OABImp Stu Guide 1

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

i
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
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

ii
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
Defining Life Events ........................................................................................................................................20-1
Defining Life Events......................................................................................................................................20-2

iii
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
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

iv
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
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

v
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
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
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
Partial Month and Prorated Processing..........................................................................................................38-12
Premium Credits ............................................................................................................................................38-13

vi
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
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
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

vii
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
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

viii
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

ix
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

x
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

xi
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

xii
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.
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

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

xv
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

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.

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.

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.

xviii
Overview of Implementing
Advanced Benefits
Chapter 1
Overview of Implementing Advanced Benefits

Chapter 1 - Page 1
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

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

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

Chapter 1 - Page 5

Chapter 1 - Page 6
Introducing Advanced
Benefits
Chapter 2

Chapter 2 - Page 1

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

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

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

Chapter 2 - Page 5
Plan Types
Plan Types
STD/LTD
Others
Life
Perqs
FSAs
Health
Vac
Buy/Sell
Savings

Chapter 2 - Page 6
Life Event Management
Life Event Management
Explicit
HRMS
database Temporal
Scheduled

Chapter 2 - Page 7
Eligibility Profiles
Eligibility profiles limit eligibility for compensation

objects.
Profiles
Program
Plan Type
Plan
Option

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

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

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

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

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

Chapter 2 - Page 13
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

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

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

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

Chapter 3 - Page 1
Reviewing a Sample Implementation

and Enrollment

Chapter 3 - Page 2
Vision
Vision
The Vision database contains seeded programs and

plans for your review

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

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

Chapter 3 - Page 5
Enrollment
Enrollment
Oracle Advanced Benefits provides 4 enrollment

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

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

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

Chapter 3 - Page 8
Following the Implementation
Steps
Chapter 4

Chapter 4 - Page 1

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

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

Chapter 4 - Page 4
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)

Chapter 4 - Page 5
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)

Chapter 4 - Page 6
Summary
Chapter 5
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
Summary
Chapter 5 - Page 2
Participant Eligibility
Chapter 6
Chapter 6 - Page 1
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
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
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
Chapter 6 - Page 5


6. Plan Types (M)
12. Program
Enrollment
Requirements (M)
Chapter 6 - Page 6
13. Plan
Enrollment
Coverage (O) (O)
Requirements (O)


23.
Communications
Activities (O) (O)
(O)
Chapter 6 - Page 7
Chapter 6 - Page 8
Introducing Benefits
Eligibility
Chapter 7

Chapter 7 - Page 1

Chapter 7 - Page 2
Benefits Eligibility
Benefits Eligibility
Eligibility components restrict benefits to qualified

participants.
Program
Plan Type
Plan
Option

Chapter 7 - Page 3
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

Chapter 7 - Page 4
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

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

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

Chapter 7 - Page 7

Chapter 7 - Page 8
Defining Eligibility Building
Blocks
Chapter 8

Chapter 8 - Page 1

Chapter 8 - Page 2
Use the eligibility building blocks as optional

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

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

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

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

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

Chapter 8 - Page 7
Practice: Defining a Benefits Group
Practice: Defining a Benefits Group

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

Chapter 8 - Page 8
Defining Derived Eligibility
Factors
Chapter 9

Chapter 9 - Page 1

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

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

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

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

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

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

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

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

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

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

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

Chapter 9 - Page 13
Practice: Defining Derived Factors
Practice: Defining Derived Factors

provided, to define a derived compensation level
factor
Navigate to the Derived Factors window using your
(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

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

Chapter 10 - Page 1

Chapter 10 - Page 2
Participant eligibility profiles limit eligibility for

Program
Plan Type
Plan
Option

Chapter 10 - Page 3
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)

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

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

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

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

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

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

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

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

Practice: Defining a Participant Eligibility Profile
Practice: Defining a Participant

Eligibility Profile

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


Summary
Chapter 11
Summary
Chapter 11 - Page 1
Summary
Summary

Define benefits eligibility
Select criteria to restrict a participants benefits
eligibility
Set up eligibility criteria and derived eligibility
factors
Build participant eligibility profiles
Summary
Chapter 11 - Page 2
Chapter 12
Chapter 12 - Page 1
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
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
Chapter 12 - Page 4
Objectives
Objectives

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
Chapter 12 - Page 5


6. Plan Types (M)
12. Program
Enrollment
Requirements (M)
Chapter 12 - Page 6
13. Plan
Enrollment
Coverage (O) (O)
Requirements (O)


23.
Communications
Activities (O) (O)
(O)
Chapter 12 - Page 7
Chapter 12 - Page 8
Introducing the
Compensation Object
Hierarchy
Chapter 13

Chapter 13 - Page 1
Introducing the Compensation

Object Hierarchy

Chapter 13 - Page 2
Building Blocks
Building Blocks
Program
Plan Type
Plan
Option

Chapter 13 - Page 3
Program
A package of benefits
offerings
Vision Flex Program
Plan Type
Plan
Option

Chapter 13 - Page 4
Plan Type
Broad category of
benefit plans
Medical

Chapter 13 - Page 5
Plan Type
Plan
Specific benefit
offering
Aetna HMO Plan

Chapter 13 - Page 6
Plan Type
Plan
Option
Coverage level
within a plan
Employee Only

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

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

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

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


Defining Program/Plan Year
Periods and Other Details
Chapter 14
Defining Program/Plan Year Periods and Other Details

Chapter 14 - Page 1
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

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

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

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

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

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

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

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

Defining Plan Types and
Options
Chapter 15

Chapter 15 - Page 1

Chapter 15 - Page 2
Plan Types
Plan Types
STD/LTD
Others
Life
Perqs
FSAs
Health
Vac
Buy/Sell
Savings

Chapter 15 - Page 3
Plan Types
Plan Types
Plan Types
Medical
Plans Aetna
EE Only
Options EE & Spouse
EE & Child(ren)
EE & Family
EE & Domestic
Partner

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

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

Chapter 15 - Page 6
Practice: Defining Plan Types
Practice: Defining Plan Types

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:
Plan Types

Chapter 15 - Page 7
Options
Options
Plan Types
Medical
Plans Aetna
EE Only
Options EE & Spouse
EE & Child(ren)
EE & Family
EE & Domestic
Partner

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

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

Practice: Defining Options
Practice: Defining Options

provided, to define options
Navigate to the Options window using your local
(N) Total Compensation > Programs and Plans > Options
Online Help
For details on how to define options please refer to the online Help path:
Options


Defining Plans
Chapter 16
Defining Plans
Chapter 16 - Page 1
Defining Plans
Defining Plans
Defining Plans
Chapter 16 - Page 2
Plans
Plans
Plan Types
Medical
Plans Aetna
EE Only
Options EE & Spouse
EE & Child(ren)
EE & Family
EE & Domestic
Partner
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
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
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
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.
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
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
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
Defining Plans
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
Defining Plans
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
Defining Plans
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
Defining Plans
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
Defining Plans
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
Defining Plans
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
Defining Plans
Practice: Defining Plans
Practice: Defining Plans

provided, to define plans
Navigate to the Plans window using your local
(N) Total Compensation > Programs and Plans > Plans
Online Help
For details on how to define a plan please refer to the online Help path:
Plans > Define a Benefits Plan
Defining Plans
Defining Plans
Defining Programs
Chapter 17
Defining Programs
Chapter 17 - Page 1
Defining Programs
Defining Programs
Defining Programs
Chapter 17 - Page 2
Program
Program
Plan Types
Medical
Plans Aetna
EE Only
Options EE & Spouse
EE & Child(ren)
EE & Family
EE & Domestic
Partner
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
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
Defining Programs
Chapter 17 - Page 5
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)
Defining Programs
Chapter 17 - Page 6
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
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
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.
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
Defining Programs
Link Life Event Reasons to the Program (Advanced Benefits)
Link Life Event Reasons to the Program

(Advanced Benefits)

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
Defining Programs
Plan Types
Medical
Plans Aetna
EE Only
Options EE & Spouse
EE & Child(ren)
EE & Family
EE & Domestic
Partner

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.
Defining Programs
Practice: Defining Programs
Practice: Defining Programs

provided, to define a program
Navigate to the Programs window using your local
(N) Total Compensation > Programs and Plans > Programs
Online Help
For details on how to define a program please refer to the online Help path:
Programs > Define a Benefits Program
Defining Programs
Defining Programs
Summary
Chapter 18
Summary
Chapter 18 - Page 1
Summary
Summary

Structure your total compensation offerings using
Use and define options, plans, plan types, and
programs
Group compensation objects into a hierarchy
Associate eligibility profiles to compensation
objects
Summary
Chapter 18 - Page 2
Life Events
Chapter 19
Life Events
Chapter 19 - Page 1
Life Events
Life Events
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
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
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
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
Life Events
Chapter 19 - Page 6
Objectives
Objectives

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
Life Events
Chapter 19 - Page 7


6. Plan Types (M)
12. Program
Enrollment
Requirements (M)
Life Events
Chapter 19 - Page 8
13. Plan
Enrollment
Coverage (O) (O)
Requirements (O)


23.
Communications
Activities (O) (O)
(O)
Life Events
Chapter 19 - Page 9
Life Events
Chapter 20

Chapter 20 - Page 1

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

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

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

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.

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

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

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

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

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

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.

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

Defining a Person Change Multiple Database Columns

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

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.

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.

Causes Related Person Life Events
Life Event Related Person Life Event
Divorce Loss of Coverage

(of employee participant) (for dependent spouse)

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

Related Person Life Events
Dependent Data Change Participant Life Event
Loss of Coverage Dependent Loss of Coverage (for

(of dependent) employee participant)

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.

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

Overriding Life Events: Example
Overriding Life Events: Example
Winner
April 1 April 1
New Hire Address Change
Override Override

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

Practice: Defining a Life Event Reason
Practice: Defining a Life Event Reason

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


Defining Collapsing Life
Events
Chapter 21

Chapter 21 - Page 1

Chapter 21 - Page 2
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

Chapter 21 - Page 3
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 = ?

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

Chapter 21 - Page 5
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

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

you how to set up a collapsing life event
Navigate to the Life Event Reasons window using
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

Chapter 21 - Page 7

Chapter 21 - Page 8
Linking Life Events to
Chapter 22

Chapter 22 - Page 1
Linking Life Events to


Chapter 22 - Page 2
Life Event Reasons and Compensation Objects
Life Event Reasons and

Link life event reasons to compensation objects to

enforce specific business rules
Program
Plan Type
Life
Event
Marriage Plan
Option

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

Chapter 22 - Page 4
Life Events Versus Eligibility Profiles
Define life events in context with eligibility profiles and

Life Eligibility Compensation

Events Profiles Objects

Chapter 22 - Page 5

Profile = Eligible Plan
EE Only
Life Event
Divorce, Ineligible
EE+Spouse

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

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

Compensation Object

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:
Programs > Associate a Life Event Reason

Chapter 22 - Page 8
Summary
Chapter 23
Summary
Chapter 23 - Page 1
Summary
Summary

Define life events
Define collapsing life events
Link life events to compensation objects
Summary
Chapter 23 - Page 2
Benefits Enrollment
Requirements
Chapter 24
Benefits Enrollment Requirements

Chapter 24 - Page 1

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

Chapter 24 - Page 3
Enrollment Requirements and Plan Design
Enrollment Requirements and Plan Design
Eligibility profiles, life events, and enrollment

requirements work together
Eligibility Profiles Life Events (OAB) 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

Chapter 24 - Page 5
Objectives
Objectives

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

Chapter 24 - Page 6


6. Plan Types (M)
12. Program
Enrollment
Requirements (M)

Chapter 24 - Page 7
13. Plan
Enrollment
Coverage (O) (O)
Requirements (O)


23.
Communications
Activities (O) (O)
(O)

Chapter 24 - Page 8
Introducing Enrollment
Requirements
Chapter 25

Chapter 25 - Page 1

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?

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).

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

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

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

Chapter 25 - Page 7
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

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.

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.

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

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

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

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
6. Program
Enrollment Periods
1. Plan Level
2. Program Level

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

Default Enrollment Codes

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


Defining Program and Plan
Enrollment Requirements
Chapter 26
Defining Program and Plan Enrollment Requirements

Chapter 26 - Page 1
Defining Program and Plan


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

Chapter 26 - Page 3
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

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.

Chapter 26 - Page 4
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

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

Chapter 26 - Page 6
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

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.

Chapter 26 - Page 7
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

Chapter 26 - Page 8
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

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
Overrides general program, plan type in program,
and plan in program enrollment requirements for the
specific event

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
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.

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

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


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

Practice: Defining Program Enrollment Requirements
Practice: Defining Program


provided, to define enrollment requirements for a
program
Navigate to the Program Enrollment Requirements
responsibility
(N)Total Compensation > Programs and Plans > Program

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

Practice: Defining Plan Enrollment Requirements
Practice: Defining Plan


provided, to define enrollment requirements for a
savings plan
Navigate to the Plan Enrollment Requirements
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:
Requirements > How To > Define Plan Enrollment Requirements

Defining Action Items and
Certifications
Chapter 27
Defining Action Items and Certifications

Chapter 27 - Page 1

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

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.

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

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

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

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

Chapter 27 - Page 8
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
Use the extensible Lookup Type BEN_ENRT_CTFN_TYP to add enrollment certification
types to Oracle HRMS.

Chapter 27 - Page 9
Link Certifications to Compensation Objects
Link Certifications to
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

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

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

Practice: Defining an Action Item Due Date
Practice: Defining an Action Item Due Date

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:
Requirements > How To > Define Program Enrollment Requirements > Define an Action Item
Due Date

Practice: Attaching a Certification to a Compensation Object
Practice: Attaching a Certification to a

Compensation Object

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:
Requirements > How To > Define Plan Enrollment Requirements

Managing Suspended
Elections and Interim
Coverages
Chapter 28
Managing Suspended Elections and Interim Coverages

Chapter 28 - Page 1
Managing Suspended Elections and

Interim Coverages

Chapter 28 - Page 2
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

Chapter 28 - Page 3
You set the unsuspend enrollment code using the

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

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

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.

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

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.

Chapter 28 - Page 8
Practice: Defining Interim Coverage
Practice: Defining Interim Coverage

provided, to define interim coverage for a plan
Navigate to the Coverage Restrictions window using
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

Chapter 28 - Page 9

Summary
Chapter 29
Summary
Chapter 29 - Page 1
Summary
Summary

Define enrollment requirements to restrict benefits
electability
Restrict enrollment changes by life event
Set up enrollment certifications
Define interim coverages for suspended elections
Summary
Chapter 29 - Page 2
Dependent and Beneficiary
Designation
Chapter 30
Dependent and Beneficiary Designation

Chapter 30 - Page 1

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

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.

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

Chapter 30 - Page 5
Topics
Topics
Dependent and Beneficiary Designation contains the

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

Chapter 30 - Page 6
Objectives
Objectives

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

Chapter 30 - Page 7


6. Plan Types (M)
12. Program
Enrollment
Requirements (M)

Chapter 30 - Page 8
13. Plan
Enrollment
Coverage (O) (O)
Requirements (O)


23.
Communications
Activities (O) (O)
(O)

Chapter 30 - Page 9

Dependent Coverage
Chapter 31
Dependent Coverage Eligibility Profiles

Chapter 31 - Page 1

Chapter 31 - Page 2
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

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.

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

Chapter 31 - Page 5
Status Profiles
Status Profiles
Status profiles determine a contacts eligibility based

on a status, such as:
Disabled
Marital
Military
Student

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

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

Chapter 31 - Page 8
Link Profiles to Compensation Objects
Attach dependent coverage eligibility profiles to

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

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.

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)

Other Designation Information for Compensation Objects
Other Designation Information for

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

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

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

Practice: Defining a Dependent Coverage Eligibility Profile
Practice: Defining a Dependent Coverage

Eligibility Profile

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

Dependent Designation
Requirements
Chapter 32
Dependent Designation Requirements

Chapter 32 - Page 1

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

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

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.

Chapter 32 - Page 5
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

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.

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

Chapter 32 - Page 8
Family Member Codes
Family Member Codes
Family member code treatment cascades down the

Eligibility Check Program

Code = null
Plan Type
Family Member
Plan
Code = Check
Option

Chapter 32 - Page 9
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

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.

Eligibility check codes cascade down in the

Eligibility Check Program

Code = null
Plan Type
Eligibility Check Plan

Code = Dep.
Only
Option

Practice: Defining Dependent Designation Requirements
Practice: Defining Dependent


provided, to define designation requirements
Navigate to the Options window using your local
(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:
Options

Beneficiary Designations
Chapter 33
Chapter 33 - Page 1
Chapter 33 - Page 2
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
Chapter 33 - Page 3

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)
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
Chapter 33 - Page 5
Practice: Designating Beneficiaries
Practice: Designating Beneficiaries

provided, to designate beneficiaries
Navigate to the Plan Enrollment Requirements
window window using your local Super or HRMS
Manager responsibility
Requirements
Online Help
For details on how to designate beneficiaries please refer to the online Help path:
Requirements > How To > Define Beneficiary Designation Requirements
Chapter 33 - Page 6
Summary
Chapter 34
Summary
Chapter 34 - Page 1
Summary
Summary

Define Dependent coverage eligibility profiles
Define Dependent designation requirements
Setup Beneficiary designations
Summary
Chapter 34 - Page 2
Activity Rates and Coverage
Calculations
Chapter 35
Activity Rates and Coverage Calculations

Chapter 35 - Page 1

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

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

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

Chapter 35 - Page 5
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.

Chapter 35 - Page 6
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

Chapter 35 - Page 7
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

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

Chapter 35 - Page 9
Objectives
Objectives

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



6. Plan Types (M)
12. Program
Enrollment
Requirements (M)

13. Plan
Enrollment
Coverage (O) (O)
Requirements (O)


23.
Communications
Activities (O) (O)
(O)

Defining Variable Rate
Profiles
Chapter 36

Chapter 36 - Page 1

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

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
Employment Personal Derived Factors Other

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

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

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

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.

Chapter 36 - Page 8
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

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.

Chapter 36 - Page 9
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

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.

Practice: Defining a Variable Rate Profile
Practice: Defining a Variable Rate Profile

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

Defining Coverage
Calculations
Chapter 37

Chapter 37 - Page 1

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

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

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

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.

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.

Chapter 37 - Page 7
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

Chapter 37 - Page 8
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

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.

Practice: Defining a Coverage Calculation
Practice: Defining a Coverage Calculation

provided, to define a coverage calculation
Navigate to the Coverages window using your local
(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


Chapter 38

Chapter 38 - Page 1

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

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

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

Chapter 38 - Page 5
Example - Actual Premium
Compensation
Object
Plan/Option for Individual

Total Participant
Participants Premium

Chapter 38 - Page 6
Employee Only
Medical Option
Plan/Option Individual
$200x Total Participant $200
Participants

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

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

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

Calculation Methods
Calculation Methods
Select a method to define how Oracle HRMS calculates

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

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

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.

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

Practice: Defining an Actual Premium
Practice: Defining an Actual Premium

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:
Calculations > How To > Define an Actual Premium


Chapter 39

Chapter 39 - Page 1

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

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

Chapter 39 - Page 4
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

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.

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

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.

Chapter 39 - Page 7
Practice: Defining an Element
Practice: Defining an Element

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

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

Chapter 40 - Page 1
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

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

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.

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

Chapter 40 - Page 6
Compensation Object
SR SR SR
EL EL EL
IV IV IV
Standard Rates
Each standard rate can have one element with one input value.

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

Chapter 40 - Page 8
Standard Rates - Multiple of Coverage
Standard Rates - Multiple of Coverage
Supplemental Life
Coverage 1x Salary
Standard Rate =
.01/1000

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

Standard Rates - Parent/Child
Standard Rates - Parent/Child
Fringe Benefit Plan
Parent Rate
Child Rate Child Rate (Taxable

(Administrative Fee) Amount)

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

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

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

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

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

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 Parent Rate
Multiple of Parent Rate and Coverage
Multiple of Premium
Multiple of Premium and Coverage

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

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)

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

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

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

Practice: Defining a Standard Rate
Practice: Defining a Standard Rate

provided, to define a standard rate
Navigate to the Standard Rates window using your
(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:
Calculations > How To > Define Standard Contributions & Distributions > Define Activity
Rates for Contribution/Distribution

Summary
Chapter 41
Summary
Chapter 41 - Page 1
Summary
Summary

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
Summary
Chapter 41 - Page 2

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11i Oracle HRMS Implement

Advanced Benefits (US)

Restricted Rights Legend

Philip Chapman, Keith Ekiss, Juliette Fleming

John Cafolla, Philip Chapman, Marshall Isaacson

This book was published using: oracletutor

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Copyright Oracle Corporation, 2002. All rights reserved.

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

Thorough knowledge of Navigation in Oracle Applications Release 11i

R11i Implementing Oracle Human Resources 148055GC120

R11i Implementing and Administer Payroll (US) D16219GC10

How This Course Is Organized

Copyright Oracle Corporation, 2002. All rights reserved.

11i Oracle HRMS Implement Advanced Benefits (US) Preface

System release bulletins

Installation and users guides

International Users Group (IOUG) articles

Copyright Oracle Corporation, 2002. All rights reserved.

11i Oracle HRMS Implement Advanced Benefits (US) Preface

Convention Element Example

Caps and Buttons, Click the Executable button.

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

Initial cap Graphics labels Customer address (but Oracle Payables)

Italic Emphasized words Do not save changes to the database.

Uppercase SQL column Use the SELECT command to view

Copyright Oracle Corporation, 2002. All rights reserved.

11i Oracle HRMS Implement Advanced Benefits (US) Preface

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

Typographic Conventions in Code

Convention Element Example

Passwords DROP USER scott

Lowercase Syntax variables CREATE ROLE role

Typographic Conventions in Navigation Paths

Copyright Oracle Corporation, 2002. All rights reserved.

11i Oracle HRMS Implement Advanced Benefits (US) Preface

Typographical Conventions in Help System Paths

The following help navigation path, for example

represents the following sequence of actions:

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

4. Under How To, select Define Elements