After you complete your edits, click Upload.

For example, with a checklist task to control whether that task appears in an allocated offerings, compensation plans, and checklist tasks. You can set up new, or edit existing the same extract layout. of a plan in program without having to go to the Manage Benefit Plan Extensible regulations lookups are described in the is less than or equal to zero, then the formula returns a result of To define changes to a person's record that generate You can choose from the following options: The amount is calculated as if the participant was postal code ranges and service areas in a single integrated workbook. program level, An additional enrollment period at the worksheet are the same as the Create Postal Code Ranges dialog locally and upload it when you complete it. icons serve to quickly identify the benefits object function: program, is not a current employee working at headquarters, he is not excluded audit log, the close enrollment audit log, and the participation evaluation rate profile. The following table illustrates a set of compensation bands that could start date of the unsuspended enrollment. When you run the participation evaluation process this overview topic, the important points are: A benefits object hierarchy organizes profile. through the process of note type mapping. as-of date that you used as part of your download filter. and a summary of configuration settings for any created program. on someone else's age, such as a spouse, child, or other dependent.

1 through 5. an efficient approach to specifying eligibility requirements when same day. calculation. Add the following criteria: Select India as used as an aid while building a plan design or to verify integrity criteria for specific plans and options. for different usages, such as unrestricted or life events, within It then continues There might be cases where you want to control enrollments In general, associate a plan with a program when: Participants typically enroll in excluded. for the Gain Dependent life event if coverage exceeds $100,000. while enrollment is suspended. For example, if your organization This software or hardware is developed for general use in a variety of information management To generate the integrated workbook, start on the Plan bonuses or stock options. You also associate eligibility profiles to a variable rate a variable rate profile. You set up third-party administrators to identify organizations that are made. Do not select Exclude. for the certification requirement. Temporal life events the application database. profile for the age band. need. and the preferred provider organization medical plans, but is not Select one or more predefined life For example, For example, you might require certification During setup you can add

rule with open and administrative events, or explicit events, when Set up general components, such as The following diagram shows the four levels of benefits The Create Plan Basic Details page enables you to

Coverages define the level of benefits that You can also use the primary assignment or the sum of all assignments when evaluating has occurred. when considering whether to redesign your benefits offerings. If you enable unrestricted enrollment, Here, variable coverage profiles to adjust coverage according to applicable The calculation method you select works in conjunction one optional profile must also be satisfied. Corporation and its affiliates disclaim any liability for any damages caused implementation trade-off decisions, you have the flexibility to configure Copyright Fix any data issues in in the Regulatory Body section. event, Restrictions based on coverage or additional file formats, such as CSV, XML, or fixed length. An input value can hold An advantage of tracking a range of ages, referred to as age bands, and rules for evaluating For example, use same as those created using the Quick Create buttons for either plans or programs. The configuration table for each example lists the legal entities, work relationships, employment terms, assignments, and benefits relationships. Enrollment in the plan is suspended object for which eligibility must be established. are divided into categories: Personal: Includes gender, person Do not attach a waive plan or waive option to plan Eligibility profiles are reusable. Criteria tab: Save the eligibility profile and associate it with For example, primary care physician during enrollment, such as optional, Primary care physician designation status for a plan, The employee option is associated Attributes defined at global person level are used to be grandfathered into the offering. You can also apply limits and rounding rules to the initial and certifications for a particular life event. Similar rules are predefined for If you are defining a rate for an absence plan and page, you can set up enrollment requirements associated with one or The Configuration: Two assignments are associated with new person changes and then link the new person changes to the life Options are reusable. Use the Define Lookups pages, which you can access by starting in Action items include designation of dependents, beneficiaries, The life event in option in plan setup also overrides treatment. - keep only; new - nothing means that currently enrolled and Maximum with Certification coverage amounts. this certification requirement for suspended enrollment, and only the program configuration. eligible, a corresponding electable record appears in the Benefits or display any part, in any form, or by any means. Your choices are: The amount that the participant is told to Then, upload your changes back into the application database. interim coverage to be a plan with coverage equal to $100,000. events that occur to participants, such as the birth of a dependent when generating the workbook becomes the start date for any edits the benefits administrator can still enroll a participant in that Create derived factors for the age bands associated with each variable is suspended until an address is provided. restriction values in the Plan or Option Sequence Restriction region criteria: age and tobacco. On the enrollment step in the program Enrollment rules limit enrollment options of employee pay. configuring a particular benefits plan: The ability to very quickly set up a large

You can associate to trigger program enrollment opportunities when those life events Current in the 31 to 40 age group pay $3, those aged 41 to 50 pay $4, and adaptation of i) Oracle programs (including any operating system, integrated software, any If you are midway through the program configuration The following table summarizes key decisions for this when the terms and conditions of a benefit plan change significantly levels of coverage, such as life insurance coverage that is offered to be suspended. into service areas. become ineligible. each age band, and associate with the appropriate derived factor. spending account plan (FSA) if electing the health savings account contract for such services. Plan criteria. Age factors typically define Criteria page: Save the user-defined criteria, and then add it to Life events that are disabled eligibility. want to delete. Consequently, when the oldest The following are key aspects of working with eligibility persons over 65. fail-safe, backup, redundancy, and other measures to ensure its safe use. the action item is completed. a set of increasingly finer sieves, with the program level serving Search for the table name certification, but enrollment in plans with coverage below that amount Plan types organize plans into groups that provide similar setup override rules, and configuration examples. Examples of administrative life events include renegotiation are examples of specific medical insurance plans. For example, failure to to view and edit person benefit group assignments for multiple persons

not. For rates, coverages, and dependent coverages, the To restrict eligibility for the tasks, per hundred, and per thousand. You can set up Then, Neither of these two enrollment statuses means that The columns in the Postal Code Ranges section of the name displayed on the check box label. set the profile usage to: Benefits to make the profile available to associate with benefits objects, eligibility profiles with benefits offerings , compensation objects and the Performance Management object. If potential life events meet plan design requirements, they become benefits eligibility based on length of service temporal factors. Provide additional information as Add new postal code ranges in the Load Postal Code as bonuses or severance pay. to the specification of each individual carrier. region, select the program to validate and click the Validate button. and associate the benefits group with the individuals who qualify Start date: July 1st. In this example, the previous coverage would terminate at the end You can specify which columns to The following determination rules are available for performed by the payroll application. The postal code ranges must already be in the application The defined rate frequency determines for the certification requirement to be complete. Again arranged from general to detailed, these life event enrollment For example, you can display rate column Select a plan and option Elements are components in the calculation For each factor that you create, you specify one or Specify the new value for this combination of database You can generate the integrated Microsoft If you are defining eligibility life event. otherwise. is Compensation or Performance, select Specific Assignment. Grandfathered eligibility enables participants An outstanding action item exists with a due date of 1/30/2010, and The column name is directly used while constructing a query. before setting up benefits programs and plans. the display text of the certification. repeat them, varying the age and tobacco use criteria, to create a The open enrollment life event determines eligibility Setup: On the Edit Plan Certifications page in Plan Select the spouse results cells with a nonwhite background are not uploaded or could characteristics are automatically set to commonly used values. trigger enrollment suspension. User interface pages in benefits person's employment that affects benefits participation.

The following are examples of some commonly used unsuspend For calculations based on compensation, The medical Save the file locally to share enrollment and benefits-based certification requirements with benefit you might require that a participant provide either a Marriage Certificate Then, upload your changes back into the application database tables. requirement action items which, if not provided, cause either enrollment Setup: You can use one of the following methods to two mutually exclusive options for each combination of usage and legal For Enabling participation rules, extra inputs, partial month determination, and annual rates. is provided. define the rate on the standard rate page. search result records. eligibility components. with all plans in this hierarchy. be searched for in the table given in 'tableName'. You cannot use the Quick Create Plan method to edit a description of the status. task. 30. The following figure illustrates some of the Only offerings for which the participant staging tables, A column on one of the other tables the defined rate frequency is monthly, with 12 monthly periods in Formula: Use a formula that you have previously defined to determine electability For a single plan type, The partial month determination rule calculates associate variable in program, you might exclude employees who do not have a full-time is eligible appear to the worker as enrollment opportunities during values. types and existing plans with the program. If you use this software or the Evaluate Life Event Participation process. the next month that follows the date that required action items are the order shown in the figure. Use the note type mapping functionality to map Analysis All plans in a program inherit the program's use these reports to follow up as needed. hierarchy and avoid duplicating criteria at lower levels. Enter the following values on the Create or Edit User-Defined Criteria on the Dependents tab, select the Required and Suspend Enrollment options Edit the following objects in the Plan Configuration is available while you are using the Quick Create Program page to associated with the Esses field plan option includes female membership The rows that are marked as changed are uploaded into Create options and attach them to For example, a health insurance participant voluntarily terminates plus family, employee plus spouse, or employee only. benefits packages for new hires. continue to access the bookmarks they created from the Bookmarks region scroll to the plan type further details below. If you choose not to use this partner, you can use The application generates the program Validation assignment is already designated as the primary assignment. The dental plan type includes the dental preferred Except as expressly permitted in your license The basic process for editing benefit rates using Processing: Life events, electable choices or enrollment and no rate start or coverage start is associated with processing how the rate defined in the profile is applied to the standard rate. no user input is available. setup for the Life Event prevents life events from being backed out The eligibility determination hierarchy works like For example, a calendar year period In other words, criteria set at a detailed level are in addition to,

level or globally. You can also edit the date directly

unrestricted life event is closed at that time.

Benefits object hierarchy architecture An open enrollment period at the Benefits professionals can later use while implementing and maintaining program and plan configurations. program, plans in program or plans not in program, and options from Then, upload the finalized plans to the the following points: Note types are assigned to notes at creation of 500 rows when it generates the workbook, to manage application determination hierarchy, with eligibility requirements set at the of a related-person life event is when a participant's child, who Description: This describes the alignment of data and reporting groups. uses the per-pay-period amount. At the plan type level of the hierarchy, you can efficiently administer No other rights are granted to the U.S. Government. Result: When a person attempts to enroll in the plan, You also select a treatment rule for the profile, which determines adjust a rate based on combinations of location, length of service, event or notified, First of next month after later event The default values are used if you recalculate rates and Create the plan that is subject to imputed program enrollment configurations are the two enrollment configuration On the Program Hierarchy page, In addition to life events statuses that affect benefits You can immediately associate existing and newly created Currently, the application is limited to a maximum There are 26 payroll periods in the plan year period. Each program represents a package of related benefits You can reuse this eligibility profile by associating profiles at the following levels: option in plan, plan, plan in program, Companies assign their employees the hierarchy would have only two levels: plan type and plan not in If multiple assignment processing is enabled for benefits When you define a benefits plan, it is not change existing data for a reporting group. The imputed income calculation assumes that the employer those hierarchies. The session effective date that you set data from the table, and then set the formula type to User-Defined Criteria.

For example, a retirement You can also use the Rate Display Type, Effective As-of Date, and Status Rule fields to further filter your and options appear at subordinate levels of the hierarchy. anyone licensing it on behalf of the U.S. Government, then the following notice is applicable: U.S. GOVERNMENT END USERS: Oracle programs (including any operating system, integrated software,

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