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11i Oracle HRMS Implement

Advanced Benefits (US)


Volume 1 - Student Guide

14815GC30
Edition 3.0
September 2002
D37082
Copyright Oracle Corporation, 2002. All rights reserved.

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Author

Philip Chapman, Keith Ekiss, Juliette Fleming

Reviewers

John Cafolla, Philip Chapman, Marshall Isaacson

This book was published using: oracletutor


Table of Contents

Overview of Implementing Advanced Benefits .............................................................................................1-1


Overview of Implementing Advanced Benefits .............................................................................................1-2
Introduction ...................................................................................................................................................1-3
Topics ............................................................................................................................................................1-5
Introducing Advanced Benefits ......................................................................................................................2-1
Introducing Advanced Benefits .....................................................................................................................2-2
Total Compensation.......................................................................................................................................2-3
Flexible Benefits Programs............................................................................................................................2-4
Build a Benefits Program...............................................................................................................................2-5
Plan Types .....................................................................................................................................................2-6
Life Event Management.................................................................................................................................2-7
Eligibility Profiles..........................................................................................................................................2-8
Contributions and Distributions.....................................................................................................................2-9
Actual Premiums............................................................................................................................................2-10
Advanced Benefits and Oracle Payroll ..........................................................................................................2-11
Communications ............................................................................................................................................2-12
Benefits Service Center .................................................................................................................................2-13
View Program Structure ................................................................................................................................2-14
Eligibility Management .................................................................................................................................2-15
Enrollment Cycle Automation .......................................................................................................................2-16
Reviewing a Sample Implementation and Enrollment .................................................................................3-1
Reviewing a Sample Implementation and Enrollment ...................................................................................3-2
Vision ............................................................................................................................................................3-3
Vision - Seeded Compensation Objects.........................................................................................................3-4
Vision - Seeded Plan Design .........................................................................................................................3-5
Enrollment .....................................................................................................................................................3-6
Demo: Reviewing an Implementation and Enrollment ..................................................................................3-7
Practice: Reviewing an Implementation ........................................................................................................3-8
Following the Implementation Steps ..............................................................................................................4-1
Following the Implementation Steps..............................................................................................................4-2
Building Blocks .............................................................................................................................................4-3
Building Blocks - Examples ..........................................................................................................................4-4
Implementation Sequence..............................................................................................................................4-5
Summary ..........................................................................................................................................................5-1
Summary........................................................................................................................................................5-2
Participant Eligibility ......................................................................................................................................6-1
Participant Eligibility.....................................................................................................................................6-2
Introduction ...................................................................................................................................................6-3
Topics ............................................................................................................................................................6-4
Objectives ......................................................................................................................................................6-5
Implementation Sequence..............................................................................................................................6-6
Introducing Benefits Eligibility ......................................................................................................................7-1
Introducing Benefits Eligibility .....................................................................................................................7-2
Benefits Eligibility.........................................................................................................................................7-3
Building Benefits Eligibility ..........................................................................................................................7-4
Evaluating Eligibility (Advanced Benefits) ...................................................................................................7-6
Evaluating Eligibility (Standard Benefits) .....................................................................................................7-7
Defining Eligibility Building Blocks ...............................................................................................................8-1
Defining Eligibility Building Blocks .............................................................................................................8-2

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Eligibility Building Blocks ............................................................................................................................8-3
Benefits Groups .............................................................................................................................................8-4
Postal Zip Ranges ..........................................................................................................................................8-5
Service Areas.................................................................................................................................................8-6
Benefits Balances...........................................................................................................................................8-7
Practice: Defining a Benefits Group ..............................................................................................................8-8
Defining Derived Eligibility Factors ..............................................................................................................9-1
Defining Derived Eligibility Factors..............................................................................................................9-2
Derived Factors..............................................................................................................................................9-3
Derived Factors Common Components .........................................................................................................9-4
Compensation Factors....................................................................................................................................9-5
Hours Worked Factors...................................................................................................................................9-6
Full-Time Equivalent Factors ........................................................................................................................9-7
Age Factors....................................................................................................................................................9-8
Length of Service Factors ..............................................................................................................................9-9
Combined Age and Length of Service ...........................................................................................................9-10
Derived Factor Calculation Rules..................................................................................................................9-11
Derived Factor Calculation (Advanced Benefits) ..........................................................................................9-12
Derived Factor Calculation (Standard Benefits) ............................................................................................9-13
Practice: Defining Derived Factors................................................................................................................9-14
Defining a Participant Eligibility Profile .......................................................................................................10-1
Defining a Participant Eligibility Profile .......................................................................................................10-2
Participant Eligibility Profiles .......................................................................................................................10-3
Eligibility Criteria..........................................................................................................................................10-4
Profiles with Multiple Criteria .......................................................................................................................10-5
Criterion with Multiple Values ......................................................................................................................10-6
Profiles Excluding Employees .......................................................................................................................10-7
Use Profiles with Any Compensation Object.................................................................................................10-8
Profiles Are Reusable ....................................................................................................................................10-9
Eligibility Cascades Downward.....................................................................................................................10-10
Attach Multiple Profiles to a Compensation Object ......................................................................................10-11
Compensation Hierarchy ...............................................................................................................................10-12
Practice: Defining a Participant Eligibility Profile ........................................................................................10-13
Summary ..........................................................................................................................................................11-1
Summary........................................................................................................................................................11-2
Compensation Objects.....................................................................................................................................12-1
Compensation Objects ...................................................................................................................................12-2
Introduction ...................................................................................................................................................12-3
Topics ............................................................................................................................................................12-4
Objectives ......................................................................................................................................................12-5
Implementation Sequence..............................................................................................................................12-6
Introducing the Compensation Object Hierarchy ........................................................................................13-1
Introducing the Compensation Object Hierarchy...........................................................................................13-2
Building Blocks .............................................................................................................................................13-3
Compensation Objects ...................................................................................................................................13-4
Key Concepts.................................................................................................................................................13-8
Compensation Object Hierarchy....................................................................................................................13-9
Variations of the Hierarchy............................................................................................................................13-10
Inherited Attribution ......................................................................................................................................13-11
Defining Program/Plan Year Periods and Other Details .............................................................................14-1
Defining Program/Plan Year Periods and Other Details................................................................................14-2
Overview .......................................................................................................................................................14-3
Program and Plan Year Periods.....................................................................................................................14-4
Regulations ....................................................................................................................................................14-5

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Seeded Regulations........................................................................................................................................14-6
Reporting Groups ..........................................................................................................................................14-7
Goods and Services .......................................................................................................................................14-8
Organizations.................................................................................................................................................14-9
Demonstration: Defining Program and Plan Year Periods ............................................................................14-10
Defining Plan Types and Options...................................................................................................................15-1
Defining Plan Types and Options ..................................................................................................................15-2
Plan Types .....................................................................................................................................................15-3
Plan Type Setup.............................................................................................................................................15-5
Plan Type Setup for Self-Service...................................................................................................................15-6
Practice: Defining Plan Types .......................................................................................................................15-7
Options ..........................................................................................................................................................15-8
Option Setup ..................................................................................................................................................15-9
Waive Options ...............................................................................................................................................15-10
Practice: Defining Options.............................................................................................................................15-11
Defining Plans ..................................................................................................................................................16-1
Defining Plans ...............................................................................................................................................16-2
Plans ..............................................................................................................................................................16-3
Key Concepts.................................................................................................................................................16-4
Plans Window - General Tab.........................................................................................................................16-5
Plans Window - Eligibility Rates Tab............................................................................................................16-6
Plans Window - Restrictions Tab ..................................................................................................................16-7
Waive Plans ...................................................................................................................................................16-8
Plans Window - Participation Tab .................................................................................................................16-9
Plans Window - Not in Program Tab.............................................................................................................16-10
Plans Not in Program.....................................................................................................................................16-11
Maintaining Plan Related Details ..................................................................................................................16-12
Link Options to Plans ....................................................................................................................................16-13
Plan Eligibility Requirements ........................................................................................................................16-14
Link the Eligibility Profile to the Plan ...........................................................................................................16-15
Link Life Event Reasons to the Plan (Advanced Benefits) ............................................................................16-16
Practice: Defining Plans.................................................................................................................................16-17
Defining Programs...........................................................................................................................................17-1
Defining Programs.........................................................................................................................................17-2
Program .........................................................................................................................................................17-3
Key Concepts.................................................................................................................................................17-4
Programs........................................................................................................................................................17-5
Program Window - General Tab....................................................................................................................17-6
Maintaining Program Details.........................................................................................................................17-8
Linking Plan Types and Plans to a Program ..................................................................................................17-9
Program Participation Eligibility ...................................................................................................................17-10
Link Life Event Reasons to the Program (Advanced Benefits) .....................................................................17-11
View Program Structure ................................................................................................................................17-12
Practice: Defining Programs ..........................................................................................................................17-13
Summary ..........................................................................................................................................................18-1
Summary........................................................................................................................................................18-2
Life Events........................................................................................................................................................19-1
Life Events.....................................................................................................................................................19-2
Overview .......................................................................................................................................................19-3
Topics ............................................................................................................................................................19-6
Objectives ......................................................................................................................................................19-7
Implementation Sequence..............................................................................................................................19-8
Defining Life Events ........................................................................................................................................20-1
Defining Life Events......................................................................................................................................20-2

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Life Event Types - Explicit............................................................................................................................20-3
Life Event Types - Temporal.........................................................................................................................20-4
Life Event Types - Scheduled........................................................................................................................20-5
Seeded Life Events ........................................................................................................................................20-6
Life Event Detection......................................................................................................................................20-7
Potential Life Events......................................................................................................................................20-8
Active Life Events .........................................................................................................................................20-9
Life Event Dates ............................................................................................................................................20-10
Life Event Occurred Date ..............................................................................................................................20-11
Person Changes and Related Person Changes ...............................................................................................20-12
Defining a Person Change Single Database Column .....................................................................................20-13
Defining a Person Change Multiple Database Columns ................................................................................20-14
FastFormula Rules for Person Changes .........................................................................................................20-15
Causes Related Person Life Events................................................................................................................20-16
Related Person Life Events............................................................................................................................20-17
Overriding Life Events ..................................................................................................................................20-18
Overriding Life Events: Example ..................................................................................................................20-19
Implementation Considerations .....................................................................................................................20-20
Practice: Defining a Life Event Reason .........................................................................................................20-21
Defining Collapsing Life Events .....................................................................................................................21-1
Defining Collapsing Life Events....................................................................................................................21-2
Collapsing Life Events...................................................................................................................................21-3
Setting Up Collapsing Life Events.................................................................................................................21-5
Collapsing Life Events...................................................................................................................................21-6
Practice: Defining a Collapsing Life Event....................................................................................................21-7
Linking Life Events to Compensation Objects..............................................................................................22-1
Linking Life Events to Compensation Objects ..............................................................................................22-2
Life Event Reasons and Compensation Objects ............................................................................................22-3
Life Events Usage..........................................................................................................................................22-4
Life Events Versus Eligibility Profiles ..........................................................................................................22-5
Impact on Eligibility and Enrollment.............................................................................................................22-7
Practice: Linking a Life Event Reason to a Compensation Object ................................................................22-8
Summary ..........................................................................................................................................................23-1
Summary........................................................................................................................................................23-2
Benefits Enrollment Requirements ................................................................................................................24-1
Benefits Enrollment Requirements ................................................................................................................24-2
Introduction ...................................................................................................................................................24-3
Enrollment Requirements and Plan Design ...................................................................................................24-4
Topics ............................................................................................................................................................24-5
Objectives ......................................................................................................................................................24-6
Implementation Sequence..............................................................................................................................24-7
Introducing Enrollment Requirements..........................................................................................................25-1
Introducing Enrollment Requirements ...........................................................................................................25-2
Key Concepts.................................................................................................................................................25-3
Enrollment Methods ......................................................................................................................................25-4
Enrollment Codes ..........................................................................................................................................25-5
Default Enrollments.......................................................................................................................................25-6
Enrollment Timing.........................................................................................................................................25-7
Coverage and Rate Dates...............................................................................................................................25-8
Enrollment Types...........................................................................................................................................25-9
The Participation Process ..............................................................................................................................25-10
Enrollment Hierarchies ..................................................................................................................................25-11
Defining Program and Plan Enrollment Requirements ...............................................................................26-1
Defining Program and Plan Enrollment Requirements ..................................................................................26-2

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Defining Enrollment Requirements ...............................................................................................................26-3
Program Enrollment Requirements................................................................................................................26-4
Plan Enrollment Requirements ......................................................................................................................26-5
Layout of Enrollment Requirements Window ...............................................................................................26-6
General Enrollment Requirements.................................................................................................................26-7
Timing Enrollment Requirements - Scheduled ..............................................................................................26-10
Timing Enrollment Requirements - Life Event..............................................................................................26-11
Life Event Change Requirements ..................................................................................................................26-12
Plan Enrollment Requirements ......................................................................................................................26-14
Practice: Defining Program Enrollment Requirements..................................................................................26-15
Practice: Defining Plan Enrollment Requirements ........................................................................................26-16
Defining Action Items and Certifications ......................................................................................................27-1
Overview .......................................................................................................................................................27-3
Action Items...................................................................................................................................................27-4
Enrollment Action Types...............................................................................................................................27-5
Action Items - Required or Optional..............................................................................................................27-6
Completing Action Items ...............................................................................................................................27-7
Certifications .................................................................................................................................................27-8
Enrollment Certifications...............................................................................................................................27-9
Link Certifications to Compensation Objects ................................................................................................27-10
Completing Certifications..............................................................................................................................27-11
Suspended Elections and Interim Coverages .................................................................................................27-12
Practice: Defining an Action Item Due Date .................................................................................................27-13
Practice: Attaching a Certification to a Compensation Object.......................................................................27-14
Managing Suspended Elections and Interim Coverages ..............................................................................28-1
Managing Suspended Elections and Interim Coverages ................................................................................28-2
Suspended Enrollments..................................................................................................................................28-3
Interim Coverage ...........................................................................................................................................28-5
Coverage Restrictions ....................................................................................................................................28-7
Interim Coverage ...........................................................................................................................................28-8
Practice: Defining Interim Coverage .............................................................................................................28-9
Summary ..........................................................................................................................................................29-1
Summary........................................................................................................................................................29-2
Dependent and Beneficiary Designation........................................................................................................30-1
Dependent and Beneficiary Designation........................................................................................................30-2
Overview .......................................................................................................................................................30-3
Topics ............................................................................................................................................................30-6
Objectives ......................................................................................................................................................30-7
Implementation Sequence..............................................................................................................................30-8
Dependent Coverage Eligibility Profiles........................................................................................................31-1
Dependent Coverage Eligibility Profiles .......................................................................................................31-2
Relationship Profiles......................................................................................................................................31-4
Age Profiles ...................................................................................................................................................31-5
Status Profiles ................................................................................................................................................31-6
Postal Zip Profiles .........................................................................................................................................31-7
Other Profile Types .......................................................................................................................................31-8
Link Profiles to Compensation Objects .........................................................................................................31-9
Designation Levels ........................................................................................................................................31-10
Other Designation Information for Compensation Objects............................................................................31-11
Dependent Certifications (Advanced Benefits)..............................................................................................31-12
Dependent Coverage and Life Events............................................................................................................31-13
Practice: Defining a Dependent Coverage Eligibility Profile ........................................................................31-14
Dependent Designation Requirements ...........................................................................................................32-1
Dependent Designation Requirements...........................................................................................................32-2

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Overview .......................................................................................................................................................32-3
Relationship Groups ......................................................................................................................................32-4
Designation Requirements .............................................................................................................................32-6
Family Member Codes...................................................................................................................................32-7
Eligibility Check Codes .................................................................................................................................32-10
Practice: Defining Dependent Designation Requirements .............................................................................32-12
Beneficiary Designations .................................................................................................................................33-1
Beneficiary Designations ...............................................................................................................................33-2
Beneficiary Certifications (Advanced Benefits) ............................................................................................33-5
Practice: Designating Beneficiaries ...............................................................................................................33-6
Summary ..........................................................................................................................................................34-1
Summary........................................................................................................................................................34-2
Activity Rates and Coverage Calculations ....................................................................................................35-1
Activity Rates and Coverage Calculations.....................................................................................................35-2
Introduction ...................................................................................................................................................35-3
Link Variable Rate Profiles to Rate Calculations ..........................................................................................35-5
Standard Rates - Basic Diagram ....................................................................................................................35-6
Rate Characteristics .......................................................................................................................................35-7
Topics ............................................................................................................................................................35-9
Objectives ......................................................................................................................................................35-10
Implementation Sequence..............................................................................................................................35-11
Defining Variable Rate Profiles......................................................................................................................36-1
Defining Variable Rate Profiles.....................................................................................................................36-2
Variable Factors.............................................................................................................................................36-3
Variable Rate Profiles....................................................................................................................................36-4
Link Variable Rate Profiles to Rate Calculations ..........................................................................................36-5
Example - Variable Standard Rate.................................................................................................................36-6
Example - Variable Premium.........................................................................................................................36-7
Example - Variable Coverage Calculation.....................................................................................................36-8
Variable Rate Calculation..............................................................................................................................36-9
Calculation Methods......................................................................................................................................36-11
Practice: Defining a Variable Rate Profile.....................................................................................................36-12
Defining Coverage Calculations .....................................................................................................................37-1
Defining Coverage Calculations ....................................................................................................................37-2
Introduction ...................................................................................................................................................37-3
Coverage Association Levels.........................................................................................................................37-4
Building Coverage Calculations ....................................................................................................................37-5
Example - Fixed Coverage.............................................................................................................................37-6
Example - Variable Coverage........................................................................................................................37-7
Defining Coverage Calculations ....................................................................................................................37-8
Calculation Methods......................................................................................................................................37-10
Practice: Defining a Coverage Calculation ....................................................................................................37-11
Defining Actual Premiums ..............................................................................................................................38-1
Defining Actual Premiums.............................................................................................................................38-2
Overview .......................................................................................................................................................38-3
Premium Calculations....................................................................................................................................38-4
Link Premiums to Compensation Objects......................................................................................................38-5
Example - Actual Premium............................................................................................................................38-6
Defining Premium Calculations.....................................................................................................................38-8
Premium Assignment.....................................................................................................................................38-9
Premium Assignment Level ...........................................................................................................................38-10
Calculation Methods......................................................................................................................................38-11
Partial Month and Prorated Processing..........................................................................................................38-12
Premium Credits ............................................................................................................................................38-13

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View Premium Results...................................................................................................................................38-14
Practice: Defining an Actual Premium...........................................................................................................38-15
Setting Up Benefits Elements..........................................................................................................................39-1
Setting Up Benefits Elements ........................................................................................................................39-2
Elements and Benefits ...................................................................................................................................39-3
Element Entries..............................................................................................................................................39-4
Defining the Element .....................................................................................................................................39-5
Linking Elements for Benefits .......................................................................................................................39-6
Element Links ................................................................................................................................................39-7
Practice: Defining an Element .......................................................................................................................39-8
Defining Standard Contributions and Distributions ....................................................................................40-1
Defining Standard Contributions and Distributions.......................................................................................40-2
Overview .......................................................................................................................................................40-3
Standard Rates Concepts ...............................................................................................................................40-4
Defined, Communicated, and Annual Amounts.............................................................................................40-5
Building Standard Rates ................................................................................................................................40-6
Standard Rates - Basic Diagram ....................................................................................................................40-7
Standard Rates Levels....................................................................................................................................40-8
Standard Rates - Multiple of Coverage..........................................................................................................40-9
Standard Rates - Multiple of Premium...........................................................................................................40-10
Standard Rates - Parent/Child........................................................................................................................40-11
Key Concepts.................................................................................................................................................40-12
Activity Types ...............................................................................................................................................40-13
Activity Types - Specific Types.....................................................................................................................40-14
Elements and Input Values ............................................................................................................................40-15
Calculation Methods......................................................................................................................................40-16
Partial Month Determination .........................................................................................................................40-17
Annual Rates..................................................................................................................................................40-18
Processing Information ..................................................................................................................................40-19
Practice: Defining a Standard Rate ................................................................................................................40-22
Summary ..........................................................................................................................................................41-1
Summary........................................................................................................................................................41-2
Flex Credits and Benefits Pools ......................................................................................................................42-1
Flex Credits and Benefits Pools.....................................................................................................................42-2
Introduction ...................................................................................................................................................42-3
Topics ............................................................................................................................................................42-5
Objectives ......................................................................................................................................................42-6
Implementation Sequence..............................................................................................................................42-7
Defining Flex Credits.......................................................................................................................................43-1
Defining Flex Credits.....................................................................................................................................43-2
Key Concepts.................................................................................................................................................43-3
Setting Up a Flex Program.............................................................................................................................43-4
Flex Credits Shell Plan ..................................................................................................................................43-5
Flex Credit Shell Plan and Standard Rates ....................................................................................................43-6
A Statement of Earnings - Total Credits ........................................................................................................43-7
Net Credits.....................................................................................................................................................43-8
Defining Flex Credits.....................................................................................................................................43-9
Flex Credits Levels ........................................................................................................................................43-10
Defining Combinations of Compensation Objects.........................................................................................43-11
Activity Types for Flex Credits .....................................................................................................................43-12
Calculation Methods for Flex Credits............................................................................................................43-13
Practice: Defining the Flex Credit Shell Plan and Shell Plan Type ...............................................................43-14
Practice: Linking the Flex Credit Shell Plan and Plan Type to the Program .................................................43-15
Practice: Defining an Element for the Flex Credit Shell Plan........................................................................43-16

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Practice: Defining the Standard Rate for the Flex Credit Shell Plan .............................................................43-17
Practice: Defining Flex Credits......................................................................................................................43-18
Defining Benefits Pools....................................................................................................................................44-1
Defining Benefits Pools .................................................................................................................................44-2
Benefits Pools ................................................................................................................................................44-3
Benefits Pools: Credit and Debit Ledger .......................................................................................................44-5
Setting Up a Benefits Pool.............................................................................................................................44-6
Excess Treatment...........................................................................................................................................44-7
Benefits Pools for Net Credits .......................................................................................................................44-8
Flex Credit Application .................................................................................................................................44-9
Flex Credit Rollovers.....................................................................................................................................44-10
Defining a Benefits Pool................................................................................................................................44-11
Summary ..........................................................................................................................................................45-1
Summary........................................................................................................................................................45-2
Benefits Communications................................................................................................................................46-1
Benefits Communications ..............................................................................................................................46-2
Overview .......................................................................................................................................................46-3
Communications ............................................................................................................................................46-5
Communication Types ...................................................................................................................................46-6
Topics ............................................................................................................................................................46-7
Objectives ......................................................................................................................................................46-8
Implementation Sequence..............................................................................................................................46-9
Defining a Communication Type....................................................................................................................47-1
Defining a Communication Type...................................................................................................................47-2
Communication Types ...................................................................................................................................47-3
Kits and Pieces...............................................................................................................................................47-4
Communication Triggers ...............................................................................................................................47-5
Communication Usages .................................................................................................................................47-6
Defining Usages.............................................................................................................................................47-7
Usage Example ..............................................................................................................................................47-8
Communications Delivery .............................................................................................................................47-9
Person Communications ................................................................................................................................47-10
Practice: Defining a Communication Type....................................................................................................47-11
Summary ..........................................................................................................................................................48-1
Summary........................................................................................................................................................48-2
U.S. Benefits Regulations ................................................................................................................................49-1
U.S. Benefits Regulations ..............................................................................................................................49-2
Overview .......................................................................................................................................................49-3
Topics ............................................................................................................................................................49-4
Objectives ......................................................................................................................................................49-5
Setting Up Imputed Income Plans ..................................................................................................................50-1
Setting Up Imputed Income Plans .................................................................................................................50-2
Overview .......................................................................................................................................................50-3
Plans Subject to Imputed Income ..................................................................................................................50-4
Imputed Income Shell Plans ..........................................................................................................................50-6
Imputed Income Plan Hierarchy ....................................................................................................................50-7
Imputed Income - Standard Rates..................................................................................................................50-8
Imputed Income - Variable Rates ..................................................................................................................50-9
Imputed Income Calculations ........................................................................................................................50-10
Practice: Defining Derived Factors for Participant Imputed Income.............................................................50-13
Practice: Defining a Plan Subject to Imputed Income ...................................................................................50-14
Practice: Defining the Imputed Income Plan Type ........................................................................................50-15
Practice: Defining an Imputed Income Shell Plan .........................................................................................50-16

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Practice: Defining Variable Rates for Imputed Income Plans........................................................................50-17
Practice: Defining an Element for Imputed Income.......................................................................................50-18
Practice: Defining an Imputed Income Calculation .......................................................................................50-19
Introducing COBRA .......................................................................................................................................51-1
Introducing COBRA......................................................................................................................................51-2
COBRA Overview.........................................................................................................................................51-3
COBRA Administration with Oracle HRMS.................................................................................................51-6
COBRA Processing .......................................................................................................................................51-7
Benefits Assignments.....................................................................................................................................51-8
Setup for COBRA Administration .................................................................................................................51-9
COBRA Administration.................................................................................................................................51-10
Defining COBRA Programs and Plans..........................................................................................................52-1
Defining COBRA Programs and Plans ..........................................................................................................52-2
Defining COBRA Plans and Programs ..........................................................................................................52-3
Defining Plans Subject to COBRA................................................................................................................52-4
Defining COBRA Programs ..........................................................................................................................52-5
COBRA Enrollment Period Level .................................................................................................................52-6
Length of COBRA Coverage.........................................................................................................................52-7
Practice: Defining a Plan Subject to COBRA................................................................................................52-8
Practice: Defining a COBRA Program ..........................................................................................................52-9
Defining COBRA Life Events and Eligibility Profiles..................................................................................53-1
Defining COBRA Life Events and Eligibility Profiles ..................................................................................53-2
COBRA Life Events (Advanced Benefits) ....................................................................................................53-3
Subsequent Life Events (Advanced Benefits)................................................................................................53-4
Defining a COBRA Qualified Life Event ......................................................................................................53-5
Defining COBRA Enrollment Requirements.................................................................................................53-6
Practice: Defining COBRA Plan Enrollment Requirements..........................................................................53-8
COBRA Eligibility Profiles ...........................................................................................................................53-9
Practice: Defining COBRA Eligibility Profiles .............................................................................................53-11
Defining COBRA Activity Rates ....................................................................................................................54-1
Defining COBRA Activity Rates...................................................................................................................54-2
COBRA Activity Rates..................................................................................................................................54-3
Defining COBRA Rates.................................................................................................................................54-4
Practice: Defining an Element for COBRA Usage ........................................................................................54-5
Practice: Defining COBRA Activity Rates ....................................................................................................54-6
Generating HIPAA Certificates .....................................................................................................................55-1
Generating HIPAA Certificates .....................................................................................................................55-2
Overview .......................................................................................................................................................55-3
HIPAA...........................................................................................................................................................55-4
HIPAA Certifications ....................................................................................................................................55-6
HIPAA Certification Setup Steps ..................................................................................................................55-7
Defining Plans Subject to HIPAA .................................................................................................................55-8
HIPAA Communication Types ......................................................................................................................55-9
HIPAA Processing.........................................................................................................................................55-10
Practice: Setting Up a Plan for HIPAA Certification.....................................................................................55-11
Practice: Defining a Communication Type for HIPAA Certification ............................................................55-12
Summary ..........................................................................................................................................................56-1
Summary........................................................................................................................................................56-2
Online Benefits Services ..................................................................................................................................57-1
Online Benefits Services................................................................................................................................57-2
Introduction ...................................................................................................................................................57-3
Topics ............................................................................................................................................................57-4
Objectives ......................................................................................................................................................57-5

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Implementation Sequence..............................................................................................................................57-6
Setting Up the Benefits Service Center ..........................................................................................................58-1
Setting Up the Benefits Service Center..........................................................................................................58-2
Concepts ........................................................................................................................................................58-3
Real-Time Life Event Management...............................................................................................................58-4
Desktop Activities .........................................................................................................................................58-5
Message Configuration ..................................................................................................................................58-7
Practice: Setting Up Desktop Activities.........................................................................................................58-8
Practice: Defining and Configuring Messages...............................................................................................58-9
Summary ..........................................................................................................................................................59-1
Summary........................................................................................................................................................59-2
Participant Eligibility - Instructor Demonstrations and Practice Solutions...............................................60-1
Practice: Defining a Benefits Group ..............................................................................................................60-2
Solution: Defining a Benefits Group .............................................................................................................60-3
Practice: Defining Derived Eligibility Factors...............................................................................................60-4
Solution: Defining Derived Eligibility Factors ..............................................................................................60-5
Practice: Defining a Participant Eligibility Profile ........................................................................................60-8
Solution: Defining a Participant Eligibility Profile........................................................................................60-9
Compensation Objects- Instructor Demonstrations and Practice Solutions ..............................................61-1
Practice: Defining Program/Plan Year Periods..............................................................................................61-2
Solution: Defining Program/Plan Year Periods .............................................................................................61-3
Practice: Defining Plan Types .......................................................................................................................61-4
Solution: Defining Plan Types.......................................................................................................................61-5
Practice: Defining Plan Type Options ...........................................................................................................61-6
Solution: Defining Plan Type Options...........................................................................................................61-7
Practice: Defining Plans.................................................................................................................................61-9
Solution: Defining Plans ................................................................................................................................61-10
Practice: Defining a Benefits Program...........................................................................................................61-15
Solution: Defining a Benefits Program ..........................................................................................................61-16
Life Events - Instructor Demonstrations and Practice Solutions ................................................................62-1
Practice: Defining a Life Event Reason .........................................................................................................62-2
Solution: Defining a Life Event Reason ........................................................................................................62-3
Practice: Defining a Collapsing Life Event....................................................................................................62-4
Solution: Defining a Collapsing Life Event ...................................................................................................62-5
Practice: Linking a Life Event Reason to a Compensation Object ................................................................62-6
Solution: Linking a Life Event Reason to a Compensation Object................................................................62-7
Benefit Enrollment Requirements - Instructor Demonstrations and Practice Solutions...........................63-1
Practice: Defining Program Enrollment Requirements..................................................................................63-2
Solution: Defining Program Enrollment Requirements .................................................................................63-3
Practice: Defining Savings Plan Enrollment Requirements ...........................................................................63-7
Solution: Defining Savings Plan Enrollment Requirements ..........................................................................63-8
Practice: Setting Up Action Items and Certifications (Advanced Benefits)...................................................63-9
Solution: Setting Up Action Items and Certifications (Advanced Benefits) ..................................................63-10
Practice: Establishing Certifications for a Plan (Advanced Benefits)............................................................63-11
Solution: Establishing Certifications for a Plan (Advanced Benefits) ...........................................................63-12
Practice: Establishing the Unsuspended Code and Interim Coverage for a Plan ...........................................63-13
Solution: Establishing Unsuspended Code and Interim Coverage for a Plan ................................................63-14
Dependent Designation - Instructor Demonstrations and Practice Solutions ............................................64-1
Practice: Defining Dependent Coverage Eligibility Profiles..........................................................................64-2
Solution: Defining Dependent Coverage Eligibility Profiles .........................................................................64-3
Practice: Defining Dependent Designation Requirements .............................................................................64-4
Solution: Defining Dependent Designation Requirements ............................................................................64-5
Practice: Designating Beneficiaries ...............................................................................................................64-8

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Solution: Designating Beneficiaries...............................................................................................................64-9
Activity Rates and Coverage Calculations - Instructor Demonstrations and Practice Solutions .............65-1
Practice: Defining a Variable Rate Profile.....................................................................................................65-2
Solution: Defining a Variable Rate Profile ....................................................................................................65-3
Practice: Defining Coverage Calculations .....................................................................................................65-5
Solution: Defining Coverage Calculations.....................................................................................................65-6
Practice: Defining Actual Premiums..............................................................................................................65-7
Solution: Defining Actual Premiums .............................................................................................................65-8
Practice: Setting Up Benefits Elements .........................................................................................................65-9
Solution: Setting Up Benefits Elements.........................................................................................................65-10
Practice: Defining Standard Rates .................................................................................................................65-14
Solution: Defining Standard Rates.................................................................................................................65-15
Flex Credits - Instructor Demonstrations and Practice Solutions...............................................................66-1
Practice: Defining the Plan Type for the Flex Credit Shell Plan....................................................................66-2
Solution: Defining the Plan Type for the Flex Credit Shell Plan ...................................................................66-3
Practice: Defining the Flex Credit Shell Plan ................................................................................................66-4
Solution: Defining the Flex Credit Shell Plan................................................................................................66-5
Practice: Linking the Flex Credit Shell Plan and Plan Type to the Program .................................................66-6
Practice: Defining an Element for the Flex Credit Shell Plan........................................................................66-8
Practice: Defining the Standard Rate for the Flex Credit Shell Plan .............................................................66-9
Solution: Defining the Standard Rate for the Flex Credit Shell Plan.............................................................66-10
Practice: Defining Flex Credits......................................................................................................................66-11
Solution: Defining Flex Credits .....................................................................................................................66-12
Practice: Defining a Benefits Pool.................................................................................................................66-13
Solution: Defining a Benefits Pool ................................................................................................................66-14
Communications- Instructor Demonstration and Practice Solution ...........................................................67-1
Practice: Defining a Communication Type (Advanced Benefits) ..................................................................67-2
Solution: Defining a Communication Type (Advanced Benefits)..................................................................67-3
US Benefits Regulations- Instructor Demonstrations and Practice Solutions............................................68-1
Practice: Defining Derived Factors for Participant Imputed Income.............................................................68-2
Solution: Defining Derived Factors for Participant Imputed Income ............................................................68-3
Practice: Defining a Plan Subject to Imputed Income ...................................................................................68-4
Solution: Defining a Plan Subject to Imputed Income...................................................................................68-5
Practice: Defining the Imputed Income Plan Type ........................................................................................68-6
Solution: Defining the Imputed Income Plan Type........................................................................................68-7
Practice: Defining the Imputed Income Shell Plan ........................................................................................68-8
Solution: Defining the Imputed Income Shell Plan........................................................................................68-9
Practice: Defining Variable Rates for the Imputed Income Plan ...................................................................68-10
Solution: Defining Variable Rates for the Imputed Income Plan...................................................................68-11
Practice: Defining an Element (Payroll Distribution) Imputed Income ......................................................68-12
Solution: Defining an Element (Payroll Distribution) Imputed Income......................................................68-13
Practice: Defining the Imputed Income Calculation ......................................................................................68-14
Solution: Defining the Imputed Income Calculation......................................................................................68-15
Practice: Defining a Plan Subject to COBRA................................................................................................68-16
Solution: Defining a Plan Subject to COBRA ...............................................................................................68-17
Practice: Defining a COBRA Program ..........................................................................................................68-18
Solution: Defining a COBRA Program..........................................................................................................68-19
Practice: Defining COBRA Program Enrollment Requirements ...................................................................68-21
Solution: Defining COBRA Program Enrollment Requirements...................................................................68-22
Practice: Defining COBRA Eligibility Profiles .............................................................................................68-25
Solution: Defining COBRA Eligibility Profiles.............................................................................................68-26
Practice: Defining an Element for COBRA Usage ........................................................................................68-27
Solution: Defining an Element for COBRA Usage........................................................................................68-28
Practice: Defining COBRA Activity Rates ....................................................................................................68-29
Solution: Defining COBRA Activity Rates ...................................................................................................68-30

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Practice: Setting Up a Plan for HIPAA Certification.....................................................................................68-32
Solution: Setting Up a Plan for HIPAA Certification ....................................................................................68-33
Practice: Defining a Communication Type for HIPAA Certification ............................................................68-34
Solution: Defining a Communication Type for HIPAA Certification............................................................68-35
Online Benefit Services- Instructor Demonstrations and Practice Solutions .............................................69-1
Practice: Setting Up Desktop Activities.........................................................................................................69-2
Solution: Setting Up Desktop Activities ........................................................................................................69-3
Practice: Defining a Message.........................................................................................................................69-4
Solution: Defining a Message ........................................................................................................................69-5
Practice: Configuring Messages.....................................................................................................................69-6
Solution: Configuring Messages ....................................................................................................................69-7

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11i Oracle HRMS Implement Advanced Benefits (US) Table of Contents


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Preface
Profile
Before You Begin This Course

Thorough knowledge of Navigation in Oracle Applications Release 11i

Prerequisites

R11i Implementing Oracle Human Resources 148055GC120

R11i Implementing and Administer Payroll (US) D16219GC10

How This Course Is Organized

11i Oracle HRMS Implement Advanced Benefits (US) is an instructor-led course featuring lecture
and hands-on exercises. Online demonstrations and written practice sessions reinforce the
concepts and skills introduced.

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11i Oracle HRMS Implement Advanced Benefits (US) Preface


xiii
Related Publications
Oracle Publications
Title Part Number
Managing Compensation and Benefits Using Oracle HRMS (US) A77144-01
Managing Total Compensation Using Oracle HRMS (UK) A73293-02
Managing Total Compensation Using Oracle HRMS (Canada) A73322-01
Managing Compensation and Benefits Using Oracle US Federal A77083-01
Managing Total Compensation Using Oracle HRMS (NZ) A95251_01
Managing Total Compensation Using Oracle HRMS (AU) A95254_01

Additional Publications

System release bulletins

Installation and users guides

read.me files

International Users Group (IOUG) articles

Oracle Magazine

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11i Oracle HRMS Implement Advanced Benefits (US) Preface


xiv
Typographic Conventions
Typographic Conventions in Text

Convention Element Example


Bold italic Glossary term (if The algorithm inserts the new key.
there is a glossary)

Caps and Buttons, Click the Executable button.


lowercase check boxes, Select the Cant Delete Card check box.
triggers, Assign a When-Validate-Item trigger to the
windows ORD block.
Open the Master Schedule window.

Courier new, Code output, Code output: debug.set (I, 300);


case sensitive directory names, Directory: bin (DOS), $FMHOME (UNIX)
(default is filenames, Filename: Locate the init.ora file.
lowercase) passwords, Password: User tiger as your password.
pathnames, Pathname: Open c:\my_docs\projects
URLs, URL: Go to http://www.oracle.com
user input,
User input: Enter 300
usernames
Username: Log on as scott

Initial cap Graphics labels Customer address (but Oracle Payables)


(unless the term is a
proper noun)

Italic Emphasized words Do not save changes to the database.


and phrases, For further information, see Oracle7 Server
titles of books and SQL Language Reference Manual.
courses, Enter user_id@us.oracle.com,
variables where user_id is the name of the user.
Quotation Interface elements Select Include a reusable module component
marks with long names and click Finish.
that have only
initial caps; This subject is covered in Unit II, Lesson 3,
lesson and chapter Working with Objects.
titles in cross-
references

Uppercase SQL column Use the SELECT command to view


names, commands, information stored in the LAST_NAME
functions, schemas, column of the EMP table.
table names

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11i Oracle HRMS Implement Advanced Benefits (US) Preface


xv
Convention Element Example
Arrow Menu paths Select File> Save.
Brackets Key names Press [Enter].

Commas Key sequences Press and release keys one at a time:


[Alternate], [F], [D]
Plus signs Key combinations Press and hold these keys simultaneously:
[Ctrl]+[Alt]+[Del]

Typographic Conventions in Code

Convention Element Example


Caps and Oracle Forms When-Validate-Item
lowercase triggers
Lowercase Column names, SELECT last_name
table names FROM s_emp;

Passwords DROP USER scott


IDENTIFIED BY tiger;
PL/SQL objects OG_ACTIVATE_LAYER
(OG_GET_LAYER
(prod_pie_layer))

Lowercase Syntax variables CREATE ROLE role


italic
Uppercase SQL commands and SELECT userid
functions FROM emp;

Typographic Conventions in Navigation Paths

This course uses simplified navigation paths, such as the following example, to direct you
through Oracle Applications.
Example:

Assignment Window
(N) People > Enter and Maintain > (M) Query-Find > (B) Assignment
This simplified path translates to the following:
1 (N) From the Navigator, select People > Enter and Maintain.
2 (M) From the menu, select Query > Find your employee.
3 (B) Click the Assignment button.

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11i Oracle HRMS Implement Advanced Benefits (US) Preface


xvi
Notations :

(N) = Navigator

(M) = Menu

(T) = Tab

(I) = Icon

(H) = Hyperlink

(B) = Button

Typographical Conventions in Help System Paths

This course uses a navigation path convention to represent actions you perform to find
pertinent information in the Oracle Applications Help System.

The following help navigation path, for example

Oracle HRMS Global > Compensation and Benefits Setup > How To > Define Elements >
Define an Element

represents the following sequence of actions:

1. In the navigation frame of the help system window, expand the Oracle HRMS Global entry.

2. Under the Oracle HRMS Global entry, expand Compensation and Benefits Setup.

3. Under Compensation and Benefits Setup, select How To.

4. Under How To, select Define Elements

5. Under Define Elements, select Define an Element

This will display step by step instructions on how to complete the Element window.

Getting Help
Oracle Applications provides you with a complete online help facility.

Whenever you need assistance, simply choose an item from the Help menu to pinpoint the type
of information you want.

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11i Oracle HRMS Implement Advanced Benefits (US) Preface


xvii
To display help for a current window:

1. Choose Window Help from the Help menu, click the Help button on the toolbar, or hold
down the Control key and type 'h'.

A web browser window appears, containing search and navigation frames on the left, and a
frame that displays help documents on the right.

The document frame provides information on the window containing the cursor. The
navigation frame displays the top-level topics for your responsibility, arranged in a tree
control.

2. If the document frame contains a list of topics associated with the window, click on a topic
of interest to display more detailed information.

3. You can navigate to other topics of interest in the help system, or choose Close from your
web browser's File menu to close help.

Searching for Help

You can perform a search to find the Oracle Applications help information you want. Simply
enter your query in the text field located in the top-left frame of the browser window when
viewing help, then click the adjacent Find button.

A list of titles, ranked by relevance and linked to the documents in question, is returned from
your search in the right-hand document frame. Click on whichever title seems to best answer
your needs to display the complete document in this frame. If the document doesn't fully answer
your questions, use your browser's Back button to return to the list of titles and try another.

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11i Oracle HRMS Implement Advanced Benefits (US) Preface


xviii
Overview of Implementing
Advanced Benefits
Chapter 1

Copyright Oracle Corporation, 2002. All rights reserved.

Overview of Implementing Advanced Benefits


Chapter 1 - Page 1
Overview of Implementing Advanced Benefits

Overview of Implementing
Advanced Benefits

Copyright Oracle Corporation, 2002. All rights reserved.

Overview of Implementing Advanced Benefits


Chapter 1 - Page 2
Introduction

Introduction

Setup for Advanced Benefits teaches you everything


you need to know about implementing Advanced
Benefits. In this module you will:
Learn about the different features and advantages
of Oracle Advanced Benefits
Find out how to implement Advanced Benefits to
maximize the power of benefits administration
Enter a complete benefits plan design in Oracle
HRMS

Copyright Oracle Corporation, 2002. All rights reserved.

Overview of Implementing Advanced Benefits


Chapter 1 - Page 3
Introduction

Introduction

Setup for Advanced Benefits covers a variety of


benefits administration topics, including:
Designing the components and structure of a
benefits program
Determining benefits eligibility and enrollment
periods
Calculating monthly premiums and employee and
employer contributions
Administering benefits based on life events
Setting up flexible benefit programs that provide
credits to offset the cost of employee benefits

Copyright Oracle Corporation, 2002. All rights reserved.

Overview of Implementing Advanced Benefits


Chapter 1 - Page 4
Topics

Topics

The Overview of Implementing Advanced Benefits


module contains the following topics:
Introducing Advanced Benefits
Reviewing a Sample Implementation and Enrollment
Following the Implementation Steps

Copyright Oracle Corporation, 2002. All rights reserved.

Overview of Implementing Advanced Benefits


Chapter 1 - Page 5
Copyright Oracle Corporation, 2002. All rights reserved.

Overview of Implementing Advanced Benefits


Chapter 1 - Page 6
Introducing Advanced
Benefits
Chapter 2

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 1
Introducing Advanced Benefits

Introducing Advanced Benefits

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 2
Total Compensation

Total Compensation

Oracle Advanced Benefits provides a complete


solution for benefits administration:
Support for fully-featured flexible benefits programs
Complex eligibility requirements
Life event administration
Centralized benefits service center processing
Automated notification for participant
communications
System extract to third party providers

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 3
Flexible Benefits Programs

Flexible Benefits Programs

Flexible Benefits Programs:


Cafeteria-style - employee-driven
Flex credits off-set employee cost of benefits
Rollover, forfeit, or convert excess credits to cash

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 4
Build a Benefits Program

Build a Benefits Program

Program
Link compensation
objects to create a
program
Plan types, plans, and Plan Type
options are reusable
Plans are linked to their
plan type Plan
Options must be in plans

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 5
Plan Types

Plan Types

STD/LTD
Others
Life

Perqs
FSAs

Health
Vac
Buy/Sell
Savings

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 6
Life Event Management

Life Event Management

Explicit

HRMS
database Temporal

Scheduled

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 7
Eligibility Profiles

Eligibility Profiles

Eligibility profiles limit eligibility for compensation


objects.
Profiles
Program

Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 8
Contributions and Distributions

Contributions and Distributions

Use Advanced Benefits to calculate employee and


employer contributions and distributions
Standard rates
Variable rates
Premiums
Coverage amounts
Flex credits

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 9
Actual Premiums

Actual Premiums

Calculate monthly premiums for:


Individual participants
Total participants in a plan or option
Total volume of coverage elected

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 10
Advanced Benefits and Oracle Payroll

Advanced Benefits and Oracle Payroll

Use Oracle HRMS elements to:


Transfer rates to Oracle Payroll or third party
systems
Record activity rate results for contributions and
distributions
Define costing rules

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 11
Communications

Communications

Use benefits communications for:


Pre-enrollment packages
Enrollment reminders and confirmations
Requests for certification
Define communication types in Oracle HRMS based
on:
Life events
Enrollment
Enrollment periods
Action items

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Introducing Advanced Benefits


Chapter 2 - Page 12
Benefits Service Center

Benefits Service Center

Use the Benefits Service Center if you employ a call


center for benefits administration
Process life events and elections in real-time
Control access to the most commonly used benefits
windows and processes

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 13
View Program Structure

View Program Structure

Once you complete your plan design, Oracle HRMS


lets you view the your program structure
Verify all options and plans are linked to your
programs

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 14
Eligibility Management

Eligibility Management

Detect Life Event Fred reports birth of Pebbles

Evaluate Detected Life Event No other life events

Derived Factors 4.3 eons of service

Determine Eligibility Eligible for Bedrock Medical

Determine Electability Employee + family electable

Determine Rates/Coverage Contribution price tags

Determine Communications Notice of election

Update Eligibility Eligibility stored in database

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Introducing Advanced Benefits


Chapter 2 - Page 15
Enrollment Cycle Automation

Enrollment Cycle Automation

Perform Post Election Edits N/A: Fred picks family option

Determine Action Items N/A: Fred selects dependent

Check for Suspensions N/A

Calculate Rates/Coverage Monthly Contribution: 200 Stones

Calculate Total/Excess Credits Price reduces excess credits

Determine Element Entries Existing element entry updated

Determine Communications Confirmation statement

Update Enrollment Records

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Advanced Benefits


Chapter 2 - Page 16
Reviewing a Sample
Implementation and
Enrollment
Chapter 3

Copyright Oracle Corporation, 2002. All rights reserved.

Reviewing a Sample Implementation and Enrollment


Chapter 3 - Page 1
Reviewing a Sample Implementation and Enrollment

Reviewing a Sample Implementation


and Enrollment

Copyright Oracle Corporation, 2002. All rights reserved.

Reviewing a Sample Implementation and Enrollment


Chapter 3 - Page 2
Vision

Vision

The Vision database contains seeded programs and


plans for your review

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Reviewing a Sample Implementation and Enrollment


Chapter 3 - Page 3
Vision - Seeded Compensation Objects

Vision - Seeded Compensation Objects

Seeded programs in Vision include:


Vision Flex Program
Vision Choice Program
Vision Retiree Program
Seeded plans include:
Life insurance
Dental
HMOs
Disability plans

Copyright Oracle Corporation, 2002. All rights reserved.

Reviewing a Sample Implementation and Enrollment


Chapter 3 - Page 4
Vision - Seeded Plan Design

Vision - Seeded Plan Design

Vision also contains other components of a complete


plan design:
Participant and Dependent Eligibility Profiles
Activity rates
Enrollment requirements for scheduled and life
event enrollments
System extracts

Copyright Oracle Corporation, 2002. All rights reserved.

Reviewing a Sample Implementation and Enrollment


Chapter 3 - Page 5
Enrollment

Enrollment

Oracle Advanced Benefits provides 4 enrollment


windows:
Flex Program
Non-Flex Program
Savings Plan
Miscellaneous Plan

Copyright Oracle Corporation, 2002. All rights reserved.

Reviewing a Sample Implementation and Enrollment


Chapter 3 - Page 6
Demo: Reviewing an Implementation and Enrollment

Demo: Reviewing an Implementation


and Enrollment

Follow the demonstration as the instructor reviews


an implementation and enrolls a participant
Navigate to the View Program Structure window
using your local Super or HRMS Manager
responsibility

(N) Total Compensation > Programs and Plans > View Program
Structure

Online Help
For details on how to view the structure of a program please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Plan Design > How To >
Navigate the Program Structure Hierarchy

Copyright Oracle Corporation, 2002. All rights reserved.

Reviewing a Sample Implementation and Enrollment


Chapter 3 - Page 7
Practice: Reviewing an Implementation

Practice: Reviewing an Implementation

Follow the demonstration, or use the notes


provided, to review an implementation
Navigate to the View Program Structure window
using your local Super or HRMS Manager
responsibility

(N) Total Compensation > Programs and Plans > View Program
Structure

Online Help
For details on how to view the structure of a program please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Plan Design > How To >
Navigate the Program Structure Hierarchy

Copyright Oracle Corporation, 2002. All rights reserved.

Reviewing a Sample Implementation and Enrollment


Chapter 3 - Page 8
Following the Implementation
Steps
Chapter 4

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Following the Implementation Steps


Chapter 4 - Page 1
Following the Implementation Steps

Following the Implementation Steps

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Following the Implementation Steps


Chapter 4 - Page 2
Building Blocks

Building Blocks

Setup Advanced Benefits following the


recommended implementation sequence
Build components - then link components
Adopt a staged approach - build then test - to
reduce time spent troubleshooting

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Following the Implementation Steps


Chapter 4 - Page 3
Building Blocks - Examples

Building Blocks - Examples

Define eligibility profiles before compensation


objects
Link eligibility profiles to compensation objects when
you define the objects
Define variable rates before standard rates
Variable rates perform operations on the standard rate

Copyright Oracle Corporation, 2002. All rights reserved.

Following the Implementation Steps


Chapter 4 - Page 4
Implementation Sequence

Implementation Sequence

1. Eligibility 2. Derived Factors 3. Eligibility


Criteria (O) (O) Profiles (O)

5. Regulations and 4. Program/Plan


6. Plan Types (M)
Other Details (O) Year Periods (M)

7. Options (M) 8. Plans (M) 9. Programs (M)

12. Program
11. Collapsing Life 10. Life Event
Enrollment
Events (O) Reasons (O)
Requirements (M)

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Following the Implementation Steps


Chapter 4 - Page 5
Implementation Sequence

Implementation Sequence

13. Plan
14. Dependent 15. Variable Rates
Enrollment
Coverage (O) (O)
Requirements (O)

18. Benefits 17. Actual 16. Coverage


Elements (O) Premiums (O) Calculations (O)

19. Standard Rates 20. Reimb. Plans 21. Flex Credit


(O) (O) Calculations (O)

23.
24. Online 22. Benefits Pools
Communications
Activities (O) (O)
(O)

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Following the Implementation Steps


Chapter 4 - Page 6
Summary
Chapter 5

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Summary
Chapter 5 - Page 1
Summary

Summary

In this module, you should have learned how to:


Implement Advanced Benefits
Enter a complete benefits plan design
Review a Sample Implement and Enrollment

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Summary
Chapter 5 - Page 2
Participant Eligibility
Chapter 6

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Participant Eligibility
Chapter 6 - Page 1
Participant Eligibility

Participant Eligibility

Copyright Oracle Corporation, 2002. All rights reserved.

Participant Eligibility
Chapter 6 - Page 2
Introduction

Introduction

You define participant eligibility components in Oracle


HRMS to:
Evaluate a persons eligibility for sponsored
benefits
Re-evaluate eligibility based on life events
Manage eligibility for continuing benefits

Copyright Oracle Corporation, 2002. All rights reserved.

Participant Eligibility
Chapter 6 - Page 3
Topics

Topics

Participant Eligibility contains the following topics:


Introducing Benefits Eligibility
Defining Eligibility Building Blocks
Defining Derived Eligibility Factors
Defining Participant Eligibility Profiles

Copyright Oracle Corporation, 2002. All rights reserved.

Participant Eligibility
Chapter 6 - Page 4
Objectives

Objectives

After completing this module, you should be able to do


the following:
Understand how Oracle HRMS helps you manage
benefits eligibility
Select criteria to restrict a participants benefits
eligibility
Set up eligibility criteria and derived eligibility
factors
Build participant eligibility profiles

Copyright Oracle Corporation, 2002. All rights reserved.

Participant Eligibility
Chapter 6 - Page 5
Implementation Sequence

Implementation Sequence

1. Eligibility 2. Derived Factors 3. Eligibility


Criteria (O) (O) Profiles (O)

5. Regulations and 4. Program/Plan


6. Plan Types (M)
Other Details (O) Year Periods (M)

7. Options (M) 8. Plans (M) 9. Programs (M)

12. Program
11. Collapsing Life 10. Life Event
Enrollment
Events (O) Reasons (O)
Requirements (M)

Copyright Oracle Corporation, 2002. All rights reserved.

Participant Eligibility
Chapter 6 - Page 6
Implementation Sequence

Implementation Sequence

13. Plan
14. Dependent 15. Variable Rates
Enrollment
Coverage (O) (O)
Requirements (O)

18. Benefits 17. Actual 16. Coverage


Elements (O) Premiums (O) Calculations (O)

19. Standard Rates 20. Reimb. Plans 21. Flex Credit


(O) (O) Calculations (O)

23.
24. Online 22. Benefits Pools
Communications
Activities (O) (O)
(O)

Copyright Oracle Corporation, 2002. All rights reserved.

Participant Eligibility
Chapter 6 - Page 7
Copyright Oracle Corporation, 2002. All rights reserved.

Participant Eligibility
Chapter 6 - Page 8
Introducing Benefits
Eligibility
Chapter 7

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Benefits Eligibility


Chapter 7 - Page 1
Introducing Benefits Eligibility

Introducing Benefits Eligibility

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Benefits Eligibility


Chapter 7 - Page 2
Benefits Eligibility

Benefits Eligibility

Eligibility components restrict benefits to qualified


participants.

Program

Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Benefits Eligibility


Chapter 7 - Page 3
Building Benefits Eligibility

Building Benefits Eligibility

You build eligibility profiles, then link the profiles to


compensation objects.

Compensation Objects
Participant Eligibility Profiles
Eligibility Criteria

Derived Factors

Eligibility Building Blocks

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Benefits Eligibility


Chapter 7 - Page 4
Building Benefits Eligibility

Building Benefits Eligibility

A detailed view of Oracle HRMS Eligibility components.

Programs Plan Types Plans Options

Participant Eligibility Profiles Dependent Eligibility Profiles

Employment Personal Derived Factors Related Coverages Other

Compensation Hours Worked Full-Time Equivalence Age Length of Service

Benefits Groups Postal Zip Ranges Service Areas Benefits Balances

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Benefits Eligibility


Chapter 7 - Page 5
Evaluating Eligibility (Advanced Benefits)

Evaluating Eligibility (Advanced Benefits)

The Participation process evaluates eligibility for users


of Advanced Benefits.

Program

Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Benefits Eligibility


Chapter 7 - Page 6
Evaluating Eligibility (Standard Benefits)

Evaluating Eligibility (Standard Benefits)

The Maintain Participant Eligibility process evaluates


eligibility for users of Standard Benefits.

Program

Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Benefits Eligibility


Chapter 7 - Page 7
Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Benefits Eligibility


Chapter 7 - Page 8
Defining Eligibility Building
Blocks
Chapter 8

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Eligibility Building Blocks


Chapter 8 - Page 1
Defining Eligibility Building Blocks

Defining Eligibility Building Blocks

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Eligibility Building Blocks


Chapter 8 - Page 2
Eligibility Building Blocks

Eligibility Building Blocks

Use the eligibility building blocks as optional


components of a participant eligibility profile:
Benefits groups
Postal zip ranges
Service areas
Benefit Balance Types

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Eligibility Building Blocks


Chapter 8 - Page 3
Benefits Groups

Benefits Groups

For complex eligibility criteria


To explicitly group a unique body of participants
Administrators enter a person into a benefits group
using the Benefits tab on the People window

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Eligibility Building Blocks


Chapter 8 - Page 4
Postal Zip Ranges

Postal Zip Ranges

You can limit benefits eligibility to participants


whose primary address is within a postal zip range
Use postal zip ranges as a component in a
participant eligibility profile
Group postal zip ranges into Service Areas

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Eligibility Building Blocks


Chapter 8 - Page 5
Service Areas

Service Areas

You define service areas to group a series of postal


zip ranges
Use service areas as a component in a participant
eligibility profile
A service area can define a region as specified by a
benefits carrier or third party administrator
Zip code ranges enhance the speed of eligibility
processing

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Eligibility Building Blocks


Chapter 8 - Page 6
Benefits Balances

Benefits Balances

Use a benefits balance to manually assign a person


a value such as stock options, hours worked, or
frozen salary
Use benefits balances as a component in a
participant eligibility profile
Benefits balances are a component in a derived
factor based on compensation or hours worked

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Eligibility Building Blocks


Chapter 8 - Page 7
Practice: Defining a Benefits Group

Practice: Defining a Benefits Group

Follow the demonstration, or use the notes


provided, to define a benefits group
Navigate to the Benefits Group window using your
local Super or HRMS Manager responsibility

(N) Total Compensation > General Definitions > Eligibility/Rate


Factors > Benefits Groups

Online Help
For details on how to complete the benefits group window please refer to the online Help path:
Oracle HRMS Applications > Oracle HRMS > Oracle HRMS Global > Setup for Standard and
Advanced Benefits > Benefits Eligibility > How To > Define Other Eligibility
Criteria > Define Benefit Groups

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Eligibility Building Blocks


Chapter 8 - Page 8
Defining Derived Eligibility
Factors
Chapter 9

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 1
Defining Derived Eligibility Factors

Defining Derived Eligibility Factors

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 2
Derived Factors

Derived Factors

There are six types of derived factors:


Compensation
Hours Worked
Full-time Equivalent
Age
Length of Service
Combination Age and Length of Service

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 3
Derived Factors Common Components

Derived Factors
Common Components

Set minimum and maximum values for eligibility


The range is inclusive of the minimum and maximum
Use determination date codes to control the date
from which the application calculates a derived
value
As of Event Date
First of Month
Previous October 1st
Round the result of a derived factor calculation

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 4
Compensation Factors

Compensation Factors

Define a compensation factor to base eligibility on a


persons salary or balance value
Select a compensation source:
Stated compensation
Balance type
Benefits balance

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 5
Hours Worked Factors

Hours Worked Factors

Define an hours worked factor to base eligibility on


an employees one-time or recurring work hours
Select an hours worked source:
System defined balance
Benefits balance

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 6
Full-Time Equivalent Factors

Full-Time Equivalent Factors

Define a full time equivalent factor to base eligibility


on an employees percentage of full-time work
The full-time equivalent source derives from the
Assignment Budget Values window
You can derive this factor based on the primary
assignment or the sum of all assignments

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 7
Age Factors

Age Factors

Define an age factor to base eligibility on the age of


an employee or contact
The application calculates age using a variety of
units, such as:
Years, months

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 8
Length of Service Factors

Length of Service Factors

Define a length of service factor to base eligibility


on an employees time spent with your enterprise
The application calculates length of service using a
variety of units, such as:
Years, quarters, days
You can calculate service based on:
Date of Hire
Adjusted Service Date

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 9
Combined Age and Length of Service

Combined Age and Length of Service

Define a combined age and length of service factor


to base eligibility on the sum of these two derived
factors
Define the separate age and length of service
factors then create the new combined factor

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 10
Derived Factor Calculation Rules

Derived Factor Calculation Rules

You can write a FastFormula Rule to calculate the


following derived factors:
Compensation
Hours Worked
Length of Service
Age

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 11
Derived Factor Calculation (Advanced Benefits)

Derived Factor Calculation


(Advanced Benefits)

Run the Participation Process in temporal mode


periodically to detect derived factor boundary
changes
This process detects seeded temporal life events such
as Age Changed or Length of Service Changed
Run the Participation Process in life event mode to
calculate derived factors and to determine eligibility

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 12
Derived Factor Calculation (Standard Benefits)

Derived Factor Calculation


(Standard Benefits)

Run the Maintain Participant Eligibility batch


process to calculate derived factors and determine
eligibility
You must manually determine if the crossing of a
derived factor boundary results in participant
enrollment opportunities
When you process an unrestricted enrollment, the
Participation process determines eligibility when
you query a person in an enrollment window

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 13
Practice: Defining Derived Factors

Practice: Defining Derived Factors

Follow the demonstration, or use the notes


provided, to define a derived compensation level
factor
Navigate to the Derived Factors window using your
local Super or HRMS Manager responsibility

(N) Total Compensation > General Definitions > Eligibility/Rate


Factors > Derived Factors

Online Help
For details on how to complete the derived compensation level factors window please refer to
the online Help path:
Oracle HRMS Applications > Oracle HRMS > Oracle HRMS Global > Setup for Standard and
Advanced Benefits > Benefits Eligibility > How To > Define Derived Compensation Factors >
Define Compensation Level

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Derived Eligibility Factors


Chapter 9 - Page 14
Defining a Participant
Eligibility Profile
Chapter 10

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 1
Defining a Participant Eligibility Profile

Defining a Participant Eligibility Profile

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 2
Participant Eligibility Profiles

Participant Eligibility Profiles

Participant eligibility profiles limit eligibility for


compensation objects.

Program

Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 3
Eligibility Criteria

Eligibility Criteria

HR, Payroll, and Benefits data determines eligibility


for sponsored benefits.
40+ individual eligibility attributes:
Employment (Job, Work Location)
Personal (Person Type, Union Member)
Derived Factors (Age, Length of Service)
Other (Benefits Group, Rule)
Related Coverages (Covered in Other plan)

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 4
Profiles with Multiple Criteria

Profiles with Multiple Criteria

If you include multiple criteria in an eligibility profile,


an individual must meet all criteria to satisfy the
profile.
Profile 1
Employment = FT Program
Work Location =
Springfield Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 5
Criterion with Multiple Values

Criterion with Multiple Values

If you include multiple values for an eligibility profile, a


person must meet at least one value to satisfy the
profile.
Profile 1
Work Location = Program
California or
Missouri or
New Mexico Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 6
Profiles Excluding Employees

Profiles
Excluding Employees

You can use eligibility profiles to exclude individuals


who satisfy the criteria for exclusion.

Profile 1
Job = Executive Program

Exclude field checked


Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 7
Use Profiles with Any Compensation Object

Use Profiles with Any


Compensation Object

You can associate a profile with any program, plan


type in program, plan in program, plan, or option in
plan.
Program

Plan Type
Profile 1

FT Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 8
Profiles Are Reusable

Profiles Are Reusable

You define participant eligibility profiles independently


of compensation objects.

Program A Program B

Profile 1 Profile 1

FT FT

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 9
Eligibility Cascades Downward

Eligibility Cascades Downward

All plan types, plans, and options within a program


inherit the characteristics of a profile associated with
the program.

Profile 1
Program
FT
Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 10
Attach Multiple Profiles to a Compensation Object

Attach Multiple Profiles to a


Compensation Object

You can attach more than one profile to a


compensation object.

Profile 1 Program
FT
60 days Plan Type

Profile 2
Exec Staff Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 11
Compensation Hierarchy

Compensation Hierarchy

If you attach more than one profile to a


compensation object, the participant must satisfy all
required profiles, and at least one optional profile
The Participation process evaluates eligibility
profiles in the order you attach the profile to the
compensation object
Attach required profiles to a compensation object
before optional profiles
To increase processing speed, attach profiles in
order of their decreasing likelihood of eligibility

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 12
Practice: Defining a Participant Eligibility Profile

Practice: Defining a Participant


Eligibility Profile

Follow the demonstration, or use the notes


provided, to define a participant eligibility profile
Navigate to the Participation Eligibility Profiles
window using your local Super or HRMS Manager
responsibility

(N) Total Compensation > General Definitions > Eligibility Profiles >
Participant

Online Help
For details on how to complete the participant eligibility profile please refer to the online Help
path:
Applications Help Library > Oracle HRMS Applications > Oracle HRMS > Oracle HRMS
Global > Setup for Standard and Advanced Benefits > Benefits Eligibility > How To > Define
an Eligibility Profile

Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 13
Copyright Oracle Corporation, 2002. All rights reserved.

Defining a Participant Eligibility Profile


Chapter 10 - Page 14
Summary
Chapter 11

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 11 - Page 1
Summary

Summary

In this module, you should have learned how to:


Define benefits eligibility
Select criteria to restrict a participants benefits
eligibility
Set up eligibility criteria and derived eligibility
factors
Build participant eligibility profiles

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 11 - Page 2
Compensation Objects
Chapter 12

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Compensation Objects
Chapter 12 - Page 1
Compensation Objects

Compensation Objects

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Compensation Objects
Chapter 12 - Page 2
Introduction

Introduction

Set up compensation objects in Oracle HRMS to:


Define and structure your compensation and
benefits programs
Manage the ongoing administration of your
enterprises compensation and benefits offerings
Provide the plans and options into which eligible
participants and dependents enroll

Copyright Oracle Corporation, 2002. All rights reserved.

Compensation Objects
Chapter 12 - Page 3
Topics

Topics

The Compensation Objects module contains the


following topics:
Introducing the Compensation Object Hierarchy
Defining Program/Plan Year Periods and Other
Details
Defining Plan Types and Options
Defining Plans
Defining Programs

Copyright Oracle Corporation, 2002. All rights reserved.

Compensation Objects
Chapter 12 - Page 4
Objectives

Objectives

After completing this module, you should be able to do


the following:
Understand how Oracle HRMS enables you to
structure your total compensation offerings using
compensation objects
Understand how to use and define options, plans,
plan types, and programs
Group compensation objects into a hierarchy
Associate eligibility profiles to compensation
objects

Copyright Oracle Corporation, 2002. All rights reserved.

Compensation Objects
Chapter 12 - Page 5
Implementation Sequence

Implementation Sequence

1. Eligibility 2. Derived Factors 3. Eligibility


Criteria (O) (O) Profiles (O)

5. Regulations and 4. Program/Plan


6. Plan Types (M)
Other Details (O) Year Periods (M)

7. Options (M) 8. Plans (M) 9. Programs (M)

12. Program
11. Collapsing Life 10. Life Event
Enrollment
Events (O) Reasons (O)
Requirements (M)

Copyright Oracle Corporation, 2002. All rights reserved.

Compensation Objects
Chapter 12 - Page 6
Implementation Sequence

Implementation Sequence

13. Plan
14. Dependent 15. Variable Rates
Enrollment
Coverage (O) (O)
Requirements (O)

18. Benefits 17. Actual 16. Coverage


Elements (O) Premiums (O) Calculations (O)

19. Standard Rates 20. Reimb. Plans 21. Flex Credit


(O) (O) Calculations (O)

23.
24. Online 22. Benefits Pools
Communications
Activities (O) (O)
(O)

Copyright Oracle Corporation, 2002. All rights reserved.

Compensation Objects
Chapter 12 - Page 7
Copyright Oracle Corporation, 2002. All rights reserved.

Compensation Objects
Chapter 12 - Page 8
Introducing the
Compensation Object
Hierarchy
Chapter 13

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 1
Introducing the Compensation Object Hierarchy

Introducing the Compensation


Object Hierarchy

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 2
Building Blocks

Building Blocks

Program

Plan Type

Plan

Option

Compensation Objects

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 3
Compensation Objects

Compensation Objects

Program
A package of benefits
offerings
Vision Flex Program
Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 4
Compensation Objects

Compensation Objects

Plan Type
Broad category of
benefit plans
Medical

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Introducing the Compensation Object Hierarchy


Chapter 13 - Page 5
Compensation Objects

Compensation Objects

Plan Type

Plan
Specific benefit
offering
Aetna HMO Plan

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 6
Compensation Objects

Compensation Objects

Plan Type

Plan

Option
Coverage level
within a plan
Employee Only

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 7
Key Concepts

Key Concepts

Program
Link compensation
objects together to create
a benefits Program
hierarchy Plan Type
Plan types, plans, and
options are reusable
Plans are characterized by Plan
their plan type
Options must be in plans
Option

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 8
Compensation Object Hierarchy

Compensation Object Hierarchy

Program Vision Flex Program

Plan Types Dental Medical Life

Plans Aetna Health Net

EE Only EE Only

Options EE & Spouse EE & Spouse

EE & Child(ren) EE & Child(ren)

EE & Family EE & Family

EE & Domestic EE & Domestic


Partner Partner

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 9
Variations of the Hierarchy

Variations of the Hierarchy

Program
Not In Program

Plan Type
Plan Type In
Program

Plan In Plan
Program

Option In Plan in Option In Plan


Program

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 10
Inherited Attribution

Inherited Attribution

Program
Eligibility and other
administrative rules are
inherited by lower levels
Plan Type of the hierarchy
You can define
additional and
overriding requirements
Plan at the lower levels

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 11
Copyright Oracle Corporation, 2002. All rights reserved.

Introducing the Compensation Object Hierarchy


Chapter 13 - Page 12
Defining Program/Plan Year
Periods and Other Details
Chapter 14

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 1
Defining Program/Plan Year Periods and Other Details

Defining Program/Plan Year Periods and


Other Details

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 2
Overview

Overview

You can set up the following features for use with


plans and programs:
Program/Plan Year Periods (mandatory)
Reporting Groups
Goods and Services
Regulations
Organizations

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 3
Program and Plan Year Periods

Program and Plan Year Periods

Set up program and plan year periods to:


Record the fiscal or calendar years through which
programs and plans are in effect
Define when a plan year begins and ends for
reimbursement plans
You must attach a plan year to a planeven if you
link the plan to a program

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 4
Regulations

Regulations

Rules, policies, or legislation that govern a benefits


plan
Used for informational purposes or for processing
restrictions
Link regulations to reporting groups and plans

Regulations
Navigate to the Regulations window using the following path from the Navigator: Total
Compensation > General Definitions > Additional Setup > Regulations

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 5
Seeded Regulations

Seeded Regulations

Oracle HRMS seeds the following US regulations:


IRC Section 79
IRC Section 125
IRC Section 457
IRC Section 129
IRC Section 401(k)
IRC Section 403(b)
COBRA
HIPAA

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 6
Reporting Groups

Reporting Groups

Define a reporting group to group together plans


and programs for reporting purposes
Define a reporting group for:
Batch processing
System extract
Report generation
Examples:
All Medical Plans Reporting Group
Third party provider reports for premiums
All plans subject to COBRA regulations

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 7
Goods and Services

Goods and Services

Use the Goods and Services window to list items for


a plan that provides goods and services
You can link goods and services to any kind of plan
or to a reimbursement plan

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 8
Organizations

Organizations

Use the Organization window to set up


organizations affiliated with your benefits offerings
Link organizations to:
Plans and programs
Benefits suppliers to whom your enterprise owes a
monthly premium

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 9
Demonstration: Defining Program and Plan Year Periods

Demonstration: Defining Program and


Plan Year Periods

Follow the demonstration as the instructor shows


you how to set up year periods
Navigate to the Program/Plan Years window using
your local Super or HRMS Manager responsibility

(N) Total Compensation > General Definitions > Additional Setup >
Program/Plan Years

Online Help
For details on how to define a program or plan year period please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Plan Design > How To > Define
a Program or Plan Year Period

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program/Plan Year Periods and Other Details


Chapter 14 - Page 10
Defining Plan Types and
Options
Chapter 15

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 1
Defining Plan Types and Options

Defining Plan Types and Options

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 2
Plan Types

Plan Types

STD/LTD
Others
Life

Perqs
FSAs

Health
Vac
Buy/Sell
Savings

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 3
Plan Types

Plan Types

Program Vision Flex Program

Plan Types
Medical

Plans Aetna

EE Only

Options EE & Spouse

EE & Child(ren)

EE & Family
EE & Domestic
Partner

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 4
Plan Type Setup

Plan Type Setup

Use Option Types for general reporting


Health Coverage
Life Insurance Coverage
Compensation Categories further classify the
benefits offered by the plan type for reporting
purposes
Set the minimum and maximum number of plans in
the plan type in which a person can enroll

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 5
Plan Type Setup for Self-Service

Plan Type Setup for Self-Service

For plans where a manager initiates an employee


distribution (such as spot bonuses or housing
allowances) you must select an option type of
Individual Compensation Distribution
Configure the display of self-service plans and
options in the plan type
Vertical enables multiple plans in a plan type
Also used for plans with many options, such as life
insurance
Horizontal limits enrollment to 1 plan per plan type
Used for medical, dental, and vision plans

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 6
Practice: Defining Plan Types

Practice: Defining Plan Types

Follow the demonstration, or use the notes


provided, to define a plan type
Navigate to the Plan Types window using your local
Super or HRMS Manager responsibility

(N) Total Compensation > Programs and Plans > Plan Types

Online Help
For details on how to define a plan type please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Plan Design > How To > Define
Plan Types

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 7
Options

Options

Program Vision Flex Program

Plan Types
Medical

Plans Aetna

EE Only

Options EE & Spouse

EE & Child(ren)

EE & Family
EE & Domestic
Partner

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 8
Option Setup

Option Setup

Link the option to one or more plan types to restrict


which plans can use the options
If necessary, enter a required period of enrollment
for participants who elect this option
Use designation requirements to restrict option
coverage to particular kinds of personal contacts

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 9
Waive Options

Waive Options

Define a waive option to represent the waiver of


coverage in a plan
Typically used for life insurance plans when you can
select more than one plan in a plan type
You must use waive options for plan types with a
vertical Self-Service display

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 10
Practice: Defining Options

Practice: Defining Options

Follow the demonstration, or use the notes


provided, to define options
Navigate to the Options window using your local
Super or HRMS Manager responsibility

(N) Total Compensation > Programs and Plans > Options

Online Help
For details on how to define options please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Plan Design > How To > Define
Options

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 11
Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plan Types and Options


Chapter 15 - Page 12
Defining Plans
Chapter 16

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 1
Defining Plans

Defining Plans

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 2
Plans

Plans

Program Vision Flex Program

Plan Types
Medical

Plans Aetna

EE Only

Options EE & Spouse

EE & Child(ren)

EE & Family
EE & Domestic
Partner

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 3
Key Concepts

Key Concepts

Plan year periods must be attached to the plan


Plans in program versus plans not in program
Plan types, options, and eligibility profiles
associated with plan
Reporting groups and organizations
Waive plans
Special plan requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 4
Plans Window - General Tab

Plans Window - General Tab

Select a plan status of Active in most instances


The application only processes active plans
Link the plan to its plan type
Indicate if you include the plan in a program
Check the Savings Plan field if you enroll
participants in this plan using the Savings Plan
window
Plans which use the Savings Plan window cannot be in
a program

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 5
Plans Window - Eligibility Rates Tab

Plans Window - Eligibility Rates Tab

Track ineligible participants during eligibility batch


processes (optional)
You can base plan eligibility or activity rates on a
persons primary assignment or the total of all
derived factors across all assignments

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 6
Plans Window - Restrictions Tab

Plans Window - Restrictions Tab

For Advanced Benefits implementations, check the


Flex Credits Plan field if this is the plan that stores
net or total flex credits for all allocated flex credits
Check the Waive Plan field to create a waive plan
For self-service, check this field when a participant can
enroll in a minimum of 1 and a maximum of 1 plan in a
plan type.
You must also select a Self-Service Display of
Horizontal for the plan type.

Plans Window Restrictions Tab


For self-service, a waive plan is needed when using a Plan Type with a Self-Service Display of
Horizontal. This display is for plan types such as medical, dental, and vision when the
maximum number of plans a person can elect in a plan type is 1.
Due to the limitations of radio buttons in the Self-Service user interface, you must provide a
waive plan when the plan type display is horizontal. If the participant elects a plan or option in
a plan, the radio buttons provide no means of de-selecting the plan or option in plan unless the
participant elects another compensation object in the plan type.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 7
Waive Plans

Waive Plans

If a plan represents the waiver of coverage, you can:


Select valid waive reasons
Control the certification required to waive coverage
Advanced Benefits customers can suspend the waiver
of coverage if the participant does not provide
required certification

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 8
Plans Window - Participation Tab

Plans Window - Participation Tab

Define the maximum waiting period for a plan


regardless of a life event
Use the Maintain Plan Eligibility window to define
the minimum waiting period for a plan

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 9
Plans Window - Not in Program Tab

Plans Window - Not in Program Tab

Set up additional plan features if the plan usage is not


in program
Establish the currency of the not in program plan
Set the activity reference period

Not In Program

Plan

Option In Plan

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 10
Plans Not in Program

Plans Not in Program

Use a plan not in program when:


Enrollment can take place at any time
Limited enrollment restrictions exist for the plan
The plan exists independently from other plans
You administer Individual Compensation
Distribution plans or savings plans

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 11
Maintaining Plan Related Details

Maintaining Plan Related Details

You can link the following items to a plan:


Plan Year Periods (required)
Reporting Groups
Goods and Services
Regulations
Organizations
Link the organization that represents a supplier to
whom your enterprise owes a monthly premium.
From the Plans window, choose the Details button
to record these items

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 12
Link Options to Plans

Link Options to Plans

Link the options you defined to the appropriate plan


Enter option sequence numbers in the order they
should appear in an enrollment window
For Advanced Benefits users, option sequences also
control interim coverage for suspended elections
Indicate if you track ineligible participants, or if you
can override eligibility results for the option in plan
Optional: Set dependent eligibility checks

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 13
Plan Eligibility Requirements

Plan Eligibility Requirements

Define participation start and end dates relative to


the qualifying life event
As of Event
First of Month On or After Event
If applicable, set a participation waiting period
If applicable, set a maximum enrollment period
Advanced Benefits customers can determine waiting
periods and maximum enrollment periods based on a
life event

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 14
Link the Eligibility Profile to the Plan

Link the Eligibility Profile to the Plan

Link the participant eligibility profile you defined to


the plan or option in plan
Indicate if the profile is required

Profiles Program

Plan Type

Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 15
Link Life Event Reasons to the Plan (Advanced Benefits)

Link Life Event Reasons to the Plan


(Advanced Benefits)

Life event eligibility overrides eligibility based on


eligibility profiles
Participation start/end dates, waiting periods, and
maximum enrollment periods can vary based on a
life event

Profile = Eligible Plan


Life Event =
New Hire
Waiting Period EE Only
= 90 Days

EE+Spouse

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 16
Practice: Defining Plans

Practice: Defining Plans

Follow the demonstration, or use the notes


provided, to define plans
Navigate to the Plans window using your local
Super or HRMS Manager responsibility

(N) Total Compensation > Programs and Plans > Plans

Online Help
For details on how to define a plan please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Plan Design > How To > Define
Plans > Define a Benefits Plan

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 17
Copyright Oracle Corporation, 2002. All rights reserved.

Defining Plans
Chapter 16 - Page 18
Defining Programs
Chapter 17

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 1
Defining Programs

Defining Programs

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 2
Program

Program

Program Vision Flex Program

Plan Types
Medical

Plans Aetna

EE Only

Options EE & Spouse

EE & Child(ren)

EE & Family
EE & Domestic
Partner

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 3
Key Concepts

Key Concepts

Program year periods


Currency type
Rate frequency
Plan types and plans associated with program
Eligibility profiles
Organizations and reporting groups

Vision
Program

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 4
Programs

Programs

Use programs for:


Plans and options with similar enrollment timing
Efficient processing of compensation objects
Compensation objects with the same currency and
rate determination
Employee populations with similar traits (active and
retired, for example)
Self-Service enrollments for plans in program

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 5
Program Window - General Tab

Program Window - General Tab

Select a program status of Active in most instances


The application only processes active programs
Select the program type to indicate the enrollment
window used to process elections:
Other, Core, COBRA (Non-Flex Program)
Flex, Flex Plus Core, COBRA with Credits (Flex
Program)

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 6
Program Window - General Tab

Program Window - General Tab

Set the currency type for all compensation objects


in the program
The activity reference period is the time period in
which the application expresses rates in the
professional user interface enrollment windows
The application assigns rates and credits to a
participant based on payroll periodicity
Enrollment frequency is the activity rate
communicated to participants, such as through
Self-Service

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 7
Maintaining Program Details

Maintaining Program Details

As with plans, you link the following items to


programs:
Plan Year Periods (required)
Reporting Groups
Organizations

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 8
Linking Plan Types and Plans to a Program

Linking Plan Types and


Plans to a Program

Link the plan types and plans you defined to the


appropriate program
Enter plan sequence numbers in the order they
should appear in an enrollment window
Each plan and plan type in program must have a
status of Active
Program

Plan Type

Plan

Linking Plan Types and Plans to a Program


Choose the Plan and Plan Types button on the Programs window to link these compensation
objects to a program. When you link a plan to a program, you must also link the corresponding
plan type (with an active status) to the program. If you do not, your program structure will be
incomplete and the application will not evaluate the plans in that plan type.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 9
Program Participation Eligibility

Program Participation Eligibility

Participation eligibility functions the same at the


program level
Define participation start and end dates
Set a participation waiting period
Set a maximum enrollment period (US COBRA)
Link eligibility profiles to the program
You can also set eligibility requirements for plan
types and plans in the program
As with plans, Advanced Benefits customers can
override eligibility results based on a life event

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 10
Link Life Event Reasons to the Program (Advanced Benefits)

Link Life Event Reasons to the Program


(Advanced Benefits)

Life event eligibility overrides eligibility based on


eligibility profiles
Participation start/end dates, waiting periods, and
maximum enrollment periods can vary based on a
life event

Profile = Eligible COBRA


Life Event = Program
Termination
Maximum EE Only
Enrollment =
18 Months
EE+Spouse

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 11
View Program Structure

View Program Structure

Program Vision Flex Program

Plan Types
Medical

Plans Aetna

EE Only

Options EE & Spouse

EE & Child(ren)

EE & Family
EE & Domestic
Partner

View Program Structure


Use the View Program Structure window to ensure that your compensation object hierarchy is
complete once you have finished defining your compensation objects. For example, if you
forget to link a plan type to a program, the plans in that plan type will not display in the
program structure.
You can navigate to the compensation object definition windows by highlighting the
appropriate compensation object and selecting the traffic signal icon.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 12
Practice: Defining Programs

Practice: Defining Programs

Follow the demonstration, or use the notes


provided, to define a program
Navigate to the Programs window using your local
Super or HRMS Manager responsibility

(N) Total Compensation > Programs and Plans > Programs

Online Help
For details on how to define a program please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Plan Design > How To > Define
Programs > Define a Benefits Program

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 13
Copyright Oracle Corporation, 2002. All rights reserved.

Defining Programs
Chapter 17 - Page 14
Summary
Chapter 18

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 18 - Page 1
Summary

Summary

In this module, you should have learned how to:


Structure your total compensation offerings using
compensation objects
Use and define options, plans, plan types, and
programs
Group compensation objects into a hierarchy
Associate eligibility profiles to compensation
objects

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 18 - Page 2
Life Events
Chapter 19

Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 1
Life Events

Life Events

Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 2
Overview

Overview

A Life Event is any change to a person that


potentially impacts their compensation and benefits.

Open Enrollment
Gain a Dependent
New Hire
Death

Marriage
Salary Change Job Change

Termination Address Change

Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 3
Overview

Overview

You administer benefits in Oracle HRMS based on life


events, such as:
New hire
Assignment change
Marriage or dependent gain
Open enrollment
Loss of eligibility
Salary increase

Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 4
Overview

Overview

Life events determine key benefits processes:


When the application processes a person
Participant enrollment eligibility and electability
Changes to enrollment or de-enrollment
Coverage start and end dates
Changes to rates, coverages, premiums, flex credits,
and imputed earnings
Required communications
Automatic and default enrollments

Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 5
Topics

Topics

The Life Events module contains the following topics:


Defining Life Events
Defining Collapsing Life Events
Linking Life Events to Compensation Objects

Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 6
Objectives

Objectives

After completing this module, you should be able to do


the following:
Define various kinds of life event reasons
Understand how the application detects and
processes life events
Administer the occurrence of multiple life events for
a participant
Link life events to compensation objects to control a
variety of business rules

Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 7
Implementation Sequence

Implementation Sequence

1. Eligibility 2. Derived Factors 3. Eligibility


Criteria (O) (O) Profiles (O)

5. Regulations and 4. Program/Plan


6. Plan Types (M)
Other Details (O) Year Periods (M)

7. Options (M) 8. Plans (M) 9. Programs (M)

12. Program
11. Collapsing Life 10. Life Event
Enrollment
Events (O) Reasons (O)
Requirements (M)

Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 8
Implementation Sequence

Implementation Sequence

13. Plan
14. Dependent 15. Variable Rates
Enrollment
Coverage (O) (O)
Requirements (O)

18. Benefits 17. Actual 16. Coverage


Elements (O) Premiums (O) Calculations (O)

19. Standard Rates 20. Reimb. Plans 21. Flex Credit


(O) (O) Calculations (O)

23.
24. Online 22. Benefits Pools
Communications
Activities (O) (O)
(O)

Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 9
Copyright Oracle Corporation, 2002. All rights reserved.

Life Events
Chapter 19 - Page 10
Defining Life Events
Chapter 20

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 1
Defining Life Events

Defining Life Events

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 2
Life Event Types - Explicit

Life Event Types - Explicit

Explicit life events - changes to a persons


HR record

HRMS
New Hire Salary Change
database

Transfer Death
Address Change

Marriage Termination Gain a Dependent

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 3
Life Event Types - Temporal

Life Event Types - Temporal

Temporal life events - occur due to the passage of time


or a derived factor boundary

Age Changed

Maximum
Enrollment Period Length of Service Changed

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 4
Life Event Types - Scheduled

Life Event Types - Scheduled

Scheduled life events - assigned by an administrator


as a batch process

Open Enrollment

Administrative
Enrollment

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 5
Seeded Life Events

Seeded Life Events

The application delivers many seeded life events for


handling common person changes. Including:
Temporal events, such as change in age or length of
service
Open enrollment
Hours worked in period
Non or late payment
Note: Seeded life events have predefined
characteristics and must not be modified.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 6
Life Event Detection

Life Event Detection

Life events can be . . .


Detected through a database change (explicit)
Created during a batch process (scheduled or
temporal)
Triggered manually using the Person Life Events
window

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 7
Potential Life Events

Potential Life Events

Potential life events notify the application to


process a person on the occurred on date
The Participation Process evaluates a potential
event for a person if:
The status is detected or unprocessed, and
The effective date of the process is equal to or greater
than the occurred date
You can void a potential life event

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 8
Active Life Events

Active Life Events

A detected life event is considered potential until


processed by the application, then it becomes
active
Active events have a status of started
Once an enrollment has been closed, the life event
status is updated to processed
Active events that have been processed can be
re-opened
You can back out an active life event with a status
of either started or processed

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 9
Life Event Dates

Life Event Dates

Life event reasons are datetracked


You can restrict how the application processes a
potential life event after a specified number of days
or a year period has passed (timeliness)
Process potential life event manually
Void potential life event

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 10
Life Event Occurred Date

Life Event Occurred Date

The life event occurred date is the basis for most


Advanced Benefits date codes. It specifies:
The date the Participation Process processes a
person
The date the Participation Process evaluates your
plan design
The date from which participation, coverage, rate,
and derived factor date codes are calculated

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 11
Person Changes and Related Person Changes

Person Changes and Related


Person Changes

Person changes are changes in system data that


indicate a participant has experienced a given life
event.
Causes related person changes indicate that a life
event experienced by the participant may cause a
life event for the participants personal contact.
Related person changes indicate that a change to
personal contact data may cause a life event for the
participant.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 12
Defining a Person Change Single Database Column

Defining a Person Change


Single Database Column

Life Event Defined by


Marriage Table: PER_ALL_PEOPLE_F
Column: Marital_Status

Old Value: any value


New Value: married

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 13
Defining a Person Change Multiple Database Columns

Defining a Person Change


Multiple Database Columns

Life Event Defined by


Job Location Table: PER_ALL_ASSIGNMENTS_F
Column: Assignment_Type
Change Old Value: any value

New Value: employee assignment

Table: PER_ALL_ASSIGNMENTS_F

Column: Location_ID

Old Value: any value


New Value: any value

Defining a Person Change


Table and column titles can be found in the eTRM on MetaLink.
The application has a defined list of table and column changes that will be detected. Not all
tables are available for life event person changes. You can select the list of values for the
Table Name and Column Name fields to view the available tables and columns.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 14
FastFormula Rules for Person Changes

FastFormula Rules for Person Changes

If necessary, you can write a rule to determine when a


person change occurs.
For example, you can specify that the Married
person change occurs only when an individuals
person type is Employee or Contact and not
Applicant.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 15
Causes Related Person Life Events

Causes Related Person Life Events

Life Event Related Person Life Event

Divorce Loss of Coverage


(of employee participant) (for dependent spouse)

Causes Related Person Life Events


A life event experienced by the participant may cause a life event for a participants personal
contact.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 16
Related Person Life Events

Related Person Life Events

Dependent Data Change Participant Life Event

Loss of Coverage Dependent Loss of Coverage (for


(of dependent) employee participant)

Related Person Life Events


A dependent can experience a data change that triggers a life event for the dependents
participant.
The corresponding FastFormula Type is called Related Person Change Causes Life Events.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 17
Overriding Life Events

Overriding Life Events

When you define a life event, you can specify


whether it will be the overriding or winning life
event during a collision
When there is a life event collisionthat is, two or
more life events occur on the same daythe event
with the override field checked is the winner
Define a collapsing life event if you can have
multiple life event winners

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 18
Overriding Life Events: Example

Overriding Life Events: Example

Winner

April 1 April 1
New Hire Address Change

Override Override

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 19
Implementation Considerations

Implementation Considerations

The database triggers a life event when data passes


through the API (either from a user enterable
window or from a data load)
Link life event reasons to compensation objects
AFTER the initial HR people data has been loaded
into the application

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 20
Practice: Defining a Life Event Reason

Practice: Defining a Life Event Reason

Follow the demonstration as the instructor shows


you how to set up a life event reason
Navigate to the Life Event Reasons window using
your local Super HRMS Manager responsibility

(N) Total Compensation > General Definitions > Additional Setup >
Life Event Reasons

Online Help
For details on how to define life event reasons please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Life Events and Benefits Batch
Processes > How To > Define General Characteristics

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 21
Copyright Oracle Corporation, 2002. All rights reserved.

Defining Life Events


Chapter 20 - Page 22
Defining Collapsing Life
Events
Chapter 21

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Collapsing Life Events


Chapter 21 - Page 1
Defining Collapsing Life Events

Defining Collapsing Life Events

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Collapsing Life Events


Chapter 21 - Page 2
Collapsing Life Events

Collapsing Life Events

You define a collapsing life event when two or more


detected life events should:
Result in a different life event, or
Void the detected life events
You can process only one life event for a person per
day

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Collapsing Life Events


Chapter 21 - Page 3
Collapsing Life Events

Collapsing Life Events

As a prerequisite, first define the life events youll


include in the collapsing life event
The resulting life event determines the enrollment
opportunities

June 1 June 1
Marriage + Address Change = ?

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Collapsing Life Events


Chapter 21 - Page 4
Setting Up Collapsing Life Events

Setting Up Collapsing Life Events

Use And/Or logic to select the combination of life


events
Enter a tolerance period to indicate the number of
days the application considers when evaluating the
collapsing life event definition
You can define the resulting live event occurred
date based on the dates of:
The original life events, or
The date of the application process that detects the life
events

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Collapsing Life Events


Chapter 21 - Page 5
Collapsing Life Events

Collapsing Life Events

Tolerance period = 5 days


Replace with
June 5 Marriage with
June 1 June 5 Move
and Batch
Joe gets Joe moves Process Life Event
married Occurred Date
June 1

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Collapsing Life Events


Chapter 21 - Page 6
Practice: Defining a Collapsing Life Event

Practice: Defining a Collapsing Life Event

Follow the demonstration as the instructor shows


you how to set up a collapsing life event
Navigate to the Life Event Reasons window using
your local Super HRMS Manager responsibility

(N) Total Compensation > General Definitions > Additional Setup >
Life Event Reasons

Online Help
For details on how to define a collapsing life event please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Life Events and Benefits Batch
Processes > How To > Define a Collapsing Life Event

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Collapsing Life Events


Chapter 21 - Page 7
Copyright Oracle Corporation, 2002. All rights reserved.

Defining Collapsing Life Events


Chapter 21 - Page 8
Linking Life Events to
Compensation Objects
Chapter 22

Copyright Oracle Corporation, 2002. All rights reserved.

Linking Life Events to Compensation Objects


Chapter 22 - Page 1
Linking Life Events to Compensation Objects

Linking Life Events to


Compensation Objects

Copyright Oracle Corporation, 2002. All rights reserved.

Linking Life Events to Compensation Objects


Chapter 22 - Page 2
Life Event Reasons and Compensation Objects

Life Event Reasons and


Compensation Objects

Link life event reasons to compensation objects to


enforce specific business rules

Program

Plan Type
Life
Event
Marriage Plan

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Linking Life Events to Compensation Objects


Chapter 22 - Page 3
Life Events Usage

Life Events Usage

Life events control enrollment requirements, such as:


Electability
Participant activity rate start and end dates
Participant and dependent coverage start and end
dates
Certifications
Enrollment defaults
Waiting periods
Maximum enrollment periods

Copyright Oracle Corporation, 2002. All rights reserved.

Linking Life Events to Compensation Objects


Chapter 22 - Page 4
Life Events Versus Eligibility Profiles

Life Events Versus Eligibility Profiles

Define life events in context with eligibility profiles and


compensation objects

Life Eligibility Compensation


Events Profiles Objects

Copyright Oracle Corporation, 2002. All rights reserved.

Linking Life Events to Compensation Objects


Chapter 22 - Page 5
Life Events Versus Eligibility Profiles

Life Events Versus Eligibility Profiles

Life event eligibility overrides eligibility based on


eligibility profiles

Profile = Eligible Plan

EE Only
Life Event
Divorce, Ineligible
EE+Spouse

Copyright Oracle Corporation, 2002. All rights reserved.

Linking Life Events to Compensation Objects


Chapter 22 - Page 6
Impact on Eligibility and Enrollment

Impact on Eligibility and Enrollment

When the Participation process detects and evaluates


a life event, the application examines the
compensation hierarchy for eligibility and electable
choices

Participation Process
Eligibility
Data Change and
Electability

Copyright Oracle Corporation, 2002. All rights reserved.

Linking Life Events to Compensation Objects


Chapter 22 - Page 7
Practice: Linking a Life Event Reason to a Compensation Object

Practice: Linking a Life Event Reason to a


Compensation Object

Follow the demonstration as the instructor shows


you how to link a life event reason to a
compensation object
Navigate to the Programs window using your local
Super HRMS Manager responsibility

(N) Total Compensation > Programs and Plans > Programs

Online Help
For details on how to link life event reasons to compensation objects please refer to the online
Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Plan Design > How To > Define
Programs > Associate a Life Event Reason

Copyright Oracle Corporation, 2002. All rights reserved.

Linking Life Events to Compensation Objects


Chapter 22 - Page 8
Summary
Chapter 23

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 23 - Page 1
Summary

Summary

In this module, you should have learned how to:


Define life events
Define collapsing life events
Link life events to compensation objects

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 23 - Page 2
Benefits Enrollment
Requirements
Chapter 24

Copyright Oracle Corporation, 2002. All rights reserved.

Benefits Enrollment Requirements


Chapter 24 - Page 1
Benefits Enrollment Requirements

Benefits Enrollment Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Benefits Enrollment Requirements


Chapter 24 - Page 2
Introduction

Introduction

You define enrollment requirements to:


Restrict electability of compensation objects
Schedule enrollment periods
Set up coverage and rate start and end dates
Link life events to compensation objects to enable
an enrollment change
Manage enrollment certifications
Create interim coverage's for suspended elections
Configure participant action items

Copyright Oracle Corporation, 2002. All rights reserved.

Benefits Enrollment Requirements


Chapter 24 - Page 3
Enrollment Requirements and Plan Design

Enrollment Requirements and Plan Design

Eligibility profiles, life events, and enrollment


requirements work together

Compensation Objects

Eligibility Profiles Life Events (OAB) Enrollment Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Benefits Enrollment Requirements


Chapter 24 - Page 4
Topics

Topics

Benefits Enrollment Requirements contains the


following topics:
Introducing Enrollment Requirements
Defining Program and Plan Enrollment
Requirements
Setting up Action Items and Certifications
Managing Suspended Elections and Interim
Coverages

Copyright Oracle Corporation, 2002. All rights reserved.

Benefits Enrollment Requirements


Chapter 24 - Page 5
Objectives

Objectives

After completing this module, you should be able to do


the following:
Define enrollment requirements to restrict benefits
electability
Understand the different enrollment types
Set up coverage and rate start and end dates
Restrict enrollment changes by life event
Manage enrollment certifications
Create interim coverages for suspended elections

Copyright Oracle Corporation, 2002. All rights reserved.

Benefits Enrollment Requirements


Chapter 24 - Page 6
Implementation Sequence

Implementation Sequence

1. Eligibility 2. Derived Factors 3. Eligibility


Criteria (O) (O) Profiles (O)

5. Regulations and 4. Program/Plan


6. Plan Types (M)
Other Details (O) Year Periods (M)

7. Options (M) 8. Plans (M) 9. Programs (M)

12. Program
11. Collapsing Life 10. Life Event
Enrollment
Events (O) Reasons (O)
Requirements (M)

Copyright Oracle Corporation, 2002. All rights reserved.

Benefits Enrollment Requirements


Chapter 24 - Page 7
Implementation Sequence

Implementation Sequence

13. Plan
14. Dependent 15. Variable Rates
Enrollment
Coverage (O) (O)
Requirements (O)

18. Benefits 17. Actual 16. Coverage


Elements (O) Premiums (O) Calculations (O)

19. Standard Rates 20. Reimb. Plans 21. Flex Credit


(O) (O) Calculations (O)

23.
24. Online 22. Benefits Pools
Communications
Activities (O) (O)
(O)

Copyright Oracle Corporation, 2002. All rights reserved.

Benefits Enrollment Requirements


Chapter 24 - Page 8
Introducing Enrollment
Requirements
Chapter 25

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 1
Introducing Enrollment Requirements

Introducing Enrollment Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 2
Key Concepts

Key Concepts

Enrollment requirements answer key questions, such


as:
How does a person enroll in a plan or option?
When can a person enroll and when do coverage
and rates begin?
What life events limit election changes?
How do required certifications and action items
affect a participants elections?

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 3
Enrollment Methods

Enrollment Methods

Enrollment requirements determine how an eligible


participant enrolls in a compensation object:
Explicitly
Automatically

Enrollment Methods
Explicit: Any enrollment that is not made automatically or defaulted by the application. The
participant must make an election or receive the default (if a default is defined).
Automatic: The enrollment is processed without the participants explicit election. Automatic
enrollment only applies if the choice is electable. Participants who want to de-enroll from an
automatic enrollment must do so explicitly (pending any restrictions such as required
enrollment periods).

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 4
Enrollment Codes

Enrollment Codes

Enrollment codes control electability based on


whether a participant is currently or newly enrolled
For currently enrolled participants, restrictions
include:
Keep current election or choose new election
Keep Only
Choose Only
Lose Only
Newly enrolled participants can choose new
elections or be allowed to choose nothing

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 5
Default Enrollments

Default Enrollments

Default enrollments provide another way to enroll


participants into compensation objects
Used if the participant does not specify an election
during the enrollment period
Assigned by the Default Enrollment process
If an option is a default, the options plan must also
be the default

Default Enrollments
You can have more than one default plan or option if eligibility differs between the
compensation objects.

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 6
Enrollment Timing

Enrollment Timing

Enrollment requirements determine when an eligible


participant can make or alter an election based on a
life event:
Enrollment period start and end dates
Coverage and rate start and end dates (by life event)
Dates to apply default elections
Close enrollment dates

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 7
Coverage and Rate Dates

Coverage and Rate Dates

Date codes control when enrollment coverage and


rates (often an element entry) begin and end for a
compensation object
You can vary the dates based on a life event
Common start codes include:
Event, First of Month, First of Next Month
Common end codes include:
1 Day Before Event, 1 Prior or End of Month

Coverage and Rate Dates


Coordinate the setup of your start and end date codes so that subsequent enrollments do not
overlap. Start and end date codes use the occurred on date of the qualifying life event to
determine the date that coverage and rates start and end.
Example
Coverage/Rates start: Event
Coverage/Rates end: 1 Day Before Event
A new hire event happens 01-FEB-2003. Person elects health care Plan A, Employee Only
option. Coverage and rates begin 01-FEB-2003. Coverage and rate end date is end-of-time.
Gain Dependent life event occurs 01-MAY-2003. Person elects health care Plan A, Employee
Plus One. Coverage and rates begin 01-MAY-2003. Plan A, Employee Only option coverage
and rates are end-dated 30-APR-2003.
Using such a combination of coverage/rate start and end date codes prevents overlapping
coverage and rates.

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 8
Enrollment Types

Enrollment Types

Enrollment types determine how the application


processes enrollments:
Unrestricted
No life events or enrollment periods
Open
Predefined enrollment period
Life event
A life event determines enrollment changes
Administrative
For mid-year plan design changes

Enrollment Types
Unrestricted enrollments and life event enrollments are mutually exclusive. Do not define life
events for compensation objects for which you use the unrestricted enrollment type.

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 9
The Participation Process

The Participation Process

The Participation Process evaluates the components


of benefits electability for:
Enrollment or de-enrollment
Enrollment periods
Coverage and rate start and end dates
Life event changes
Required periods of enrollment
Default enrollment codes
Automatic enrollments

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 10
Enrollment Hierarchies

Enrollment Hierarchies

Enrollment hierarchies control the order in which


the Participation Process evaluates the
compensation object hierarchy for electability
Set up your enrollment requirements at the
appropriate level based on the hierarchies
You define general enrollment requirements at the
highest applicable level
Enrollment requirements set at a lower level in the
hierarchy prevail over requirements set at a higher
level

Enrollment Hierarchies
Enrollment hierarchies work from the lowest level up; eligibility hierarchies work from the top
level down. Please note the numbering in the slides that follow.

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 11
Enrollment Hierarchies

Enrollment Hierarchies

Enrollment Method and Enrollment Codes


1. Option in Plan by Life Event
2. Plan not in Program by Life Event
3. Plan in Program by Life Event
4. Plan Type in Program by Life Event
5. Program by Life Event
6. Option in Plan
7. Plan not in Program
8. Plan in Program
9. Plan Type in Program
10. Program

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 12
Enrollment Hierarchies

Enrollment Hierarchies

Coverage and Rate Start/End Date codes


1. Plan not in Program by Life Event
2. Program by Life Event
3. Plan not in Program
4. Plan in Program
5. Plan Type in Program
6. Program
Enrollment Periods
1. Plan Level
2. Program Level

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 13
Enrollment Hierarchies

Enrollment Hierarchies

Life Event Changes


1. Option in Plan
2. Plan Not in Program
3. Plan in Program
4. Plan Type
Required Period of Enrollment
1. Option in Plan
2. Option
3. Plan
4. Plan Type in Program

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 14
Enrollment Hierarchies

Enrollment Hierarchies

Default Enrollment Codes


1. Option in Plan
2. Plan Not in Program
3. Plan in Program
4. Plan Type in Program
Automatic Enrollment
1. Option in Plan
2. Plan in Program

Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 15
Copyright Oracle Corporation, 2002. All rights reserved.

Introducing Enrollment Requirements


Chapter 25 - Page 16
Defining Program and Plan
Enrollment Requirements
Chapter 26

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 1
Defining Program and Plan Enrollment Requirements

Defining Program and Plan


Enrollment Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 2
Defining Enrollment Requirements

Defining Enrollment Requirements

Link enrollment requirements to compensation


objects:
Use the Program Enrollment Requirements window
for:
Programs, plan types, plans in program
Use the Plan Enrollment Requirements window for:
Plans not in program, options in plan

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 3
Program Enrollment Requirements

Program Enrollment Requirements

Use the Program Enrollment Requirements window to


define:
Enrollment methods
Enrollment codes*
Enrollment coverage start and end dates
Scheduled and qualifying life event enrollment
periods as well as changes due to life events
Default enrollments
Program and plan type in program dependent
designation requirements

Program Enrollment Requirements


Enrollment codes restrict a participants electable choices based on whether the participant is
currently enrolled in the compensation object for which you are defining enrollment
requirements.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 4
Plan Enrollment Requirements

Plan Enrollment Requirements

Use the Plan Enrollment Requirements window to


define the same features as at the program level,
plus:
Option enrollment restrictions and defaults
Coverage limitations and interim coverage
Beneficiary designation requirements
Certifications for:
Plans, options in plan, and life events
Plan enrollment requirements override information
defined on the Program Enrollment Requirements
window

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 5
Layout of Enrollment Requirements Window

Layout of Enrollment
Requirements Window

General Tab
Electability and enrollment determination regardless of
life event
Timing Tab
Scheduled enrollments
Life event enrollment dates
Life Events Tab
Enrollment change restrictions by life event
Dependent/Designations Tab
Dependents and beneficiary coverages

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 6
General Enrollment Requirements

General Enrollment Requirements

General Tab, Program Tab


Enrollment method: explicit or automatic
Unrestricted enrollment type
Enrollment code
Current, Can Keep or Choose; New, Can Choose
Current, Keep only; New, Nothing
Coverage and rate start and end date codes

General Enrollment Requirements


For a program or a plan not in program, you must choose either to allow unrestricted
enrollments or to process enrollments based on life events. You cannot switch back and forth.
However, you can define unrestricted enrollments and then later change your plan design to
require enrollment processing based on life events by turning off unrestricted enrollments.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 7
General Enrollment Requirements

General Enrollment Requirements

General Tab, Plan Type Tab


Restrictions for life insurance plan types
Minimum or maximum number of plans in which a
participant can be enrolled in the plan type
Required period of enrollment for all plans in the plan
type
Requirements entered here override general
program enrollment requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 8
General Enrollment Requirements

General Enrollment Requirements

General Tab, Plan Tab


Set all the same restrictions as at the program level
(optional)
Indicate if the plan is the default for the program
Requirements entered here override program and
plan type in program enrollment requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 9
Timing Enrollment Requirements - Scheduled

Timing Enrollment
Requirements - Scheduled

Timing Tab, Scheduled Tab


Timing controls when an election can occur
Set up an open or administrative enrollment period
Indicate when to assign default elections
Determine when the application considers a
participants enrollment as closed
Coverage and rate start and end date codes
Overrides general program, plan type in program,
and plan in program enrollment requirements for the
specific event

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 10
Timing Enrollment Requirements - Life Event

Timing Enrollment Requirements -


Life Event

Timing Tab, Life Event Tab


Attach the life event to the program
Set up an enrollment period based on a life event
Indicate when to assign default elections
Determine when the application considers a
participants enrollment as closed
Coverage and rate start and end date codes
Overrides general program, plan type in program, and
plan in program enrollment requirements for the
specific event

Timing Enrollment Requirements Life Event


When you process a life event, the Participation Process always checks for participant and
dependent eligibility. However, the process only checks the enrollment requirements if you
attach a life event to the Timing tab of the compensation object.
If the program allows unrestricted enrollments, leave all fields on the Timing tab blank.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 11
Life Event Change Requirements

Life Event Change Requirements

Life Event Tab, Program Tab


General requirements for a specific life event
Indicate if a participants current election precludes an
enrollment change based on the life event
Indicate if eligibility for the current election prevents
an enrollment change based on the life event
Set the enrollment method, enrollment code, and
default for the life event
Override program enrollment requirements for a
specific life event

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 12
Life Event Change Requirements

Life Event Change Requirements

Life Event Tab, Plan Type and Plan Tabs


For plan types and plans, indicate if the life event
enables a change for a plan or option, or both plan and
option
Set enrollment change restrictions for a life event as
you did at the program level
For plans, indicate if the plan is the default
Overrides general program, plan type in program,
and plan in program enrollment requirements for the
specific event

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 13
Plan Enrollment Requirements

Plan Enrollment Requirements

Use the Plan Enrollment Requirements window to


set enrollment restrictions for:
Plans
Plans not in program
Options in plan
Check the Enroll in Plan and Option field for plans
(such as a Savings plan) where the participant
enrolls in both the plan and one or more options

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 14
Practice: Defining Program Enrollment Requirements

Practice: Defining Program


Enrollment Requirements

Follow the demonstration, or use the notes


provided, to define enrollment requirements for a
program
Navigate to the Program Enrollment Requirements
window using your local Super or HRMS Manager
responsibility

(N)Total Compensation > Programs and Plans > Program


Enrollment Requirements

Online Help
For details on how to define program enrollment requirements please refer to the online Help
path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Benefits Enrollment
Requirements > How To > Define Program Enrollment Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 15
Practice: Defining Plan Enrollment Requirements

Practice: Defining Plan


Enrollment Requirements

Follow the demonstration, or use the notes


provided, to define enrollment requirements for a
savings plan
Navigate to the Plan Enrollment Requirements
window using your local Super or HRMS Manager
responsibility

(N)Total Compensation > Programs and Plans > Plan Enrollment


Requirements

Online Help
For details on how to define program enrollment requirements please refer to the online Help
path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Benefits Enrollment
Requirements > How To > Define Plan Enrollment Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Program and Plan Enrollment Requirements


Chapter 26 - Page 16
Defining Action Items and
Certifications
Chapter 27

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 1
Defining Action Items and Certifications

Defining Action Items and Certifications

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 2
Overview

Overview

Actions Items are actions a participant must take to


complete an enrollment, or to designate a
dependent or beneficiary
Certifications are documentation the participant
must provide to:
Enroll or change elections as a result of a life event
Waive participation in a compensation object
Designate a dependent or beneficiary
Receive reimbursements

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 3
Action Items

Action Items

You do not explicitly link action items to a


compensation object
The application creates action items based on
enrollment requirements you define
You can set the due date by which the participant
must complete an action item

Action Items
Use the Program or Plan Enrollment Requirements window to set action item due dates.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 4
Enrollment Action Types

Enrollment Action Types

Enrollment Action Types are the kinds of action


items a participant can receive
The seeded Enrollment Action Types include:
Enrollment Certification Required
Need Additional Dependents/Beneficiaries Designated
Dependent/Beneficiary Requires Legislative Identifier
Dependent/Beneficiary Requires Date of Birth

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 5
Action Items - Required or Optional

Action Items - Required or Optional

For dependent and beneficiary designations, you


can define optional or required action items
For required actions, the application suspends the
enrollment until the participant completes the action
The application deletes the suspended enrollment if
the action item is not completed by the due date or
before the next life event

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 6
Completing Action Items

Completing Action Items

Use the Person Enrollment Action Items window to


record when a participant completes an action
The application unsuspends the enrollment and
removes any interim coverage
If the action item is required and has an expired due
date:
The Close Unresolved Action Item process deletes the
suspended enrollment
Any interim coverage becomes the final enrollment

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 7
Certifications

Certifications

Certifications are documents required to enroll or


change elections in a compensation object
There are 5 types of certifications:
Enrollment
Dependent Coverage
Beneficiary Designation
Reimbursement
Waive Coverage

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 8
Enrollment Certifications

Enrollment Certifications

Enrollment certifications are generated during


enrollment in a plan or option
There are 3 seeded enrollment certification types:
Proof of External Coverage
Proof of Good Health
Proof of Other Coverage

Enrollment Certifications
Use the extensible Lookup Type BEN_ENRT_CTFN_TYP to add enrollment certification
types to Oracle HRMS.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 9
Link Certifications to Compensation Objects

Link Certifications to
Compensation Objects

You can link certifications to various locations in the


compensation object hierarchy
Plan
Option in Plan
Life Event Program

Plan Type
Enrollment Certification
Required
Plan
Beneficiary Requires
Certification Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 10
Completing Certifications

Completing Certifications

For compensation objects to which you attach a


certification, the application suspends the
enrollment until the participant provides the
certification
Use the Person Enrollment Certifications window to
record when a participant submits a certification
If a participant does not provide the certification
before the action item due date, the Close
Enrollments process removes the elected
enrollment

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 11
Suspended Elections and Interim Coverages

Suspended Elections and


Interim Coverages

The application suspends an enrollment if a


required action item exists for a participant
You can define interim coverage for the period that
a participants elected choice is suspended

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 12
Practice: Defining an Action Item Due Date

Practice: Defining an Action Item Due Date

Follow the demonstration, or use the notes


provided, to establish a due date for the Dependent
Requires Date of Birth action item for a nonflex
program
Navigate to the Action Types window using your
local Super HRMS Manager responsibility

(N) Total Compensation > Programs and Plans > Program


Enrollment Requirements > (B) Action Types

Online Help
For details on how to define action item due dates please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Benefits Enrollment
Requirements > How To > Define Program Enrollment Requirements > Define an Action Item
Due Date

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 13
Practice: Attaching a Certification to a Compensation Object

Practice: Attaching a Certification to a


Compensation Object

Follow the demonstration, or use the notes


provided, to establish a required certification for
enrollment in a plan
Navigate to the Certifications window using your
local Super HRMS Manager responsibility

(N) Total Compensation > Programs and Plans > Plan Enrollment
Requirements > (B) Certifications

Online Help
For details on how to link certifications to compensation objects please refer to the online Help
path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Benefits Enrollment
Requirements > How To > Define Plan Enrollment Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Action Items and Certifications


Chapter 27 - Page 14
Managing Suspended
Elections and Interim
Coverages
Chapter 28

Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 1
Managing Suspended Elections and Interim Coverages

Managing Suspended Elections and


Interim Coverages

Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 2
Suspended Enrollments

Suspended Enrollments

The application suspends enrollment choices


pending completion of a required action item
When the action item is completed, the suspension
is removed
You can select an unsuspend enrollment code to
control the coverage and rate start dates of the
unsuspended enrollment
As of completed date
Use existing enrollment start date
Recalculate using date completed and enrollment start
date

Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 3
Suspended Enrollments

Suspended Enrollments

You set the unsuspend enrollment code using the


Coverage Restrictions window
Plan enrollment requirements window
General tab, Plan tab, Coverage alternate region

Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 4
Interim Coverage

Interim Coverage

You can define interim coverage for the period that


a participants elected choice is suspended
You can qualify the conditions under which interim
coverage is provided based on:
The participants current enrollment (if any)
The suspended election
Interim coverage is defined using the Coverage
Restrictions window on Plan Enrollment
Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 5
Interim Coverage

Interim Coverage

The Interim to Assign code refines which interim


coverage is provided based on a new or current
enrollment:
Current always same (same plan type)
Current same elected (same plan)
New
The rest of the code determines the compensation
object to assign
Next lower
Default
Min
Nothing

Interim Coverage
The current always same codes determine interim coverage if you are currently enrolled in a
plan within a plan type. The current same elected codes determine interim coverage if you
are currently enrolled in an option within a plan.

Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 6
Coverage Restrictions

Coverage Restrictions

For interim coverage, set the Restrict Change Based


On code for consistency with your plan
Select Option Restriction Applies if the plan has
options
Select Benefit Restriction Applies for plans such as
life insurance where you define a coverage range
without options

Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 7
Interim Coverage

Interim Coverage

The sequence number you assign to a plan or


option controls the interim coverage that is
assigned if you use next lower
For example:
Current same elected, next lower; new, defaults

Interim Coverage
In the above example, if a person selects an option the interim code checks for an enrollment
record for any option in the plan. If the person is not enrolled in the plan (new to the plan), the
person receives the default option for the plan.
For example, a life insurance plan has 5 options: 1x salary through 5x salary. If a person is
currently enrolled in 1x salary and elects 5x salary, the person receives interim coverage of the
next lower option, 4x salary.

Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 8
Practice: Defining Interim Coverage

Practice: Defining Interim Coverage

Follow the demonstration, or use the notes


provided, to define interim coverage for a plan
Navigate to the Coverage Restrictions window using
your local Super HRMS Manager responsibility

(N) Total Compensation > Programs and Plans > Plan Enrollment
Requirements > Certifications

Online Help
For details on how to define interim coverage for compensation objects please refer to the
online Help path:
Applications Help Library > Oracle HRMS Applications > Oracle HRMS > Oracle HRMS
Global > Setup for Standard and Advanced Benefits > Benefits Enrollment Requirements >
How To > Define Plan Enrollment Requirements > Define Enrollment Coverage Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 9
Copyright Oracle Corporation, 2002. All rights reserved.

Managing Suspended Elections and Interim Coverages


Chapter 28 - Page 10
Summary
Chapter 29

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 29 - Page 1
Summary

Summary

In this module, you should have learned how to:


Define enrollment requirements to restrict benefits
electability
Restrict enrollment changes by life event
Set up enrollment certifications
Define interim coverages for suspended elections

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 29 - Page 2
Dependent and Beneficiary
Designation
Chapter 30

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent and Beneficiary Designation


Chapter 30 - Page 1
Dependent and Beneficiary Designation

Dependent and Beneficiary Designation

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent and Beneficiary Designation


Chapter 30 - Page 2
Overview

Overview

Dependent designation setup occurs at different


levels in the application:
Personal contacts
Dependent coverage eligibility profiles
Designation requirements for plans and options
Life event changes that affect dependents
Beneficiary designation is maintained only for plans
Use the Plan Enrollment Requirements window to set
up beneficiary designation requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent and Beneficiary Designation


Chapter 30 - Page 3
Overview

Overview

As a prerequisite:
A participants contacts must be personal in order
to be evaluated for dependent eligibility
On the Contacts window, the Personal field is
automatically checked for Contacts with
relationship types of Spouse or Child
For all other contacts, an administrator must manually
check the Personal field when entering the contact
Dependent eligibility determination requires the
timely and accurate entry of contact data

Overview
The Dependent and Beneficiary fields on the Contacts window are not used for Standard or
Advanced Benefits.

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent and Beneficiary Designation


Chapter 30 - Page 4
Overview

Overview

Dependent coverage eligibility profiles determine


eligibility for a participants personal contacts
Dependent profiles act like participant profiles
Dependent designation requirements limit
dependent eligibility based on:
The minimum and maximum number of allowable
dependents in the compensation object
The familial relationship between the primary
participant and the personal contact
You set the level at which dependent eligibility and
coverage date ranges apply
Program, Plan Type, Plan

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent and Beneficiary Designation


Chapter 30 - Page 5
Topics

Topics

Dependent and Beneficiary Designation contains the


following topics:
Dependent coverage eligibility profiles
Dependent designation requirements
Beneficiary designations

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent and Beneficiary Designation


Chapter 30 - Page 6
Objectives

Objectives

After completing this module, you should be able to do


the following:
Understand how to record the personal contacts of a
participant for dependent eligibility
Set up dependent coverage eligibility profiles
Define dependent designation requirements
Link life events to compensation objects that impact
dependent designation
Set up beneficiary designation restrictions

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent and Beneficiary Designation


Chapter 30 - Page 7
Implementation Sequence

Implementation Sequence

1. Eligibility 2. Derived Factors 3. Eligibility


Criteria (O) (O) Profiles (O)

5. Regulations and 4. Program/Plan


6. Plan Types (M)
Other Details (O) Year Periods (M)

7. Options (M) 8. Plans (M) 9. Programs (M)

12. Program
11. Collapsing Life 10. Life Event
Enrollment
Events (O) Reasons (O)
Requirements (M)

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Dependent and Beneficiary Designation


Chapter 30 - Page 8
Implementation Sequence

Implementation Sequence

13. Plan
14. Dependent 15. Variable Rates
Enrollment
Coverage (O) (O)
Requirements (O)

18. Benefits 17. Actual 16. Coverage


Elements (O) Premiums (O) Calculations (O)

19. Standard Rates 20. Reimb. Plans 21. Flex Credit


(O) (O) Calculations (O)

23.
24. Online 22. Benefits Pools
Communications
Activities (O) (O)
(O)

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Dependent and Beneficiary Designation


Chapter 30 - Page 9
Copyright Oracle Corporation, 2002. All rights reserved.

Dependent and Beneficiary Designation


Chapter 30 - Page 10
Dependent Coverage
Eligibility Profiles
Chapter 31

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Dependent Coverage Eligibility Profiles


Chapter 31 - Page 1
Dependent Coverage Eligibility Profiles

Dependent Coverage Eligibility Profiles

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Dependent Coverage Eligibility Profiles


Chapter 31 - Page 2
Dependent Coverage Eligibility Profiles

Dependent Coverage Eligibility Profiles

Dependent coverage eligibility profiles restrict the


personal contacts a participant can designate for
coverage
There are five types of dependent coverage
eligibility profiles:
Relationship
Age
Status
Postal Zip
Other

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Dependent Coverage Eligibility Profiles


Chapter 31 - Page 3
Relationship Profiles

Relationship Profiles

Relationship profiles determine eligibility based on the


personal nature of the contacts relationship to the
participant:
Spouse
Child
Adopted Child, etc.

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Dependent Coverage Eligibility Profiles


Chapter 31 - Page 4
Age Profiles

Age Profiles

Age profiles use derived age factors to determine


eligibility based on the contacts age, not the
participants age

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Dependent Coverage Eligibility Profiles


Chapter 31 - Page 5
Status Profiles

Status Profiles

Status profiles determine a contacts eligibility based


on a status, such as:
Disabled
Marital
Military
Student

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Dependent Coverage Eligibility Profiles


Chapter 31 - Page 6
Postal Zip Profiles

Postal Zip Profiles

Postal zip profiles determine eligibility based on the


contacts primary address within one or more postal
ranges
If the contact shares a residence with the
participant, the dependent eligibility process uses
the participants postal zip to determine eligibility

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Coverage Eligibility Profiles


Chapter 31 - Page 7
Other Profile Types

Other Profile Types

You can also determine a contacts eligibility based on


their status as:
Covered in Another Plan
Typically determined based on the life event occurred
date or one day prior to the event
Designator Currently Enrolled
Yes or No

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Dependent Coverage Eligibility Profiles


Chapter 31 - Page 8
Link Profiles to Compensation Objects

Link Profiles to Compensation Objects

Attach dependent coverage eligibility profiles to


compensation objects
If you include multiple criteria in a profile, the
individual must meet all criteria to be eligible

Profile 1 Program
Relationship = Child
Age < 18
Plan Type

Plan

Link Profiles to Compensation Objects


Use the Program and Plan Enrollment Requirements window to link dependent coverage
eligibility profiles to compensation objects based on your designation level.
Check the Mandatory field if a dependent coverage eligibility profile is required. As with
participant eligibility profiles, if you link more than one dependent coverage eligibility profile
to a compensation object, the dependent must satisfy all mandatory profiles and at least one
optional profile.

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Coverage Eligibility Profiles


Chapter 31 - Page 9
Designation Levels

Designation Levels

Designation level codes determine the level at


which the application checks for dependent
coverage eligibility profiles and coverage dates
Program, Plan Type, or Plan
Set the designation level code in the Program
Enrollments window (Dependent Coverage tab)
If the code is Program or Plan Type, select the
eligibility profile here too
If the code is Plan, use the Plan Enrollment
Requirements window (Designations tab)

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Coverage Eligibility Profiles


Chapter 31 - Page 10
Other Designation Information for Compensation Objects

Other Designation Information for


Compensation Objects

You can indicate if the compensation object


requires the participant to designate a dependent or
beneficiary
Required designation suspends the election
Set the dependent coverage start and end dates
A typical setup defines dependent coverage as starting
and ending based on the participants enrollment start
and end date

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Coverage Eligibility Profiles


Chapter 31 - Page 11
Dependent Certifications (Advanced Benefits)

Dependent Certifications
(Advanced Benefits)

You can require the receipt of certification before


you allow a participant to designate a dependent.
Examples include:
Adoption Certificate
Legal Custody Certificate
The application suspends the election if certification
is not provided
Certifications are often specific to life events

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Coverage Eligibility Profiles


Chapter 31 - Page 12
Dependent Coverage and Life Events

Dependent Coverage and Life Events

Use the Dependent Change of Life Event window to


determine how a participant can change dependents
after a particular life event
The Dependent change codes are:
May either add or remove dependents
May add dependents
May remove dependents
May neither add nor remove dependents
You must link all life events to a compensation
object that enable a change, including Open and
Unrestricted life events

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Coverage Eligibility Profiles


Chapter 31 - Page 13
Practice: Defining a Dependent Coverage Eligibility Profile

Practice: Defining a Dependent Coverage


Eligibility Profile

Follow the demonstration, or use the notes


provided, to define a dependent coverage eligibility
profile
Navigate to the Dependent Coverage Eligibility
Profiles window using your local Super or HRMS
Manager responsibility

(N) Total Compensation > General Definitions > Eligibility Profiles >
Dependent Coverage

Online Help
For details on how to define a dependent coverage eligibility profile please refer to the online
Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Benefits Eligibility > How To >
Eligibility > Define a Dependent Coverage Eligibility Profile

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Coverage Eligibility Profiles


Chapter 31 - Page 14
Dependent Designation
Requirements
Chapter 32

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Dependent Designation Requirements


Chapter 32 - Page 1
Dependent Designation Requirements

Dependent Designation Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 2
Overview

Overview

Dependent designation requirements determine if


an enrolled participant can or must cover an eligible
dependent based on:
Relationship type between the contact and the
participant
Minimum and maximum number of dependents
allowed for the compensation object
You can set designation requirements for a plan,
option in plan, or option

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 3
Relationship Groups

Relationship Groups

You can set designation restrictions for people who


belong to a Relationship Group
The seeded Relationship Groups include:
Child
Spouse
Domestic Partner
Spouse or Domestic Partner
Family
No Designees

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 4
Relationship Groups

Relationship Groups

For a Group Relationship, you can define:


The minimum and maximum number of dependents or
beneficiaries eligible for designation
The relationship types you include as part of the group
(required)
A participant must satisfy each group relationship
you define for the option or plan

Relationship Groups
To enforce an employee only coverage option: you must select a Group Relationship of No
Designees and enter the minimum and maximum number of designees as zero. This setup
prevents a participant from designating a dependent for the employee only option.
To enforce an employee + spouse option: select a Group Relationship of Spouse, enter the
minimum and maximum number of designees as one, select a Type of Dependents, and a
Relationship Type of Spouse.
To enforce an employee + family option: a typical set up includes two Group Relationships.
Select Family as the first Group Relationship, enter a minimum of two designees and No
Maximum (typically). Select a Type of Dependents, and Relationship Type of Spouse, Child,
Adopted child, etc. as dictated by your plan design. Select Spouse as the second Group
Relationship. Enter the minimum and maximum number of designees as one, select a Type of
Dependents, and a Relationship Type of Spouse or Domestic Partner.

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 5
Designation Requirements

Designation Requirements

Use these windows to define designation


requirements:
Options window
Plan Enrollment Requirements window (for plans and
options in plans)
As with eligibility profiles, designation requirements
cascade down the compensation object hierarchy
Designation requirements defined at a lower level
override those set at a higher level

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 6
Family Member Codes

Family Member Codes

Family member codes restrict participant eligibility


based on the eligibility status of dependents as
determined by your designation requirements
If you do not select a code, the application does not
restrict participant eligibility based on designation
requirements
However, designation requirements are still enforced
when the participant makes an election

Family Member Codes


Family member contact information must already be recordedand accuratein the database,
or else you will experience life event errors. Use caution when implementing this feature.

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 7
Family Member Codes

Family Member Codes

Family member codes can be defined at various


locations in the hierarchy.
Programs window
Programs
Plan Types in Program
Plans in Program
Plans window
Plans
Options in Plans

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 8
Family Member Codes

Family Member Codes

Family member code treatment cascades down the


compensation object hierarchy

Eligibility Check Program


Code = null
Plan Type

Family Member
Plan
Code = Check

Option

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 9
Eligibility Check Codes

Eligibility Check Codes

Eligibility check codes instruct the application to


examine eligibility for:
Participant
Participant and Dependent
Dependent Only
Dependent Only allows for a dependent to be
covered in a plan in which the participant is
ineligible
For example, a dependent student away at college

Eligibility Check Codes


As with Family Member codes, you should use caution when implementing eligibility check
codes. The participants contact information must already be recordedand accuratein the
database, or else you will experience inaccurate eligibility and enrollment results.

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 10
Eligibility Check Codes

Eligibility Check Codes

Eligibility check codes cascade down in the


compensation object hierarchy

Eligibility Check Program


Code = null
Plan Type

Eligibility Check Plan


Code = Dep.
Only
Option

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 11
Practice: Defining Dependent Designation Requirements

Practice: Defining Dependent


Designation Requirements

Follow the demonstration, or use the notes


provided, to define designation requirements
Navigate to the Options window using your local
Super or HRMS Manager responsibility

(N) Total Compensation > Programs and Plans > Options

Online Help
For details on how to define dependent designation requirements please refer to the online
Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Plan Design > How To > Define
Options

Copyright Oracle Corporation, 2002. All rights reserved.

Dependent Designation Requirements


Chapter 32 - Page 12
Beneficiary Designations
Chapter 33

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Beneficiary Designations
Chapter 33 - Page 1
Beneficiary Designations

Beneficiary Designations

Copyright Oracle Corporation, 2002. All rights reserved.

Beneficiary Designations
Chapter 33 - Page 2
Beneficiary Designations

Beneficiary Designations

You can designate personal contacts as


beneficiaries of a plan or option in plan
Non-personal contacts can also be covered as
beneficiaries:
Organizations
Trustees
Third parties

Copyright Oracle Corporation, 2002. All rights reserved.

Beneficiary Designations
Chapter 33 - Page 3
Beneficiary Designations

Beneficiary Designations

Use the Plan Enrollment Requirements window to


set up beneficiary designation restrictions
Beneficiary designations work similarly to
dependent designation except for:
Designations are based on a percentage of the total
benefit amount or a specific amount
Action items triggered if you require trustee or spousal
certification (Advanced Benefits)

Copyright Oracle Corporation, 2002. All rights reserved.

Beneficiary Designations
Chapter 33 - Page 4
Beneficiary Certifications (Advanced Benefits)

Beneficiary Certifications
(Advanced Benefits)

You can require the receipt of certification before


you allow a participant to designate a beneficiary
Examples include:
Marriage Certificate
Domestic Partner Certificate
The application suspends the election if certification
is not provided
You can link beneficiary certifications to a plan

Copyright Oracle Corporation, 2002. All rights reserved.

Beneficiary Designations
Chapter 33 - Page 5
Practice: Designating Beneficiaries

Practice: Designating Beneficiaries

Follow the demonstration, or use the notes


provided, to designate beneficiaries
Navigate to the Plan Enrollment Requirements
window window using your local Super or HRMS
Manager responsibility

(N) Total Compensation > Programs and Plans > Plan Enrollment
Requirements

Online Help
For details on how to designate beneficiaries please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Benefits Enrollment
Requirements > How To > Define Beneficiary Designation Requirements

Copyright Oracle Corporation, 2002. All rights reserved.

Beneficiary Designations
Chapter 33 - Page 6
Summary
Chapter 34

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 34 - Page 1
Summary

Summary

In this module, you should have learned how to:


Define Dependent coverage eligibility profiles
Define Dependent designation requirements
Setup Beneficiary designations

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Summary
Chapter 34 - Page 2
Activity Rates and Coverage
Calculations
Chapter 35

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 1
Activity Rates and Coverage Calculations

Activity Rates and Coverage Calculations

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 2
Introduction

Introduction

You define activity rates and coverage calculations to


calculate:
The monthly premiums paid by the plan sponsor to
the third party provider
A participant or employer contribution to a plan or
option
A participant distribution from a plan or option
The coverage amount a participant receives in a
plan or option, such as a life insurance plan

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 3
Introduction

Introduction

Most compensation objects use a standard activity


rate to calculate employee/employer contributions
and distributions
You can attach an element and an input value to the
standard rate for use by payroll or for costing
purposes
You can create variable rate profiles (similar to
eligibility profiles) that cause a standard rate to vary
based on a discrete factor

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 4
Link Variable Rate Profiles to Rate Calculations

Link Variable Rate Profiles to


Rate Calculations

You link variable rate profiles to activity base rates,


premiums, and coverage calculations for a
compensation object.

Compensation Object

Standard Rate Flex Credits Actual Premiums Coverages

Variable Rate Profile

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 5
Standard Rates - Basic Diagram

Standard Rates - Basic Diagram

Compensation Object

SR SR SR

EL EL EL

IV IV IV

Standard Rate
Each standard rate can have one element with one input value.

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 6
Rate Characteristics

Rate Characteristics

Standard rates, variable rates, and imputed income


calculations use activity types to identify the function
of rate.
Employee Contribution, Employer Distribution, etc.
For most activity types, you still must define the
processing of the corresponding element
Certain activity types enable special processing for
Self-Service, continuing benefits, and
reimbursement processing

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 7
Rate Characteristics

Rate Characteristics

Activity rates employ a calculation method that you


select to calculate contributions and distributions
Flat amounts
Multiple of premium, compensation, coverage
No standard value (when rate is always variable)
Standard rates and variable rates let you specify the
tax type of a rate calculation for informational
purposes

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 8
Topics

Topics

The Activity Rates and Coverage Calculations module


contains the following topics:
Defining Variable Rate Profiles
Defining Coverage Calculations
Defining Actual Premiums
Setting Up Benefits Elements
Defining Standard Contributions and Distributions

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 9
Objectives

Objectives

After completing this module, you should be able to do


the following:
Vary a contribution or distribution rate by a discrete
factor
Define coverage calculations for plans such as life
insurance plans
Calculate monthly benefits premiums
Set up Oracle HRMS elements for use with Standard
and Advanced Benefits
Define standard activity rates

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 10
Implementation Sequence

Implementation Sequence

1. Eligibility 2. Derived Factors 3. Eligibility


Criteria (O) (O) Profiles (O)

5. Regulations and 4. Program/Plan


6. Plan Types (M)
Other Details (O) Year Periods (M)

7. Options (M) 8. Plans (M) 9. Programs (M)

12. Program
11. Collapsing Life 10. Life Event
Enrollment
Events (O) Reasons (O)
Requirements (M)

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 11
Implementation Sequence

Implementation Sequence

13. Plan
14. Dependent 15. Variable Rates
Enrollment
Coverage (O) (O)
Requirements (O)

18. Benefits 17. Actual 16. Coverage


Elements (O) Premiums (O) Calculations (O)

19. Standard Rates 20. Reimb. Plans 21. Flex Credit


(O) (O) Calculations (O)

23.
24. Online 22. Benefits Pools
Communications
Activities (O) (O)
(O)

Copyright Oracle Corporation, 2002. All rights reserved.

Activity Rates and Coverage Calculations


Chapter 35 - Page 12
Defining Variable Rate
Profiles
Chapter 36

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 1
Defining Variable Rate Profiles

Defining Variable Rate Profiles

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 2
Variable Factors

Variable Factors

Coverages, activity rates, and premiums can vary


according to a variety of factors, such as:

Age Gender Grade

Full/Part-Time Leave of Absence

Participation in Another Plan Length of Service

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 3
Variable Rate Profiles

Variable Rate Profiles

You group the factors that cause an activity rate to


vary into a variable rate profile
Variable rate profiles function like eligibility profiles
and are re-usable

Variable Rate Profile

Employment Personal Derived Factors Other

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 4
Link Variable Rate Profiles to Rate Calculations

Link Variable Rate Profiles to


Rate Calculations

You link variable rate profiles to activity base rates,


premiums, and coverage calculations.

Compensation Object

Standard Rate Flex Credits Actual Premiums Coverages

Variable Rate Profile

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 5
Example - Variable Standard Rate

Example - Variable Standard Rate

Plan
Medical Plan

Standard Rate
Contribution Rate

Variable Rate
Employee Contribution = 100
Profile

Employment
Criteria Part-Time Regular

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Defining Variable Rate Profiles


Chapter 36 - Page 6
Example - Variable Premium

Example - Variable Premium

Plan
Medical Plan

Actual
Base Premium Rate
Premium

Variable Rate
Flat Amount = 200
Profile

Derived Factor
Service Area = California

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 7
Example - Variable Coverage Calculation

Example - Variable Coverage Calculation

Stock
Stock Plan
Option Plan

Coverage
Number of Stock Options
Calculation

Variable Rate
Stock Options = 1,000
Profile

Derived Factor
Length of Service = 1 to 3 Years

Coverage Calculations
Coverage calculations can be monetary or non-monetary values, such as a life insurance
amount or stock options grant.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 8
Variable Rate Calculation

Variable Rate Calculation

The activity type identifies the function performed


by the variable rate calculation
Employee Individual Contribution
Employer Matching Plan Contribution
The treatment code specifies the operation
performed by the variable rate on the calculation to
which you attach the variable rate
Add to
Replace
Multiply by
Subtract From

Variable Rate Calculation


Treatment code examples:
Add to: If non-smoker, add 30 flex credits for medical plan.
Replace: Typically used for coverage calculations for life insurance plans and with imputed
income calculations in the US.
Multiply by: Add a 2% administration fee for part-time employees enrolled in a plan.
Subtract from: If smoker, subtract 30 flex credits.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 9
Variable Rate Calculation

Variable Rate Calculation

The usage code controls the type of calculation to


which you can link the variable rate profile
Rates (Standard Rate, Flex Credit, Imputed)
Coverages
Actual Premiums
You can limit the variable rate profile to participants
with a particular kind of assignment
You can set upper and lower limits on the result of a
variable rate calculation
Select an Ultimate High or Ultimate Low value to
override a calculation limit for the rate to which you
attach the variable rate profile

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 10
Calculation Methods

Calculation Methods

Calculation methods are composed of:


Values you define
Operations you perform on those values
Usage codes control the available calculation
methods, which include:
Flat Amount
Multiple of Coverage
Multiple of Compensation
Multiple of Compensation and Coverage
Multiple of Premium

Calculation Methods
The fields on the calculation method tabbed region vary based on the calculation method you
select.
The variable rate can vary based on the result of another calculation. For example, you can
define a variable rate based on a calculated premium or calculated coverage.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 11
Practice: Defining a Variable Rate Profile

Practice: Defining a Variable Rate Profile

Follow the demonstration, or use the notes


provided, to define a variable rate profile
Navigate to the Variable Rate Profiles window using
your local Super or HRMS Manager responsibility

(N) Total Compensation > Rate/Coverage Definitions > Variable


Rate Profiles

Online Help
For details on how to define a variable rate profile please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Activity Rates and Coverage
Calculations > How To > Define Variable Rates

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Variable Rate Profiles


Chapter 36 - Page 12
Defining Coverage
Calculations
Chapter 37

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 1
Defining Coverage Calculations

Defining Coverage Calculations

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 2
Introduction

Introduction

Coverage calculations define the coverage amount


available to a participant.
Life insurance
Accidental death and disability
Stock options
Vacation days

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 3
Coverage Association Levels

Coverage Association Levels

You can link coverage calculations to:


Plans
Options in Plan

FSA Plan

1x Salary Supp Life Option in Plan

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 4
Building Coverage Calculations

Building Coverage Calculations

Coverage calculations can have different building


block components:
Defined or Benefits balances
Derived factors
Variable rate profiles Coverage Calculation

Derived Factor Variable Profile

Benefits Balance

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 5
Example - Fixed Coverage

Example - Fixed Coverage

Plan
Group Term Life Insurance Plan

Coverage Life Insurance Coverage = 1x


Calculation Salary

Example-Fixed Coverage
In this example, the fixed coverage calculation is the same for all participants, regardless of
eligibility or demographics.
Coverage calculations can be monetary or non-monetary values, such as a life insurance
amount or stock options grant.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 6
Example - Variable Coverage

Example - Variable Coverage

Vacation
Vacation Buy/Sell Plan
Plan

Coverage
Number of Vacation Days
Calculation

Variable Rate
Vacation Days = 20
Profile

Derived Factor Length of Service = 5 to 10 Years

Example-Variable Coverage
In this example, coverage varies based on an employees length of service. Employees with 5
to 10 years of service receive 20 vacation days.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 7
Defining Coverage Calculations

Defining Coverage Calculations

Link the coverage calculation to a plan or option in


plan
Set the unit of measure if the coverage amount is
non-monetary
Shares
Hours
Days
If applicable, link one or more variable rate profiles
to a coverage calculation

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 8
Defining Coverage Calculations

Defining Coverage Calculations

Check the Max Overridable field if you can manually


override the coverage calculation result for a person
Set a boundary period to restrict the coverage
amount to a given time period
For example, 15 vacation days per year

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 9
Calculation Methods

Calculation Methods

The calculation method defines how a participants


coverage amount is determined
Flat amount
Flat range
Multiple of compensation
Same as annualized elected activity rate
You can limit the coverage calculation result to a
minimum/maximum range

Calculation Methods
For spending accounts, you can enter coverage at enrollment or determine the coverage based
on the employee contribution rate.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 10
Practice: Defining a Coverage Calculation

Practice: Defining a Coverage Calculation

Follow the demonstration, or use the notes


provided, to define a coverage calculation
Navigate to the Coverages window using your local
Super or HRMS Manager responsibility

(N) Total Compensation > Rate/Coverage Definitions > Coverage


Calculations

Online Help
For details on how to define a coverage calculation please refer to the online Help path:Oracle
HRMS > Setup for Standard and Advanced Benefits > Activity Rates and Coverage
Calculations > How To > Define Coverage Calculations

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 11
Copyright Oracle Corporation, 2002. All rights reserved.

Defining Coverage Calculations


Chapter 37 - Page 12
Defining Actual Premiums
Chapter 38

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 1
Defining Actual Premiums

Defining Actual Premiums

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 2
Overview

Overview

Actual premiums are the monthly amount paid by a


plan sponsor to a benefits supplier
Oracle HRMS supports premium calculation for:
Individual participants
The total number of participants enrolled in a plan or
option in plan
The total volume of coverage elected in a plan or
option in plan

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 3
Premium Calculations

Premium Calculations

Premium calculations define how to calculate, cost,


and process an actual premium
You can define a premium calculation for use with
any plan type:
Medical
Dental
Other

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 4
Link Premiums to Compensation Objects

Link Premiums to Compensation Objects

You link actual premium calculations to:


Plans
Options in Plan

Kaiser Medical Plan


Plan

Option
Kaiser Medical EE Only
$15.50

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 5
Example - Actual Premium

Example - Actual Premium

Compensation
Object

Plan/Option for Individual


Total Participant
Participants Premium

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 6
Example - Actual Premium

Example - Actual Premium

Employee Only
Medical Option

Plan/Option Individual
$200x Total Participant $200
Participants

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 7
Defining Premium Calculations

Defining Premium Calculations

The application calculates per participant premiums


when the election is saved
For premiums based on total participants or total
coverage volume, run the Premium Calculation
process to calculate the premium
Run the Premium Calculation process to write a
premium result for a selected participant or
compensation object

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 8
Premium Assignment

Premium Assignment

The premium assignment determines when the


application calculates the monthly premium
During Enrollment (for individual participants)
During Premium Calculation Process
Select During Premium Calc Process for premiums
based on:
Total participants
Total coverage elected

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 9
Premium Assignment Level

Premium Assignment Level

The assignment level controls whether you assign


the premium to the:
Participant
Plan or Option
Both the Participant and the Plan or Option
You can calculate premiums prospectively or
retrospectively

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 10
Calculation Methods

Calculation Methods

Select a method to define how Oracle HRMS calculates


actual premiums.
Flat Amount
Multiple of Coverage
Multiple of Total Coverage
Multiple of Total Participants

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 11
Partial Month and Prorated Processing

Partial Month and Prorated Processing

You can prorate a premium for participants who


gain or lose coverage mid-month
Define a wash rule if participants who are covered
by a plan or option for less than a full month have
no premium obligation

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 12
Premium Credits

Premium Credits

You can apply credits to a participants premium if a


retroactive change or processing error occurred
You can restrict the allowable period in which you
can apply credits to:
The current pay period
A specified number of months in the plan year prior to
the current month
The Premium Calculation process calculates credits
based on your actual premium definition

Premium Credits
You can only apply credits to premiums assigned to a participant during the premium
calculation process.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 13
View Premium Results

View Premium Results

Use the Monthly Participant Premium window to


view and edit premium results for a participant
Use the Monthly Plan or Option Premium window to
view and edit premium results for a plan or option in
plan

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 14
Practice: Defining an Actual Premium

Practice: Defining an Actual Premium

Follow the demonstration, or use the notes


provided, to define an actual premium
Navigate to the Actual Premiums window using your
local Super or HRMS Manager responsibility:

(N) Total Compensation > Rate/Coverage Definitions > Actual


Premiums

Online Help
For details on how to define an actual premium please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Activity Rates and Coverage
Calculations > How To > Define an Actual Premium

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 15
Copyright Oracle Corporation, 2002. All rights reserved.

Defining Actual Premiums


Chapter 38 - Page 16
Setting Up Benefits Elements
Chapter 39

Copyright Oracle Corporation, 2002. All rights reserved.

Setting Up Benefits Elements


Chapter 39 - Page 1
Setting Up Benefits Elements

Setting Up Benefits Elements

Copyright Oracle Corporation, 2002. All rights reserved.

Setting Up Benefits Elements


Chapter 39 - Page 2
Elements and Benefits

Elements and Benefits

Use elements to:


Transfer rates to Oracle Payroll or third party systems
Record activity rate results for benefits contributions
and distributions
Define costing rules
Capture the per pay period enrollment activity rate
assigned to a persons element entry
Attach elements to the standard activity rate

Copyright Oracle Corporation, 2002. All rights reserved.

Setting Up Benefits Elements


Chapter 39 - Page 3
Element Entries

Element Entries

The values an element records are called element


entries
You can record any benefits value you like:
Activity rates
Flex credits (Advanced Benefits)
Vacation days
Element entries are created during enrollment
Through saving on an enrollment window, or
Batch processes (Default enrollment, etc.)
Values in element entries are per pay period

Copyright Oracle Corporation, 2002. All rights reserved.

Setting Up Benefits Elements


Chapter 39 - Page 4
Defining the Element

Defining the Element

You determine the taxation and deduction


frequency used in Oracle Payroll when defining an
element
Contribution and distribution amounts are
calculated by the Participation Process (based on
the activity rate) and written to the element entry
upon enrollment
You do not enter a Benefit Classification for elements
attached to an activity base rate
You must select a termination rule of Final Close for
elements attached to an activity base rate

Defining the Element


When you terminate an employee, the termination process end-dates the element based on the
termination rule you define for the element. Administrators should enter a final close date for a
person that is after the date the Participation Process de-enrolls the participant.
Setting the termination rule for an element to Final Close enables you to terminate an employee
and have their benefits elements end-dated in the future based on the activity rate end date code
for the compensation object.

Copyright Oracle Corporation, 2002. All rights reserved.

Setting Up Benefits Elements


Chapter 39 - Page 5
Linking Elements for Benefits

Linking Elements for Benefits

You link benefits elements as needed for costing


purposes only
The Participation Process determines eligibility
based on eligibility profiles
Eligibility is not determined on the element link
window
Eligibility fields on the element link window must not
conflict with your benefits eligibility profiles

Copyright Oracle Corporation, 2002. All rights reserved.

Setting Up Benefits Elements


Chapter 39 - Page 6
Element Links

Element Links

You create an open link because eligibility is not


defined on the Element Link window (if you do not
establish costing for the element)
All elements must be linked (including open links)
so that the application can make an element entry
during enrollment
Costing continues to function as in previous
releases of Oracle HRMS

Element Links
An Open link refers to the fact that eligibility is not defined on the element itself. You create an
open link by selecting the element you have defined in the Element Link window and saving
the record.

Copyright Oracle Corporation, 2002. All rights reserved.

Setting Up Benefits Elements


Chapter 39 - Page 7
Practice: Defining an Element

Practice: Defining an Element

Follow the demonstration, or use the notes


provided, to define an element and create an open
link
Navigate to the Element window using your local
Super or HRMS Manager responsibility:
(N) Total Compensation > Basic > Element Description
Navigate to the Element Link window using your
local Super or HRMS Manager responsibility:
(N) Total Compensation > Basic > Link

Online Help
1. For details on how to complete the Element Description window please refer to the online
Help path:
Oracle HRMS > Total Compensation Elements Setup > Elements > How To > Define an
Element
2. For details on how to complete the Element Link window please refer to the online Help
path:
Oracle HRMS > Total Compensation Elements Setup > Elements > How To > Define
Element Links

Copyright Oracle Corporation, 2002. All rights reserved.

Setting Up Benefits Elements


Chapter 39 - Page 8
Defining Standard
Contributions and
Distributions
Chapter 40

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 1
Defining Standard Contributions and Distributions

Defining Standard Contributions


and Distributions

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 2
Overview

Overview

Standard activity rate calculations determine:


The amount a person contributes to participate in a
plan or option
The amount paid to a participant as a distribution
from a plan or option
Amounts you can cost or distribute to payroll:
Contributions/Distributions
Vacation days
Stock options
Flex Credits

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 3
Standard Rates Concepts

Standard Rates Concepts

You create a separate contribution or distribution


calculation for each compensation object
As a prerequisite, you should already have defined:
Variable rates
Coverage calculations
Premiums
Elements and input values

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 4
Defined, Communicated, and Annual Amounts

Defined, Communicated, and


Annual Amounts

Standard rates always calculate the defined,


communicated, and annual amount
The defined amount is determined by the activity
reference period you define for the program or plan
not in program
The communicated amount is the value displayed in
Self-Service or in a communication
The annual amount is the annualized defined amount

Defined, Communicated, and Annual Amounts


For example:
Defined amount = 100/month
Communicated amount = 50/biweekly pay period
Annual amount = 1200/year
The communicated amount is the enrollment/rate frequency you define for the program or for a
plan not in program.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 5
Building Standard Rates

Building Standard Rates

Standard Rate calculations can have different building


block components:
Coverages
Premiums
Standard Rate
Benefits balances
Derived factors
Variable profiles Coverage Calc Variable Profile

Derived Factor Variable Profile

Benefits Balance Derived Factor

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 6
Standard Rates - Basic Diagram

Standard Rates - Basic Diagram

Compensation Object

SR SR SR

EL EL EL

IV IV IV

Standard Rates
Each standard rate can have one element with one input value.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 7
Standard Rates Levels

Standard Rates Levels

You link the standard rate to a compensation object:


Option in Plan, Option in Plan in Program
Plan, Plan in program

Savings Plan Deferral Program


Percentage
Plan Type

Plan
Medical $15.50 ER Pre Tax
Contrib Option

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 8
Standard Rates - Multiple of Coverage

Standard Rates - Multiple of Coverage

Supplemental Life

Coverage 1x Salary

Standard Rate =
.01/1000

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 9
Standard Rates - Multiple of Premium

Standard Rates - Multiple of Premium

Medical Employee Only

Medical Employee Only Premium

Standard Rate = Multiple Standard Rate = Multiple


of Premium: 75% of Premium: 25%
Employer Contribution Employee Contribution

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 10
Standard Rates - Parent/Child

Standard Rates - Parent/Child

Fringe Benefit Plan

Parent Rate

Child Rate Child Rate (Taxable


(Administrative Fee) Amount)

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 11
Key Concepts

Key Concepts

Establishing a standard rate involves defining:


General characteristics of the activity rate
Calculation methods
Partial month prorating
Payroll processing requirements
Variable rates

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 12
Activity Types

Activity Types

Activity types indicate whether the standard rate is a


contribution or a distribution made by the participant
or the employer.
Employee Individual Contribution
Employee Payroll Contribution
Employee Payroll Distribution
Employer Payroll Distribution
Participant Receives (for COBRA)
Plan Distribution
Cost
Credit

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 13
Activity Types - Specific Types

Activity Types - Specific Types

These Activity Types have specific meanings:


Self Service Display (provides an additional display
column for the rate)
Typically used for fringe benefit taxes
Continuing Benefits Payments
Use any participant rate
Reimbursement Requests
In order to save a reimbursement request, you must
have a standard rate defined with one of the three
reimbursement types

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 14
Elements and Input Values

Elements and Input Values

If rates are used by Oracle Payroll or transferred to a


third party administrator, select an element and an
input value for the rate
For benefits administration, you can only transfer
standard rates and imputed income rates to elements
You can define one element and one input value per
activity rate

Elements and Input Values


Premiums, coverage calculations, and flex credits use the standard rate to pass the value to the
element.

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 15
Calculation Methods

Calculation Methods

As with coverages and premiums, you select a


calculation method for standard rates:
Flat Amount
Multiple of Compensation
Multiple of Compensation and Coverage
Multiple of Coverage
Multiple of Parent Rate
Multiple of Parent Rate and Coverage
Multiple of Premium
Multiple of Premium and Coverage

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 16
Partial Month Determination

Partial Month Determination

You can prorate a standard rate for participants who


gain or lose coverage mid-month
You can limit proration to participants who are either
starting or stopping coverage
Define a wash rule if participants who are covered
by a plan or option for less than a full month are not
subject to a contribution or distribution for that
month

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 17
Annual Rates

Annual Rates

Use the Annual Rates tab to control participant


contributions to reimbursement plans and to
estimate year to date contributions
Used for Flexible Spending Accounts
Used for mid-year flexible spending changes (for
rare administrative circumstances)
For example, January 1st contribute 1200 for the year
In June, participant changes contribution to 800 for the
year (for remaining 6 months you would only need to
collect the remaining 200)

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 18
Processing Information

Processing Information

Use the Processing Information tab to:


Select the application that processes the activity rate
(information only)
Specify the point during the enrollment process at
which you record the activity rate
Processing sources to select from include:
OAB, Oracle Payroll, Third Party Agent
Indicate if the rate is one-time only or recurring
Select the same value as for the element
Select recurring for reimbursement distributions

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 19
Processing Information

Processing Information

Value Override Allowed indicates the administrator


can override the rate using the Override Plan
Enrollment window
Assign on Enrollment indicates the application
assigns the rate upon election and creates an
element entry
The investment options for a savings plan typically do
not assign a value upon enrollment

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 20
Processing Information

Processing Information

Display on enrollment indicates the application


displays the value during election
The displayed value becomes the elected rate if the
participant does not change the rate
Typically, you should display contributions from
employees but not employers
Process Each Pay Period Default indicates the
application calculates the standard rate each pay
period unless otherwise specified

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 21
Practice: Defining a Standard Rate

Practice: Defining a Standard Rate

Follow the demonstration, or use the notes


provided, to define a standard rate
Navigate to the Standard Rates window using your
local Super or HRMS Manager responsibility

(N) Total Compensation > Rate/Coverage Definitions > Standard


Rates

Online Help
For details on how to define a standard rate please refer to the online Help path:
Oracle HRMS > Setup for Standard and Advanced Benefits > Activity Rates and Coverage
Calculations > How To > Define Standard Contributions & Distributions > Define Activity
Rates for Contribution/Distribution

Copyright Oracle Corporation, 2002. All rights reserved.

Defining Standard Contributions and Distributions


Chapter 40 - Page 22
Summary
Chapter 41

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 41 - Page 1
Summary

Summary

In this module, you should have learned how to:


Vary a contribution or distribution rate by a discrete
factor
Define coverages for plans such as life insurance
plans
Calculate monthly benefits premiums
Set up Oracle HRMS elements for use with Standard
and Advanced Benefits
Define standard activity rates

Copyright Oracle Corporation, 2002. All rights reserved.

Summary
Chapter 41 - Page 2