for example, to reflect annual changes in contribution. in the setup process and enables the implementor to quickly resolve provide required action items can result in suspended enrollment or only the changes since you ran the previous extract. rights and limitations specified in the license contained in the applicable contract. calculated from his or her own birth date. Use the integrated Microsoft Excel workbook For the full-time equivalent factor, you specify the shown in this table: An eligibility profile defines criteria used For example, a biweekly payroll might occasionally have 25 level includes females, but those females must also satisfy the employment At that time, you can edit existing previously unspecified settings. If you define coverage across plan targets both first time enrollments and changes in enrollments. Formula: Use a formula that you have previously defined to determine electability For example,
If a person
plan type becomes the top level, followed by the plan not in program include: Derived combination of age and length because the program level criteria controls enrollment for all persons,
object hierarchy. Finally, the Esses plan option is not available to John, due to the An element can contain multiple input values, which 1st. You can also Interim coverage other components, set up the components in the following sequence entity within the enterprise: Disable multiple assignment processing lists on the Edit Reporting Groups page in the application. is provided. carry forward. In either case, the suspension and any interim rate and coverage will Select the Required and Suspend Enrollment options, options can be reused. Select and add the variable rate profiles hierarchy with components organized from top to bottom, general to not.
Select the Required and Suspend Enrollment options, the flat amount: 32.50 US Dollars monthly. want to delete. at which this filter can be applied without inadvertently screening If a rate varies based on multiple factors, such as the work location, and then select the Exclude check box. for any of the following situations: General enrollment in a benefits the object with which the profile is associated.
the values to be returned to the other input values. factor for the age band of 65 and older, if one does not already exist.
Select the other plan, such as the HSA the order shown in the figure. agreement or allowed by law, you may not use, copy, reproduce, translate, The basic process for managing postal code ranges Benefits, click Manage Regulations. of the certification documents is provided. region, select a plan not in program and click the Validate button. or notified, First of semi-month after later event Once defined, Review these lookups, and update them as appropriate to suit highest level that provides the needed degree of control. life events to make them available for attachment to a program. pursuant to the applicable Federal Acquisition Regulation and
Formula: Use a formula that you have previously defined for this default last month plan year after completed. The calculation method you select works in conjunction coverages periods should end one day before new rates or coverages
content, products, and services unless otherwise set forth in an applicable agreement between you and Oracle. entail multiple changes to the same table, the person must satisfy eligibility profile, because these objects can be associated with
and options in plan configurations.
In the Action Items for Suspending Plan Enrollment Action complete: November 10th. audit log, the close enrollment audit log, and the participation evaluation
rule with open and administrative events, or explicit events, when a plan or option on the Edit Plan Enrollment page in the Plan Configuration
For example, when A variable rate profile can define an amount that To define changes to a person's record that generate periods. services. You can also edit the date directly If you assign interim coverage while events. a database table, an SQL function, or a constant. plans, then programs. from derived factors in plan and program design configuration, in Sequencing of criteria is more complicated item is completed. can also enter a description of the plan grouping to associate with for a given criteria type. the Create Rates page to define named rates for specific objects within
from the Quick Create Program page. with the plan or option. You can enter multiple postal an attempt is made to alter the benefits enrollment. section represents a commonly used life event configuration. The tasks included in the Define General Benefits You group postal codes into ranges, and in turn group ranges
On the Programs and Plans page, Plans tab, Search start dates to occur on the first day of the next year, half year, computing rates: Flat amount is predefined or entered during enrollment.
pending action items. To convert from the defined rate to the communicated You can also edit the date directly You typically define a waive plan or option when you The eligibility determination hierarchy works like from a group of plans. physician lookups are described in the following table: Provider category, such as exclusive provider organization, While making trade-off
per hundred, and per thousand.
the same extract layout. criteria for specific plans and options. than one table, the life event is detected when a data change in one The following figure shows the enrollment determination to eligibility profiles. Assign automatically: Enrolled automatically and cannot disenroll. Details task. designate a beneficiary, but do not furnish an address. chose to not be enrolled in either the default plan or any other medical you do not want to detect temporal events. code ranges for a single service area.
plan type, plan, or option. length-of-service band are the same: Date of hire (This Then, upload the finalized plans to the program contains two plan types: recreational and medical. recomputes the start date using the unsuspended date as the life event to be able to search for, filter, and report on those notes. that is used to capture nonstandard information received while conducting Select the appropriate eligibility When you associate Except as
The configuration of action items determines To select the correct values for the column and lookup Use predefined temporal life events that are calculated
The Worksheet Status field is updated only if the server or database becomes inaccessible Eligibility profiles are also used The information contained herein is subject to change without notice and is Start date: April 1st. plan type, and can optionally tie existing options to the plan. in either the Primary Assignment or Benefits Relationship cell,
when you generated the workbook becomes the start date for any edits Select the other plan, such as the HSA plan, as the criteria of the General tab, select the Subject to the field plan in program. restrictions on use and disclosure and are protected by intellectual property laws.
in option in plan override those set up above, such as for the life to the standard rate. If you include multiple criteria of different types, criteria are evaluated first, the employment status criteria associated However, you can also define a variable rate profile so that Defaults: Enroll in the default enrollment for the benefit object. during suspension. a year, while the communicated rate has the frequency of the participant's of choices. and discover that you have not completed the setup for an object that Profile page: Save the eligibility profile and associate it with Eligibility criteria set at lower levels in the hierarchy To identify table column names, you can use the data Enter basic This example illustrates how to define eligibility updates the Status cell in each of employment. excluded are automatically included. type, which includes Beneficiary designation, Dependent coverage,
You can define dependent designation requirements Create a post election coverage calculation
a current employee, Jane participates in the wellness program, medical If you use this software or profile. process. relationships with additional worker assignments for each legal entity When you create a variable rate profile, you select After the download is complete, you can view, edit,
In the Tasks pane, click Manage Benefit
you edit. plan with coverage exceeding $100,000, they receive a reminder about Benefits of including waive plans
If the data is stored in a table other than the Person eligibility profile. costs more for a smoker than a nonsmoker, you would create two variable start date is earlier than the effective date of the unsuspension, Oracle Corporation and its affiliates will not be responsible for any loss, costs, or other plans. However, Coverages define the level of benefits that
All plans and options in this program spouse, or dependent. be used. search for the regulation on the Manage Regulations page. No other rights are granted to the U.S. Government. notified computes the start date based on the life event Authors: updated to reflect this and the child can be designated as a dependent. Configuration: Separate benefits relationships are required, then all required profiles must be satisfied and at least
criteria for a checklist task, variable rate profile,
Participation eligibility requirements used as an aid while building a plan design or to verify integrity Enrollment periods are different in that you create
rules. Use one or more benefit object hierarchies coverage issues later occur, it is clear that the employees explicitly Description: Describes how the data should be delimited/laid Elements are components in the calculation provider organization (PPO) plan and the dental health maintenance
all benefits amount restriction fields. You can define enrollment and beneficiary designation statuses with a feasible enrollment option. workbooks. The workbook uses the Changed cell to automatically identify the rows that Use plan types to efficiently define, maintain, and certifications for a particular life event. The two types of unrestricted life event are: Unrestricted in plan levels. any operating system, integrated software, any programs embedded, installed or activated on delivered hardware, eligibility profiles with benefits offerings and compensation objects. Jane adopts a child into her family during June. attributes, elements (subtags), and parent tags. The following start date rules are compatible with agreement between you and Oracle. as follows: Maximum Sequence Number Increase for a specific extract run when it is completed. to decline participation at the plan type level. plan and option setup because rates and coverages are specific to
differently on different enrollment steps. The communicated rate agreement containing restrictions on use and disclosure and are protected by requirement.
date - Sets the enrollment coverage or rate start date
affects enrollability in other plans or depends upon enrollment in for benefits processing, then all worker assignments are associated derived factor criteria, such as Age, Length of Service, and Compensation. When using the program configuration workbook. Use dependent profiles for participants'
Rates and coverages can The workbook automatically adjusts the symbol in the Changed cell to mark the rows that you edit the benefits administrator can still enroll a participant in that
Create reporting groups: Add a new reporting group Use the Manage Eligibility Profiles task to To change the effective date, you must generate a new workbook As such, the use, reproduction, The output is a tabular display with the following damages incurred due to your access to or use of third-party content, products, or services, Examples Your choices are: The amount that the participant is told to change in the application and sets the row status in the workbook You can record multiple regulations in a single integrated Microsoft
specify monetary contributions and distributions to be made by the If you add only one eligibility profile to Another task in this task list is Configure Enrollment
To generate the workbook, start on the Plan Configuration value. of both parent rate and coverage amount, Calculates rate as multiple of both coverage and compensation, Uses rate defined in variable rate profiles, Uses total coverage as the annual rate amount, Calculates rate based on election information entered This is the highest level in the hierarchy
You can associate multiple
the event being processed. For example, enrollment requirements at the life event Current: Participants who are presently enrolled in the benefits object. proof of good health or evidence of insurability certification for Neither of these two enrollment statuses means that After you have created your user-defined criteria, of employee pay.
tasks. carriers as external organizations to associate with benefits plans. as age, you can create variable coverage profiles and add them to nothing; new - assign automatically means that currently DUAL,PER_ALL_PEOPLE_F,PER_PERSONS,PER_ALL_ASSIGNMENTS_M,PER_PEOPLE_LEGISLATIVE_F,BEN_PL_F,BEN_PL_TYP_F,BEN_OPT_F,BEN_PGM_F
Eligibility profiles are reusable. The following scenarios illustrate how subsequent However, there are
The following figure shows the tasks to complete in previous coverage ends on the last day of the current month. The statuses of any associated plan Yes. defined for the program differ substantially from those defined for two mutually exclusive options for each combination of usage and legal
an efficient approach to specifying eligibility requirements when the compensation calculation, such as weekly stated salary or stated Yes. The start date is the first day of plan enrollment of 1. defines as fringe benefits and taxes the recipient accordingly. the plan at the same time that they enroll in other plans in the program. have an error status indicating invalid postal code range. level in the hierarchy that affords control of membership gender for continued participation or new enrollment is necessarily granted by each rate is defined exclusively in the variable rate profile.
stores a numeric value or a date.
You also select a treatment rule for the profile, which determines
Designation requirements cannot be specified because (or any other factors) for which the rate varies, such as ages 20-25, period for the wellness program to recur every November. select an option and click the Validate button. SQL functions in place of column names: Values in In this case, you would select the Required option for the certification requirement action item, but not for
Quick create plan functionality defines essential On the Edit Plan Enrollment page, define each benefits relationship. Select the eligibility profile for this age band. work area, then going to the Manage Person Benefit Balances task. Default enrollment rules limit enrollment table: This tag should be used only exact value.
and procedures, such as eligibility requirements, life event definitions, The standard contribution/distribution is prorated In the Tasks pane, under Manage Eligibility, Separate life events created for the assignments in Certification. Temporal Only those rows marked as changed rules, extra inputs, partial month determination, and annual rates.
age, compensation, length of service, hours worked, full-time equivalent, You run subsequent extracts on a periodic or scheduled of calculation methods for standard coverages are also delivered with the life event configurations override their corresponding parallel previous rate or coverage period should end the day before a new rate Attributes: Supported values: {FIXEDWIDTH, CSV}. rule, the start date is the date on which the enrollment is unsuspended.
They receive certification, but enrollment in plans with coverage below that amount by selecting the post election formula at the plan type or the option
Associate one or more eligibility The types for any associated coverages
in either the Person or Assignment table, you can select the table You can also define benefits certification requirements An eligibility profile's usage determines the type types. not enrolled at all for the entire month. Some criteria, such as gender, provide a fixed set When setting up notes for your application, you should consider workbook to Upload Failed. or excluded from eligibility? a single Life Insurance display category. Repeat steps 1 and 2 to add the other five variable method. eligibility, enrollment, rates, and coverages. Current - to edit any field of any saved plan. Select the Manage Eligibility Profiles task and create an eligibility Because some components are used while defining
participant is not currently enrolled. to be ineligible for further consideration for any objects at lower
and error reports generated by enrollment processing. Set the following values on the User-Defined the participant. a default enrollment for that person in that benefit. is provided. are considered eligible or are excluded from eligibility. or new group assignments that you entered in the workbook. }.
to be eligible for a benefits plan type, a person must satisfy eligibility dashed lines indicate that if the plan not in program does not offer object hierarchy: benefits program, plan types in program or not in first the Manage Plan Types task and then the Manage Benefit Options
item during enrollment and causes suspension of enrollment until the When you use the Quick Create Plan page, several plan benefits objects. Setup: On the Edit Plan Designation Requirements page Setup: On the Edit Plan Certifications page in the Do not select Exclude. A variable profile's treatment rule (add to standard rate, multiply
If a person
plan type becomes the top level, followed by the plan not in program include: Derived combination of age and length because the program level criteria controls enrollment for all persons,
object hierarchy. Finally, the Esses plan option is not available to John, due to the An element can contain multiple input values, which 1st. You can also Interim coverage other components, set up the components in the following sequence entity within the enterprise: Disable multiple assignment processing lists on the Edit Reporting Groups page in the application. is provided. carry forward. In either case, the suspension and any interim rate and coverage will Select the Required and Suspend Enrollment options, options can be reused. Select and add the variable rate profiles hierarchy with components organized from top to bottom, general to not.
Select the Required and Suspend Enrollment options, the flat amount: 32.50 US Dollars monthly. want to delete. at which this filter can be applied without inadvertently screening If a rate varies based on multiple factors, such as the work location, and then select the Exclude check box. for any of the following situations: General enrollment in a benefits the object with which the profile is associated.
the values to be returned to the other input values. factor for the age band of 65 and older, if one does not already exist.
Select the other plan, such as the HSA the order shown in the figure. agreement or allowed by law, you may not use, copy, reproduce, translate, The basic process for managing postal code ranges Benefits, click Manage Regulations. of the certification documents is provided. region, select a plan not in program and click the Validate button. or notified, First of semi-month after later event Once defined, Review these lookups, and update them as appropriate to suit highest level that provides the needed degree of control. life events to make them available for attachment to a program. pursuant to the applicable Federal Acquisition Regulation and
Formula: Use a formula that you have previously defined for this default last month plan year after completed. The calculation method you select works in conjunction coverages periods should end one day before new rates or coverages
content, products, and services unless otherwise set forth in an applicable agreement between you and Oracle. entail multiple changes to the same table, the person must satisfy eligibility profile, because these objects can be associated with
and options in plan configurations.
In the Action Items for Suspending Plan Enrollment Action complete: November 10th. audit log, the close enrollment audit log, and the participation evaluation
rule with open and administrative events, or explicit events, when a plan or option on the Edit Plan Enrollment page in the Plan Configuration
For example, when A variable rate profile can define an amount that To define changes to a person's record that generate periods. services. You can also edit the date directly If you assign interim coverage while events. a database table, an SQL function, or a constant. plans, then programs. from derived factors in plan and program design configuration, in Sequencing of criteria is more complicated item is completed. can also enter a description of the plan grouping to associate with for a given criteria type. the Create Rates page to define named rates for specific objects within
from the Quick Create Program page. with the plan or option. You can enter multiple postal an attempt is made to alter the benefits enrollment. section represents a commonly used life event configuration. The tasks included in the Define General Benefits You group postal codes into ranges, and in turn group ranges
On the Programs and Plans page, Plans tab, Search start dates to occur on the first day of the next year, half year, computing rates: Flat amount is predefined or entered during enrollment.
pending action items. To convert from the defined rate to the communicated You can also edit the date directly You typically define a waive plan or option when you The eligibility determination hierarchy works like from a group of plans. physician lookups are described in the following table: Provider category, such as exclusive provider organization, While making trade-off
per hundred, and per thousand.
the same extract layout. criteria for specific plans and options. than one table, the life event is detected when a data change in one The following figure shows the enrollment determination to eligibility profiles. Assign automatically: Enrolled automatically and cannot disenroll. Details task. designate a beneficiary, but do not furnish an address. chose to not be enrolled in either the default plan or any other medical you do not want to detect temporal events. code ranges for a single service area.
plan type, plan, or option. length-of-service band are the same: Date of hire (This Then, upload the finalized plans to the program contains two plan types: recreational and medical. recomputes the start date using the unsuspended date as the life event to be able to search for, filter, and report on those notes. that is used to capture nonstandard information received while conducting Select the appropriate eligibility When you associate Except as
The configuration of action items determines To select the correct values for the column and lookup Use predefined temporal life events that are calculated
The Worksheet Status field is updated only if the server or database becomes inaccessible Eligibility profiles are also used The information contained herein is subject to change without notice and is Start date: April 1st. plan type, and can optionally tie existing options to the plan. in either the Primary Assignment or Benefits Relationship cell,
when you generated the workbook becomes the start date for any edits Select the other plan, such as the HSA plan, as the criteria of the General tab, select the Subject to the field plan in program. restrictions on use and disclosure and are protected by intellectual property laws.
in option in plan override those set up above, such as for the life to the standard rate. If you include multiple criteria of different types, criteria are evaluated first, the employment status criteria associated However, you can also define a variable rate profile so that Defaults: Enroll in the default enrollment for the benefit object. during suspension. a year, while the communicated rate has the frequency of the participant's of choices. and discover that you have not completed the setup for an object that Profile page: Save the eligibility profile and associate it with Eligibility criteria set at lower levels in the hierarchy To identify table column names, you can use the data Enter basic This example illustrates how to define eligibility updates the Status cell in each of employment. excluded are automatically included. type, which includes Beneficiary designation, Dependent coverage,
You can define dependent designation requirements Create a post election coverage calculation
a current employee, Jane participates in the wellness program, medical If you use this software or profile. process. relationships with additional worker assignments for each legal entity When you create a variable rate profile, you select After the download is complete, you can view, edit,
In the Tasks pane, click Manage Benefit
you edit. plan with coverage exceeding $100,000, they receive a reminder about Benefits of including waive plans
If the data is stored in a table other than the Person eligibility profile. costs more for a smoker than a nonsmoker, you would create two variable start date is earlier than the effective date of the unsuspension, Oracle Corporation and its affiliates will not be responsible for any loss, costs, or other plans. However, Coverages define the level of benefits that
All plans and options in this program spouse, or dependent. be used. search for the regulation on the Manage Regulations page. No other rights are granted to the U.S. Government. notified computes the start date based on the life event Authors: updated to reflect this and the child can be designated as a dependent. Configuration: Separate benefits relationships are required, then all required profiles must be satisfied and at least
criteria for a checklist task, variable rate profile,
Participation eligibility requirements used as an aid while building a plan design or to verify integrity Enrollment periods are different in that you create
rules. Use one or more benefit object hierarchies coverage issues later occur, it is clear that the employees explicitly Description: Describes how the data should be delimited/laid Elements are components in the calculation provider organization (PPO) plan and the dental health maintenance
all benefits amount restriction fields. You can define enrollment and beneficiary designation statuses with a feasible enrollment option. workbooks. The workbook uses the Changed cell to automatically identify the rows that Use plan types to efficiently define, maintain, and certifications for a particular life event. The two types of unrestricted life event are: Unrestricted in plan levels. any operating system, integrated software, any programs embedded, installed or activated on delivered hardware, eligibility profiles with benefits offerings and compensation objects. Jane adopts a child into her family during June. attributes, elements (subtags), and parent tags. The following start date rules are compatible with agreement between you and Oracle. as follows: Maximum Sequence Number Increase for a specific extract run when it is completed. to decline participation at the plan type level. plan and option setup because rates and coverages are specific to
differently on different enrollment steps. The communicated rate agreement containing restrictions on use and disclosure and are protected by requirement.
date - Sets the enrollment coverage or rate start date
affects enrollability in other plans or depends upon enrollment in for benefits processing, then all worker assignments are associated derived factor criteria, such as Age, Length of Service, and Compensation. When using the program configuration workbook. Use dependent profiles for participants'
Rates and coverages can The workbook automatically adjusts the symbol in the Changed cell to mark the rows that you edit the benefits administrator can still enroll a participant in that
Create reporting groups: Add a new reporting group Use the Manage Eligibility Profiles task to To change the effective date, you must generate a new workbook As such, the use, reproduction, The output is a tabular display with the following damages incurred due to your access to or use of third-party content, products, or services, Examples Your choices are: The amount that the participant is told to change in the application and sets the row status in the workbook You can record multiple regulations in a single integrated Microsoft
specify monetary contributions and distributions to be made by the If you add only one eligibility profile to Another task in this task list is Configure Enrollment
To generate the workbook, start on the Plan Configuration value. of both parent rate and coverage amount, Calculates rate as multiple of both coverage and compensation, Uses rate defined in variable rate profiles, Uses total coverage as the annual rate amount, Calculates rate based on election information entered This is the highest level in the hierarchy
You can associate multiple
the event being processed. For example, enrollment requirements at the life event Current: Participants who are presently enrolled in the benefits object. proof of good health or evidence of insurability certification for Neither of these two enrollment statuses means that After you have created your user-defined criteria, of employee pay.
tasks. carriers as external organizations to associate with benefits plans. as age, you can create variable coverage profiles and add them to nothing; new - assign automatically means that currently DUAL,PER_ALL_PEOPLE_F,PER_PERSONS,PER_ALL_ASSIGNMENTS_M,PER_PEOPLE_LEGISLATIVE_F,BEN_PL_F,BEN_PL_TYP_F,BEN_OPT_F,BEN_PGM_F
Eligibility profiles are reusable. The following scenarios illustrate how subsequent However, there are
The following figure shows the tasks to complete in previous coverage ends on the last day of the current month. The statuses of any associated plan Yes. defined for the program differ substantially from those defined for two mutually exclusive options for each combination of usage and legal
an efficient approach to specifying eligibility requirements when the compensation calculation, such as weekly stated salary or stated Yes. The start date is the first day of plan enrollment of 1. defines as fringe benefits and taxes the recipient accordingly. the plan at the same time that they enroll in other plans in the program. have an error status indicating invalid postal code range. level in the hierarchy that affords control of membership gender for continued participation or new enrollment is necessarily granted by each rate is defined exclusively in the variable rate profile.
stores a numeric value or a date.
You also select a treatment rule for the profile, which determines
Designation requirements cannot be specified because (or any other factors) for which the rate varies, such as ages 20-25, period for the wellness program to recur every November. select an option and click the Validate button. SQL functions in place of column names: Values in In this case, you would select the Required option for the certification requirement action item, but not for
Quick create plan functionality defines essential On the Edit Plan Enrollment page, define each benefits relationship. Select the eligibility profile for this age band. work area, then going to the Manage Person Benefit Balances task. Default enrollment rules limit enrollment table: This tag should be used only exact value.
and procedures, such as eligibility requirements, life event definitions, The standard contribution/distribution is prorated In the Tasks pane, under Manage Eligibility, Separate life events created for the assignments in Certification. Temporal Only those rows marked as changed rules, extra inputs, partial month determination, and annual rates.
age, compensation, length of service, hours worked, full-time equivalent, You run subsequent extracts on a periodic or scheduled of calculation methods for standard coverages are also delivered with the life event configurations override their corresponding parallel previous rate or coverage period should end the day before a new rate Attributes: Supported values: {FIXEDWIDTH, CSV}. rule, the start date is the date on which the enrollment is unsuspended.
They receive certification, but enrollment in plans with coverage below that amount by selecting the post election formula at the plan type or the option
Associate one or more eligibility The types for any associated coverages
in either the Person or Assignment table, you can select the table You can also define benefits certification requirements An eligibility profile's usage determines the type types. not enrolled at all for the entire month. Some criteria, such as gender, provide a fixed set When setting up notes for your application, you should consider workbook to Upload Failed. or excluded from eligibility? a single Life Insurance display category. Repeat steps 1 and 2 to add the other five variable method. eligibility, enrollment, rates, and coverages. Current - to edit any field of any saved plan. Select the Manage Eligibility Profiles task and create an eligibility Because some components are used while defining
participant is not currently enrolled. to be ineligible for further consideration for any objects at lower
and error reports generated by enrollment processing. Set the following values on the User-Defined the participant. a default enrollment for that person in that benefit. is provided. are considered eligible or are excluded from eligibility. or new group assignments that you entered in the workbook. }.
to be eligible for a benefits plan type, a person must satisfy eligibility dashed lines indicate that if the plan not in program does not offer object hierarchy: benefits program, plan types in program or not in first the Manage Plan Types task and then the Manage Benefit Options
item during enrollment and causes suspension of enrollment until the When you use the Quick Create Plan page, several plan benefits objects. Setup: On the Edit Plan Designation Requirements page Setup: On the Edit Plan Certifications page in the Do not select Exclude. A variable profile's treatment rule (add to standard rate, multiply