Using Benefits

Oracle Fusion
Cloud Human
Resources
Using Benefits
24A
Oracle Fusion Cloud Human Resources
Using Benefits
24A
F88737-01
Copyright © 2011, 2024, Oracle and/or its affiliates.
Author: Byju Thampi
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Using Benefits
Contents
Get Help ................................................................................................................................ i
1 Overview 1
Overview of Using Benefits .......................................................................................................................................................... 1
2 Maintain Benefits Enrollments 3

Overview of Benefits Service Center .......................................................................................................................................... 3
Overview of the My Dashboard Page ........................................................................................................................................ 3
How You Configure the My Dashboard Page .......................................................................................................................... 4
Row Limit on Benefits Dashboard Counts ................................................................................................................................ 5
Apply Row Limit on Benefits Dashboard Counts .................................................................................................................... 5
Overview of the Benefits Summary Page ................................................................................................................................. 6
Life Event Statuses ........................................................................................................................................................................ 8
How Benefits Relationships Impacts Benefits Processing .................................................................................................... 9
How can I ensure that a worker's benefits relationship is accurate? ................................................................................. 13
The Assign and Update Benefits Relationships Process ..................................................................................................... 14
When do I run the Assign and Update Benefits Relationships process? .......................................................................... 15
How You Get the Latest Benefits Relationship Information for a Worker ........................................................................ 16
How Action Items Are Processed .............................................................................................................................................. 17
Manage Action Items Process ................................................................................................................................................... 19
Impact of Action Items and Suspensions on Manage Action Items Process ................................................................. 20
Review and Resolve Participant Action Items ........................................................................................................................ 21
Benefits Relationships and Action Items ................................................................................................................................. 21
Impact of Action Items and Suspensions on Close Enrollment Process .......................................................................... 21
Impact of Action Items and Suspensions on Participation Evaluation Processes ......................................................... 22
Examples of Original Coverage Start Date in Benefits ........................................................................................................ 23
Why can't I see or edit a benefit participant's contacts? .................................................................................................... 24
Configure Contacts Page Security for Participants and Administrators .......................................................................... 25
FSA and HSA Calculators in Benefits ...................................................................................................................................... 25
Estimate Savings and Spending Using FSA and HSA Calculators .................................................................................... 26
FAQs for Enrollments .................................................................................................................................................................. 26
Using Benefits
3 Manage Benefits Processing and Uploads 33

Reports and Analytics ................................................................................................................................................................. 33
Process Parameters ..................................................................................................................................................................... 34
Person Number Entry in Benefits Batch Processes ............................................................................................................. 39
How You Purge Benefits Staging Data ................................................................................................................................... 40
Advanced Logs for Purge Processes ....................................................................................................................................... 40
Spreadsheet Loaders ................................................................................................................................................................... 41
FAQs for Evaluation and Reporting ......................................................................................................................................... 55
4 Manage Document Uploads 59

Upload Supporting Documents ................................................................................................................................................ 59
Review and Approve Documents ............................................................................................................................................. 59
How You Resolve Participant Queries on Document Approvals ....................................................................................... 60
How can I change the validity period for documents? ....................................................................................................... 60
How You Manage Missing Certifications ............................................................................................................................... 60
Enable Participants to Declare Missing Certifications .......................................................................................................... 61
5 Enroll in Benefits 63
Overview of the Benefits Work Area ....................................................................................................................................... 63
How You Enroll in Benefits ........................................................................................................................................................ 63
Examples of Entering Contact Start Date for Benefits Designation Purposes ............................................................... 65
Considerations for Using the Change Beneficiaries Page .................................................................................................. 66
How You Can Update Beneficiary Designations ................................................................................................................... 67
Enable Participants to Update Beneficiary Designations Anytime ................................................................................... 67
FAQs for Self Service Elections ................................................................................................................................................. 68
6 Prepare for Open Enrollment 71

Overview of Benefits Open Enrollment ................................................................................................................................... 71
Prepare Program and Plan Configuration for Open Enrollment ........................................................................................ 74
Options to Configure Open Enrollment Period ..................................................................................................................... 78
Reinstatement Rules .................................................................................................................................................................... 81
Options to Configure Open Enrollment Rates ....................................................................................................................... 82
Restart Coverage for Flexible Spending Accounts ............................................................................................................... 85
Configure Enrollment Display ................................................................................................................................................... 87
Identify and Resolve In-Progress Life Events Before Open Enrollment ........................................................................... 88
FAQs for Open Enrollment Preparations ................................................................................................................................ 90
Using Benefits
7 Manage Open Enrollment 91

Overview of Benefits Open Enrollment ................................................................................................................................... 91
Process Trial Open Enrollment ................................................................................................................................................. 94
Manage Open Enrollment Period ............................................................................................................................................. 96
Scheduled Event Participation Process Options ................................................................................................................... 98
Monitor Processes and Resolve Errors ................................................................................................................................... 99
Life Events That Occur During Open Enrollment Period .................................................................................................. 100
Examples of Processing Life Events That Occur During Open Enrollment .................................................................... 101
How Participants and Administrators Enter Enrollments .................................................................................................. 103
Set Up and Process an Open Enrollment Period ................................................................................................................ 104
How You Manage an Open Enrollment Window ................................................................................................................. 108
Extend Open Enrollment Window .......................................................................................................................................... 109
How You Manage Tasks After the Open Enrollment Closes ............................................................................................. 109
Remove Incorrect Person Data in Non-Production Environments ................................................................................... 112
8 Billing 113
Overview of Billing in Benefits ................................................................................................................................................. 113
Guidelines to Use Benefits Billing Processes ........................................................................................................................ 114
Apply Credits to Participants .................................................................................................................................................... 115
Refund Excess Credits to Participants .................................................................................................................................... 115
FAQs for Billing ............................................................................................................................................................................ 116
9 Integrated Workbooks for Loading Data 121

Overview of Managing Benefits Objects in Integrated Workbooks .................................................................................. 121
Manage Person Benefit Groups in the Integrated Workbook ............................................................................................ 121
Manage Person Benefit Balances in the Integrated Workbook ........................................................................................ 123
Manage Person Habits in the Integrated Workbook ........................................................................................................... 125
Overview of Managing Benefit Enrollments in the Integrated Workbook ...................................................................... 127
Benefit Enrollment Integrated Workbook Columns ............................................................................................................ 128
Upload Enrollment Workbook Data to Interim Tables ......................................................................................................... 131
Upload Benefit Enrollments Batch to Database Tables ...................................................................................................... 133
Manage Benefit Enrollment Certifications in the Integrated Workbook ........................................................................ 134
FAQs for Integrated Workbooks .............................................................................................................................................. 135
10 Benefits Setup Maintenance 137

Maintenance Setup Tasks in Benefits: Overview ................................................................................................................. 137
Using Benefits
11 Court Orders 139

Overview of Benefit Court Order Administration ................................................................................................................ 139
FAQs for Court Orders ............................................................................................................................................................... 139
12 Benefit Plan Comparison 141

Overview of Plan Comparison .................................................................................................................................................. 141
Compare Benefits Plans ............................................................................................................................................................ 141
FAQ for Benefit Plan Comparison ........................................................................................................................................... 141
Oracle Fusion Cloud Human Resources Get Help
Using Benefits
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Oracle Fusion Cloud Human Resources Get Help
Using Benefits
ii
Oracle Fusion Cloud Human Resources Chapter 1
Using Benefits Overview
1 Overview
Overview of Using Benefits

This overview outlines the activities throughout the benefits cycle, from maintaining benefits enrollment information for
your employees to running processes and reports.
The Manage Benefits business process contains the following activities:
• Manage Benefit Plans, Programs, and Events

• Maintain Benefits Enrollments
• Elect Benefits
The following table provides the main work areas to use for these activities:
Activity Work Areas
Manage Benefit Plans, Programs, and Plan Configuration

Events
Maintain Benefits Enrollments Enrollment
Evaluation and Reporting
Reports and Analytics
Elect Benefits Me, Benefits
Manage Benefit Plans, Programs, and Events

Update configurations of benefits objects, including:
• Eligibility
• Life events
• Plans and programs
• Rates and coverages
• Flex credits
You can also configure display of information in the self service enrollment guided process, and export and import plan
configurations.
1
Using Benefits Overview
Maintain Benefits Enrollments

Coordinate and manage day-to-day benefits enrollment activities for participants in a central location. Run processes to
manage enrollments for multiple employees. Administer certification requirements and designation requirements that
enrollments generate.
Reports
View reports based on enrollments and other transactions, including:
• Person enrollment summary

• Person enrollment kit
• Person enrollment results
• Pending action items
• Life event reports
The Creating and Editing Analytics and Reports guide explains how you can edit or create reports for your own
purposes.
Elect Benefits
Participants can:
• Change benefit elections

• View pending action items
• Update contacts
• Update beneficiary organizations
• View and print a summary report
Related Topics
• Overview of Benefits Service Center
• Overview of Benefits Open Enrollment
• Overview of Benefits Reports and Analytics
2
Using Benefits Maintain Benefits Enrollments
2 Maintain Benefits Enrollments
Overview of Benefits Service Center

Coordinate and manage day-to-day benefits enrollment activities for participants in a central location.
Using the Benefits Service Center page, benefits professionals can:
• Enter and update benefits selections, individual eligibility exceptions, and overrides for participants
• View enrollments, update coverage and dependents, and designate beneficiaries as a participant's personal and
employment data changes
• Record the history of communications and notable transactions for retrieval with a participant's records
Enrollments generate action items that help benefits professionals administer:
• Certification requirements, such as proof of student status or proof of good health

• Designation requirements, such as dependents, beneficiaries, and primary care physicians
Related Topics
Overview of the My Dashboard Page

Administrators can use the My Dashboard page to see at a glance the list of tasks they need to perform.
For example, you can quickly get to know how many people have life events that need manual intervention, and how
many people have pending actions. You can get to the details from the activity counts, or even jump to a specific
person's benefits summary to do person-related benefits tasks.
To get to the My Dashboard page, on the Home page, click Benefits Administration, and then click Enrollment.
How You Adjust the Timeline

By default, benefits activities that happened in the current week appear. You can change the timeline by choosing to
view activities in the current month, the next 3 months into the future, or the last 3 months in the past.
How You Learn More About Benefits Activities

You can use the My Dashboard page to see at a glance the list of tasks you need to perform. For instance, you see
that 10 people have pending actions. If you want to learn more about this activity count, simply click the activity link to
access a page to see those persons that have the pending actions. Then, click the person's name to open their benefits
summary. On that page, you can check the scorecard to know how many pending actions the person has. For example,
10 pending actions. Click the count to open a page that tells you the specific action item that's pending.
3
How You View the Benefits Summary for a Specific Person

If you want to open the benefits summary of a specific person, enter the name, or person number, or any other
keyword, such as an email address, in the Search for a Person box. If the person record exists, you should see the person
record appear in the results below the box. Click the person's name to open their Benefits Summary page.
How You Configure the My Dashboard Page

The My Dashboard page, out of the box, displays all the counts except the People with Closed Events count. You can
choose to hide or show these counts.
For example, if your company doesn't deal with court orders, you can choose to hide that count. You can even change
the sequence in which the counts appear.
If you have the required access permissions, you configure the My Dashboard page from the Setup and Maintenance
work area, using the Manage Common Lookups task. Open the ORA_BEN_RESP_SUMMARY look up type.
Each activity count that you see on the My Dashboard page appears as a lookup code. Here's what you can configure:
Configuration aspect How to configure
Display or hide an activity and its count Select or deselect the Enabled check box. For example, if your organization doesn't use the billing
feature, you might want to deselect the Enabled check box for the People with unpaid bills row.
If you deselect the Enabled check box for all the counts, the entire section won't appear on My
Dashboard. Only the search box appears.
Determine the top 4 activity counts The first 4 activity counts, starting with the display sequence number 1, are the counts that appear on
the My Dashboard page. Other activity counts appear, but only when you click the Show more link.
Reword the activity Enter a new name in the Meaning field.
Change the display sequence of activity Enter a new sequence number in the Display Sequence field for the lookup code. Adjust the sequence
counts numbers in the rest of the lookup codes as required.
Note: The People with closed life events count doesn't appear by default. You can, however, choose to display it. You
might see a decrease in performance because of the typically large counts associated with this activity.
If you want your users to use only the Search and not the counts, you can hide the dashboard section completely by
using the functionality in the HCM Experience Design Studio.
4
Related Topics
Row Limit on Benefits Dashboard Counts

If you see any errors due to the high volume of data used for the calculation of activity counts in Benefits dashboard,
you can apply the row limit on those counts.
This limits the number of rows used for the calculation of activity counts.
The maximum value used for limiting the row counts is 50000. Here’s how the row limits are calculated:
Calculation of Row Limits
Value You Set Value Used for Calculations
50000 or less. The value you set.
More than 50000. 50000
Any non-numeric values. For example, 50000

Fifteen Thousand.
Values include special characters. For 50000

example, 25,000 or 150.5
Related Topics
• Apply Row Limit on Benefits Dashboard Counts
Apply Row Limit on Benefits Dashboard Counts

Here’s how you enable the lookup code to set the maximum row limit:
Steps to set the maximum row limit

1. Select the Manage Common Lookups task in the Setup and Maintenance work area.
2. Create a lookup type with these details:
◦ Lookup Type: BEN_DASHBOARD_ROW_LIMIT
◦ Meaning: Benefits Dashboard Row Limit
◦ Module: Benefits Repository
3. Search for BEN_DASHBOARD_ROW_LIMIT.
4. Add a new row in the Lookup Codes section.
5. Enter MAX_ROW_LIMIT as the Lookup Code.
6. . Add a new row in the Lookup Codes section.
7. Select the Enabled check box.
8. Enter the row limit in the Meaning column. The maximum value used for limiting the row counts is 50000.
5
9. Click Save. When you create and enable the MAX_ROW_LIMIT lookup code, you see a plus sign (+) next to the
person count if the row count exceeds the maximum limit you set.
Related Topics
• Row Limit on Benefits Dashboard Counts
Overview of the Benefits Summary Page

The Benefits Summary page of a benefits participant has these key areas that let you complete benefits related tasks or
answer any questions that a participant might have.
Here are the details of the areas on the Benefits Summary page:
Number Area Details
1 Side Panel This panel contains supporting tasks related

to the participant. For example, you use the
People to Cover task to see and manage the
person's dependents and beneficiaries that you
can later use during enrollment. You use the
Benefit Groups task to see what groups the
participant is enrolled in and manage new and
existing memberships.
6
Number Area Details
2 Effective Dates and Benefits Relationship The information in the Benefits Summary page
appears on the basis of the effective date and
the benefits relationship that you select.
3 Scorecard You can see the counts of various benefits

aspects or activities. For example, you can
see a count of the life events that require your
intervention, new life events, pending actions,
court orders, and documents that you need to
review.
Click the count to open a page or navigate to a

section within the summary page that has more
details.
4 Enrollments section The current enrollments for the participant as

of the effective date appear here. Use the filter
to see only those benefits with pending actions
or benefits that are suspended. The Actions
menu lets you change benefit elections, view
flex credits, and enrollment results. Depending
on plan setup, you can click the Actions
(ellipses) link to override the enrollment.
5 Evaluated Life Events section When the application processes a life event and
starts an enrollment window, the details appear
in this section. If the effective date you have
set is within the enrollment window, the Enroll
button appears. You can then make elections.
Depending on your configuration, you can use
the Actions menu to add an open enrollment
event.
For each evaluated life event, depending

on setup, you can click Actions (ellipses) to
back out the event, close the event, override
participant eligibility for that event, or view
enrollment opportunities that the life event
offers.
You can also print the enrollment document

so that you can share the report with the
participants to record their elections.
6 Potential Life Events section If life events were detected for the participant,
they appear here. To add a life event, click
Add. The Actions menu contains tasks to
process the life events. If you have configured
collapsing logic, click Determine Winning
Events. To process the life events and start an
enrollment window, you click Evaluate Life
Events.
7 Court Orders section This section lists existing court orders that were
defined for the participant. You can add or edit
court orders.
7
Number Area Details
8 Certification section If there are documents that you need to review

and approve, they will appear here. Use the
filter to see documents that are pending for
approval especially when there's a large list.
9 Notes section You use the Notes section to record any

comments or additional text that you want to
store for your reference.
Related Topics
Life Event Statuses

Life event status indicates the degree to which the event has been processed. This topic defines the status values found
on each tab of the Person Life Event page in the Benefits Service Center page.
Potential Life Event Tab

This table defines the status values found on the Potential Life Event tab.
Status Description
Detected The life event, such as marriage event, was triggered for the person and participation evaluation
processing hasn't yet evaluated it.
Unprocessed You created the life event manually on this tab. The next time participation evaluation processing runs,
it changes the status to Detected.
Voided You select this status to indicate that the potential event should not be processed further.
Manual This status prevents participation evaluation processing from processing a detected event. Use it to
indicate that manual intervention is required. Set this status either manually or configure it to be set
automatically:
• Manually select this status when you manually create an event for a person.
• Configure the Timeliness Evaluation setting of a particular life event to set the status to Manual
when a detected event falls outside the defined timeliness period.
Life Event Tab

This table defines the status values found on the Life Event tab.
8
Status Description
Processed Participation evaluation processing evaluated this life event and one of the following conditions is true:
• The life event provided electable choices and enrollment opportunities, the participant enrolled,
and the life event was closed.
• The life event didn't provide enrollment opportunities because the participant doesn't meet
eligibility requirements.
Started Participation evaluation processing evaluated this life event and determined that the participant
currently has electable choices available for enrollment.
Backed Out The Back Out Life Events process ran for this life event in batch or individually for this person. Backing
out a life event rescinds any updates to worker records that resulted from the life event. You can back
out only life events in the Started or Processed status.
Voided When you run the Back Out Life Events process, you specify whether to delete or void the event.
How Benefits Relationships Impacts Benefits Processing

Benefits relationships control how a worker's benefits are grouped for processing. A worker might have different sets of
benefits attached to different benefits relationships.
Settings That Affect Benefits Relationship Assignments

Configure two default benefits relationship settings for each combination of country or legal entity, and benefits usage:
Setting Description
Default Benefits Relationship The default benefits relationship assigned automatically to all new hires and workers with one
assignment.
Enable Multiple Assignment Processing If disabled, then all workers have the default benefits relationship.
If enabled, you must configure whether and how to assign benefits relationships to additional
assignments by default.
Use the Configure Default Benefits Relationships task in the Setup and Maintenance work area.
In the Benefits Service Center page, benefits professionals can change:
• The benefits relationships associated with individual workers

• The work assignments associated with the worker's benefits relationships
9
How Benefits Relationship Assignments Affect Benefits Processing

Benefits relationships affect these benefits entities:
• Potential life events

• Life event
• Eligibility records
• Electable choices
• Enrollment options
• Dependent coverage
• Beneficiary designations
• Primary care physician designations
• Deductions
A worker might have assignments that are associated with different benefits relationships.
The following six examples list:
• Different ways that worker assignments might be structured within an organization

• How the benefits relationships would be associated
• The impact on life events, electable choices or enrollment options, and benefits eligibility
Example 1: Single Legal Entity, Work Relationship, Employment Terms,

Assignment and Benefits Relationship
Configuration: Only one assignment and one benefits relationship exist.
Legal Entity Work Relationship Employment Terms Assignment Benefits Relationship
Galaxy UK 1 Architect Architect A (default)
Processing: Life events, electable choices or enrollment options, and benefits eligibility are evaluated based on the
assignment in this benefits relationship.
Example 2: Work Relationships in Two Different Legal Entities

Configuration: Two sets of work relationships, employment terms and assignments exist, one for each legal entity.
The person has two sets of benefits, one for each legal entity. Each assignment is associated with a different benefits
relationship.
Galaxy UK 1 Architect Architect A (default for the legal

entity)
10
Galaxy US 2 Consultant Consultant B (default for the legal

entity)
Processing: This table shows the basis for benefits evaluation and processing for each data type:
Data Type Benefits Evaluation Processing Basis
Life events Primary assignment from each legal entity.
Electable choices or enrollment options One set of data for each legal entity.
Eligibility Use eligibility to provide benefits from the appropriate legal entity. Eligibility criteria are defined at the
legal entity level or globally.
Example 3: Multiple Assignments in a Single Legal Entity

Configuration: One benefits relationship is associated with different employment terms and assignments.
Galaxy US 1 Architect Architect A (default)
Galaxy US 1 Consultant Consultant A
Life events Primary assignment
Electable choices or enrollment options One set of data for each life event
Eligibility Attributes defined at global person level are used for both life events. Assignment-level attributes are
used in the respective life events.
Example 4: Multiple Assignments in a Single Legal Entity - One Benefits

Relationship for Each Assignment
Configuration: Separate benefits relationships are associated with each assignment.
11
Galaxy US 1 Consultant Consultant B
Life events Separate life events created for Architect and Consultant assignments
Eligibility Attributes defined at global person level are used for both life events. Assignment-level attributes are
Example 5: Multiple Assignments in a Single Legal Entity - One Benefits

Relationship Has Two Assignments, Another Has Remaining Assignments
Configuration: Two assignments are associated with one benefits relationship, and another assignment with a second
benefits relationship.
Galaxy US 1 Product Manager Product Manager A
Galaxy US 1 Consultant Consultant B
Life events Separate life events are created for the assignments in benefits relationships A and B
Eligibility Attributes defined at the global person level and assignment level are used for life events
12
Example 6: Complex Multiple Benefits Relationships

Configuration: Many assignments are associated with one or more benefits relationships.
Galaxy US 1 Product Manager Orlando A
Galaxy US 1 Product Manager Dallas A
Galaxy US 1 Product Manager Atlanta B
Galaxy US 1 Consultant San Francisco C
Galaxy US 1 Consultant Los Angeles D
Life events Separate life events created for the assignments in each benefits relationship
Eligibility Attributes defined at global person level are used for all life events. Assignment-level attributes are
Related Topics
• Guidelines to Configure Default Benefits Relationships
How can I ensure that a worker's benefits relationship is

accurate?
You can verify the accuracy of the benefits relationship of either a specific worker or multiple workers.
The following table lists scenarios and actions to ensure accuracy:
13
Scenario Action
For a specific worker Click Refresh on the Benefits Relationship tab of the Manage Benefits Relationship page in the
Benefits Service Center page.
Ensure that the default benefits relationship configuration for the worker's legal entity or country
exists.
For multiple workers Use the Assign and Update Benefits Relationship process in the Evaluation and Reporting work area.
Related Topics
• How You Get the Latest Benefits Relationship Information for a Worker
• The Assign and Update Benefits Relationships Process
The Assign and Update Benefits Relationships Process

Use this process to ensure that the benefits relationship information for multiple workers is accurate. You run the
process from the Evaluation and Reporting work area, Processes tab, Maintenance Processes subtab.
The process assigns and updates worker benefits relationships on the basis of the configuration that exists in the
Configure Default Benefits Relationships page.
Settings That Affect Processing

The following table describes the options that affect processing.
Parameter Effect of Selecting
Create default benefits relationship Select to create the default configuration for the worker's legal entity in the Configure Default Benefits
assignment configuration Relationships page, if no setup exists. You might want to do this when you rehire a worker or transfer a
worker to a different legal entity.
The process creates default configurations for both usages: normal and unrestricted life event
processing.
Assign benefits relationship for life event Select to assign the worker a benefits relationship for life event processing based on worker
processing information and the default benefits relationship configuration.
Assign benefits relationship for Select to assign the worker a benefits relationship for unrestricted benefits processing based on worker
unrestricted processing information and the default benefits relationship configuration.
Benefits Relationship to Delete Select whether you want to delete the life event type of benefits relationship or the unrestricted type of
benefits relationship.
Mode of Deletion Select whether you want to delete the relationship or end date it.
14
Parameter Effect of Selecting
End Date If you have selected End Date as the mode of deletion, you can set the date on which you want to end
the benefits relationship.
How Benefits Relationship Assignments and Updates Are Processed

If you decide to assign a benefits relationship to workers, the process, if required, updates worker assignments
associated with the benefits relationship. For example, if a worker's primary assignment changed, the process updates
the benefits relationship with the new assignment.
You manage the worker's benefits relationship details using the Manage Benefits Relationship task in the Benefits
Service Center page.
Related Topics
• Benefits Process Parameters
When do I run the Assign and Update Benefits

Relationships process?
Typically, you run the Assign and Update Benefits Relationships process in these scenarios.
Scenario Processing
You have existing worker records in your The process:

organization before you start using Oracle
Fusion Benefits. • Creates the default benefits relationship configuration
These workers don't have benefits • Assigns the benefits relationships based on the configuration
relationships assigned.
• Updates the worker assignments associated with the benefits relationship
Also, you haven't included default benefits
relationship assignment configurations
that apply to those worker's countries and
legal entities.
When you rehire a worker or transfer a The process:

worker to another country or legal entity
• Ends the previous benefits relationship and starts a new benefits relationship for the worker as of
the date of the rehire or transfer.
• Updates benefits relationship worker assignment information, if required.
When the primary assignment for a worker The process updates the benefits relationship worker assignment information.
changes
When a worker is terminated The process ends the current benefits relationship
15
All scenarios in this topic assume that you select the following parameters before you submit the process:
• Create default benefits relationship assignment configuration

• Assign benefits relationship for life event processing
• Assign benefits relationship for unrestricted processing
Related Topics
• The Assign and Update Benefits Relationships Process
How You Get the Latest Benefits Relationship

Information for a Worker
To update a worker's benefits relationship information, click Refresh on the Benefits Relationship tab of the Manage
Benefits Relationship page in the Benefits Service Center page.
Conditions That Affect Refresh Processing

Refresh processing varies based on these conditions:
• Whether benefits relationships already exist for the worker

• Whether the worker's assignments are already associated with benefits relationships
How the Refresh Processing Works

The following table describes the results of the refresh processing for each condition.
Condition Processing
Benefits relationships don't exist for the Creates worker benefits relationships for life event processing or unrestricted life event processing. The
worker refresh processing creates benefits relationships only if the corresponding values exist for the worker's
legal entity or country on the Configure Default Benefits Relationship page.
Worker is terminated or transferred to End dates the assignment record associated with the benefits relationship as of the termination date
another legal entity
Worker's primary assignment has changed Associates the new assignment with the benefits relationship
or is incorrect
Related Topics
• Guidelines to Configure Default Benefits Relationships
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How Action Items Are Processed

The configuration of action items determines what happens during enrollment processing. For example, failure to
provide required action items can result in suspended enrollment or simply cause delinquent items to appear in benefits
administration reports.
Settings That Affect Action Item Processing

The following action item settings affect processing:
Setting Description
Suspend Enrollment When enabled, notifies participant of pending action item during enrollment and causes suspension of
enrollment until the item is completed.
Determination Rule Determines when the item is required, such as always or only for initial enrollment.
Due Date Determines when the item starts appearing on audit and error reports generated by enrollment
processing.
Interim coverage setup also affects enrollment processing, as described in the next section. You define interim coverage
for a plan or option on the Plan Enrollment page using the Benefit Plan Details task in the Plan Configuration work area.
How Action Items Are Processed

If enrollment processing suspends enrollment due to incomplete action items, it then applies interim coverage, if
configured. No further life event processing takes place until the participant completes the action items.
Note: Incomplete or past-due action items for one benefits relationship don't stop processing of events for another
benefits relationship for the same worker.
Reporting of pending action items and certificates occurs as part of enrollment processing. Benefits administrators can
use these reports to follow up as required.
Process Reporting
Close enrollment action items The audit log includes any:
• Past-due required action items

• Incomplete action items that you configured to suspend enrollment
Close enrollment The audit log includes any:
• Past-due required action items
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Process Reporting
• Incomplete action items that you configured to suspend enrollment
Participation evaluation The error report contains any incomplete action items that you configured to suspend enrollment for a
participant.
The following scenarios illustrate subsequent life events processing for a participant with an open action item.
Suspension Results in No Further Life Event Processing

Scenario:
1. On January 1, 2015, you process the Add a Child life event with an occurred date of January 1, 2015, and make
corresponding elections.
2. An action item, configured for suspension, is generated with a due date of January 30, 2015. The participation
evaluation process suspends the enrollment and applies the configured interim coverage.
3. You process the Relocation event on January 15, 2015.
Result:
• The Relocation event can't process until you resolve the suspension for the Add a Child event.
• The action item associated with the Add a Child event appears on the audit report after action item processing.
• The participant's name appears on the error report after participation evaluation processing.
• Contact the participant and attempt to resolve the action item. After you mark the action item as complete,
enrollment for the Add a Child event completes and you can process the Relocation event.
Suspension of Beneficiary Designee Only

Scenario:
1. On January 1, 2015, you process the Add a Child event with an occurred date of January 1, 2015, and make
2. An outstanding action item for beneficiary designation, configured for suspension, is generated with a due date
of January 30, 2015. The participation evaluation process suspends the enrollment for the beneficiary designee.
Result:
• The participation process evaluates the Relocation event for enrollment opportunities even though an
outstanding action item exists. This is because the action item exists only for the beneficiary designation, not
for the entire offering.
• You can process future life events for the participant.
Suspension with No Interim Coverage

Scenario:
1. On January 1, 2015, you process the Add a Child event with an occurred date of January 1, 2015, and make
evaluation process suspends the enrollment, but no interim coverage exists.
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Result: The Relocation event can't process until you resolve the suspension for the Add a Child event.
Subsequent Life Event Processing Causes Previous Life Event to be Backed

Out
Scenario:
1. On January 10, 2015, you process the Add a Child event with an occurred date of January 10, 2015 and make
3. On January 15, 2015, you process the Relocation event with an occurred date of January 1, 2015.
Result: Life event processing backs out the Add a Child event, along with any pending action items. It processes the
Relocation event, unless the timeliness setup for the life event prevents life events from backing out in this situation.
Termination Processing After Suspension

Scenario:
1. On March 1, 2015, you process the Marriage life event and make corresponding elections.
2. An action item, configured for suspension, is generated with a due date of March 30, 2015. The participation
3. You process the Termination event on March 20, 2015.
Result: The participation process evaluates the Termination event even though there is a pending action item from the
Marriage life event.
Related Topics
• Options to Configure Certifications and Other Action Items
• Overview of Benefits Certifications and Other Action Items
• Guidelines to Configure Enrollment Suspensions
Manage Action Items Process

You can use this process to close participant action items that have no suspensions set up.
To run this process, in the Evaluation and Reporting work area, click the Processes tab. Then, expand the Election
Processes section, and click Manage Action Items.
When a person record with a past due action item is detected, the process lists that person record in the log file. If
suspensions are in place, they will remain, and that person record appears on the audit log. A benefits administrator
can then follow up with the employee to resolve the action item. If there is a suspended action item, no future life event
processing can occur for that person, until that action item is resolved.
The Manage Action Items process also tracks, in a log file, any past-due action items that have suspensions set up. It
also records information on any enrollment that was suspended as a result of past-due action items.
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Impact of Action Items and Suspensions on Manage

Action Items Process
This topic lists how different setup conditions of action items and suspensions impact the working of the Manage
Action Items process.
No suspensions are set up for the enrolled The process closes the action items.
benefits objects.
Suspensions are set up. No action.

Participant has completed action items, so
no suspended benefits objects exist.
Suspensions are set up. The process records the person information in the audit log.
Action item doesn't have a due date set up.
Participant hasn't completed the action

item yet.
Action item due date is set up.

item yet.
The action item's due date is set up.

item yet.
The action item's due date is past.
Incomplete action items have caused only The beneficiary records continue to remain in a suspended state. The process records the beneficiary
the beneficiary records to be suspended. information in the audit log.
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Review and Resolve Participant Action Items

As a benefits administrator, here's how you resolve action items for a participant.
1. Click Navigator > Benefits Administration > Enrollment.

2. Search for the participant.
3. Ensure that the current effective date is before the action item's due date.
4. In the Benefits Summary page of the participant, click Pending Action Items on the scorecard.
5. Click an action item's link. In the page that appears, provide the required details to resolve the item.
Benefits Relationships and Action Items

Unresolved action items for one benefits relationship will not stop processing of events for another benefits relationship
for the same person.
Each benefits relationship is handled separately and doesn't impact each other. The past-due action items are restricted
only to the applicable benefits relationship.
Impact of Action Items and Suspensions on Close

Enrollment Process
This topic lists how different setup conditions of action items and suspensions impact the working of the Close
Enrollment process.
No suspensions are set up for any of the The process closes the life event.
enrolled benefits objects.
Suspensions are set up. The process closes the life event.
Suspensions are set up. The process:

Action item doesn't have a due date set up. • Closes the life event
• Indicates successful processing
• Creates an audit log entry for that person record
item yet.
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Action item due date is set up. • Closes the life event
item yet.

Action item due date is set up. • Closes the life event
item yet.
The action item's due date is past.
Impact of Action Items and Suspensions on Participation

Evaluation Processes
This topic lists how different setup conditions of action items and suspensions impact the working of the participation
evaluation processes.
No suspensions are set up for any of the No action. The process indicates successful processing.
enrolled benefits objects.
Suspensions are set up. No action. The process indicates successful processing.

Action item doesn't have a due date set up. • Indicates unsuccessful processing
• Creates a log entry
item yet.

Action item due date is set up. • Indicates unsuccessful processing
item yet.
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• Indicates unsuccessful processing
Action item due date is set up.

item yet.
Action item due date is past.
Examples of Original Coverage Start Date in Benefits

The original coverage start date indicates when the participant and dependents began continuous coverage under a
benefit plan or option. The following example shows how the original start date changes in different situations.
Use the View Enrollment Results task on the Actions menu of the Enrollment section in the Benefits Service Center
landing page to see the original coverage start date for a participant and dependents.
Impact of Enrollment Changes on the Original Coverage Start Date

One of the benefits that your enterprise offers to newly hired workers is a health insurance plan that has the following
options:
• Employee Only
• Employee plus One
• Employee plus Family
A worker joins your enterprise on January 1, 2015 and enrolls in the Employee Only option.
The following table lists subsequent changes to the worker's enrollment and their impact on the dependent's coverage
start date and the original coverage start date.
Enrollment Event Coverage Start Date
March 1, 2015 The coverage start date and the original coverage start date for the worker and spouse is March 1, 2015.
The worker gets married and enrolls in the

Employee plus One option.
March 1, 2016 The coverage start date and the original coverage start date for the worker, spouse, and child is March
1, 2016.
The worker gives birth to a child and
changes enrollment to the Employee plus The worker and designees have the same dates because the worker enrolled in a new option.
Family option.
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Enrollment Event Coverage Start Date
October 1, 2016 Enrollment for worker, spouse, and child ends.
The worker changes from working full-

time to part-time and is no longer eligible
for coverage.
April 1, 2017 The coverage start date and the original coverage start date for the worker, spouse, and child is April 1,
2017.
The worker changes from working part-
time to full-time. The original coverage start date is April 1, 2017 because of the break in coverage from October 2016
through March 2017.
The worker enrolls in the Employee plus
Family option and designates spouse and
child as dependents.
July 1, 2017 Worker, spouse, and first child:
The worker gives birth to a second child • Coverage start date: July 1, 2017
and makes designations accordingly to the
Employee plus Family option. • Original coverage start date: April 1, 2017
Second child:
• Coverage start date: July 1, 2017

• Original coverage start date: July 1, 2017
The original coverage start date for the worker, spouse, and the first child is April 1, 2017, which is when
they were first covered.
Why can't I see or edit a benefit participant's contacts?

First, check whether the contact is future dated as contacts are not visible until the contact's effective start date is
reached.
If that is not the issue, then your data role might not include access to related contact information for participants.
• Your application administrator must provide you with the proper data role and person security profile so that
you can access related contact information for participants.
• The application administrator grants you access by following the steps provided in the Configuring Security for
Manage Contacts Page for Benefits: Worked Example topic.
Related Topics
• Configure Contacts Page Security for Participants and Administrators
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Configure Contacts Page Security for Participants and

Administrators
Standard data role and person security profile configurations typically restrict access to the Manage Contacts page to
only the participant, in the self-service guided process.
This topic covers how to grant benefits administrators and specialists access to participant contacts in the Benefits
Service Center page.
The administrator or specialist must have a person security profile with Include Related Contacts selected. Users
inherit the profile through a chain of associated roles, from the parent job role through the descendant duty and data
roles.
You can create or edit a data role and:

• Edit the person security profile already associated with the data role
• Edit an existing person security profile and associate it with the created or existing data role
• Create the person security profile and associate it with the created or existing data role
Note: Only application administrators with IT Security Manager privileges can complete these tasks, which they
perform in the Setup and Maintenance work area.
Creating or Editing a Data Role

1. Go to the Manage Data Role and Security Profiles task.
2. Either edit an existing data role or create one.
To edit a data role:
a. Search for and select the data role that you want to edit.
b. On the Search Results toolbar, click Assign.
3. In the Person section of the new or existing data role, select the person security profile that you want for this
data role.
4. When you are ready, click Submit.
Creating or Editing a Person Security Profile

1. Go to the Manage Person Security Profile task.
2. Either edit the existing profile or create one.
3. In the Basic Details section of the new or existing profile, select Include Related Contacts.
4. When you are ready, click Save and Close.
FSA and HSA Calculators in Benefits

Overview of the health savings and flexible spending account calculators.
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The health savings and flexible spending account calculators estimate your savings and spending. These calculators are
designed mainly for savings plans in the United States, such as the standard Health Savings Account (HSA) and Flexible
Savings Account (FSA).
You need to enter your contributions to get a projection of how much can be saved and how the contributions grow
over a period of time. Here's a list of calculators that you can find in the Self-Service Benefits page:
Calculator Purpose
HSA Get an estimate of your earnings, tax savings for your health savings accounts. You can do the
estimations either for yourself or for your family.
Dependent Care FSA Understand how much more you can save by enrolling in a flexible spending account.
Health Care FSA Estimate your annual health care costs and potential tax savings.
Estimate Savings and Spending Using FSA and HSA

Calculators
Here's how you access the FSA and HSA calculators from Self-Service Benefits.
1. Click Me Benefits on the Home page.

2. Depending on your benefits setup, you can see different calculators to help you with estimates. Select the
appropriate calculator.
3. Enter the values to estimate your savings and spending.
FAQs for Enrollments

How can a participant make elections offline
If a participant doesn't have access to the self-service pages, you can print and share the Enrollment Document with
them. Once they return the completed document to you, you can enter the enrollment information for them by using
the document.
This document is available when the participant has a life event in the Started status.
Here's how you view and use the Enrollment Document:

1. On the Home page, click Benefits Administration > Enrollment, to open the Benefits Service Center work
area.
2. Open the Benefits Summary page of the participant in the Benefits Service Center.
3. In the Evaluated Life Event section, click Actions > Print Enrollment Document.
4. Share the document with the participant.
5. The participant manually selects or changes enrollment options and returns the document.
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6. You edit enrollment information for the participant using the returned document.
How can I unprocess a life event that was processed in error?

You need to back out and void the life event in the Benefits Service Center page.
Here's how you do it:
1. Select the event on the Life Events tab of the Manage Person Life Events page.
2. Select Back Out Event on the Actions menu.
3. Specify Voided as the life event status.
To delete the voided life event:
1. Select Show Voided Potential Life Events on the Potential Life Events tab.
2. Select the voided potential life event and delete it.
Note: Backing out an HR data change doesn't back out automatically any potential life event that the HR data change
automatically triggered, such as marital status change. If the triggering HR data change is invalid, you must manually
back out the life event, as described in this topic.
What are the different dates that I see when I enter a life event?
Here are the details of the dates that you see.
Date Details
Occurred Date Actual date when the life event happened. For example, when you enter a marriage as a life event,
you specify the date of marriage as the occurred date. This date is important for Benefits to evaluate
person-related eligibility, enrollment opportunities, and rate value determination.
Reported Date Date when you enter the life event in the application. For example, the date when you enter the
marriage as a life event. This date is used to evaluate timeliness rules.
Status Date Date when the life event moves to the current status. For example, the Open Enrollment life event's
occurred date is January 1, 2021. The administrator processes the open event, that's a potential life
event, on September 27, 2020. This is the same date that the application sets as the status date for
the potential life event. Similarly, when a potential life event is added from the Benefits Service Center
page, status date is the unprocessed date. When a life event is added by the Report a Life Event task in
the Self-Service Benefits page, status date can be the detected date or manual date.
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Related Topics
How can I diagnose any issues with a person's benefits

enrollments?
When you need details of a person's event, eligibility, and enrollment data, you can run the Person Benefits Diagnostic
Test if you have access to the Diagnostic Dashboard. Select Run Diagnostics Tests from the Setting and Actions menu in
the global header.
Related Topics
What happens to existing benefits if workers transfer to another

legal entity?
Eligible workers continue to receive benefits that they elected in the previous legal entity.
Before a global transfer, administrators must ensure that default benefits relationship assignment rules for the
destination legal entity or country exist on the Configure Default Benefits Relationships page.
How can I diagnose any issues with a participant's benefits

information?
Run the Benefits Health Check diagnostics report.
To run the report:
1. Click the logged in user's icon, and click Run Diagnostics Tests in the Troubleshooting section.
2. In the Diagnostic Dashboard page, search for the Benefits Health Check Diagnostics report, select it, and click
Add to Run.
3. In the Choose Tests to Run and Supply Inputs table, click Run.
How can I diagnose participant eligibility issues?

Run the Person Benefits Eligibility diagnostics report from the Diagnostic Dashboard page.
The report helps you find out if there are any setup issues in the plan configuration that's preventing temporal events
from being detected. The report also tells you whether you have configured the offering to track ineligibility. Specifically,
the Track Ineligible section in the report shows you all the levels in the program hierarchy where you have, and haven't,
set up the Track Ineligible Persons check box.
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You can also see information that indicates the eligibility status of the person at all levels in the hierarchy. The Eligibility
column in the report indicates the eligibility status.
To run the report:
1. Click the logged in user's icon, and click Run Diagnostic Tests in the Troubleshooting section.
2. In the Diagnostic Dashboard page, search for the Person Benefits Eligibility diagnostics report, select it, and
click Add to Run.
3. In the Choose Tests to Run section, click the Input Status icon to enter the effective date, person number, and
program that you want to generate the report for.
4. Click Run.
5. In the Diagnostic Test Run Status table, click the Refresh button to see the latest status.
6. When the execution status reads Complete, click the Report icon to view the report.
How can I diagnose any issues with the US Affordable Care Act
(ACA) setup?
Run the Affordable Care Act diagnostics report.
To run the report:

1. Click the logged in user's icon, and click Run Diagnostic Tests in the Troubleshooting section.
2. In the Diagnostic Dashboard page, search for the Affordable Care Act diagnostics report, select it, and click Add
to Run.
3. In the Choose Tests to Run and Supply Inputs table, click Run.
How can I upload certifications received and close related action

items for multiple participants?
Use the Upload Enrollment Certifications integrated workbook in the Evaluation and Reporting work area to create and
upload a batch of certification details. Then, select that batch in the Close Enrollment Action Items to close action items.
Note: The Close Enrollment Action Items process closes only those action items that have no suspensions set up. If
suspension setup does exist for an enrollment, then the suspension will remain enforced and the processed person
appears in an audit log. Administrators must manually resolve such action items.
Why can't I see the absence plan balance for the time-off sale
enrollments in Benefits?
Ensure that you associated the absence plan when you created or edited the benefit plan. In the Basic Details step,
check whether you selected the required absence plan from the Absence Plan list.
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Also, in the enrollment page, the Absence Balance field might be hidden. On the View menu, click Columns and select
the Absence Balance column.
How can I display future-dated contacts on the people to cover

page?
If you're an administrator, you need to select the Display future-dated contacts check box on the Self-Service
Configuration page for participants to see such contacts.
How can I configure future-dated contacts to appear on the

People to Cover page?
Future-dated contacts appear in the People to Cover page. You need to enable it from the Self-Service Configuration
page.
For example, on July 26, 2020, an employee adds a domestic partner with a relationship start date of 14th November
2020. The People to Cover page displays this newly-added domestic partner along with other contacts of the employee.
Here's how you can display future-dated contacts in the People to Cover page:
1. On the Home Page, click Benefits Administration >Plan Configuration.

2. In the Tasks panel drawer, click Self-Service Configuration.
3. Select the Display future-dated contacts check box.
4. Click Save.
Can I make changes to a future-dated contact?

Yes, on the People to Cover page. For example, you might need to add more detail, change the detail, or even delete the
contact. A message identifies that the contact's start date is in the future.
Can I enroll a future-dated contact in an offering?

When you add future-dated contacts, you can see a message that states that although you have created the contact,
they might not be eligible for enrollment.
The message makes it clear that the contact won't appear on the enrollment pages, under the Dependents and
Beneficiaries section.
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How can I display additional values on Benefits Service Centre and

Self-Service Benefits pages?
You can display additional values on the Benefits Service Center and Self-Service Benefits user interfaces using the
standard Page Composer functionality.
These are the additional values that you can display:
• Life event name

• Program or plan name
• Person name, person number
• Legal entity ID
• Legislation code
• Country code
You can configure the Overview and Confirmation pages in self-service to display the life event name and the program
and plan names. For example, you might want to display the life event in the Enrollment flow to help participants know
which life event is providing the enrollment opportunity.
Related Topics
31
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Using Benefits Manage Benefits Processing and Uploads
3 Manage Benefits Processing and Uploads
Reports and Analytics

This table lists benefits reports and analytics.
Name or Type of Report or Analytic Description Navigation
Life Event Summary Analytic that provides details of life events in Benefits > Evaluation and Reporting
different statuses in your enterprise. You can
also view details by legal employer, benefit The Summary section on the Overview page
group, location, and payroll. contains the life event summary. The Life
Events tab in this section enables you to
view details by legal employer, benefit group,
location, and payroll.
Manage Action Items A process that generates details of participant Benefits > Evaluation and Reporting
enrollments that contain pending action items.
On the Overview page Summary section, select
the Processes tab. Expand Election Processes,
and click Submit for the Manage Action Items
row.
Person Enrollment Summary Report Displays the benefit enrollments for Reports and Analytics > Shared Folders >
participants. Human Capital Management > Benefits >
Enrollment
Enrollment Kit Report Displays, by participant, a choice list of Reports and Analytics > Shared Folders >
programs, plans, and options in which the Human Capital Management > Benefits >
participant may elect to enroll, as well as areas Enrollment
for the participant to designate dependents and
beneficiaries.
Real-Time Analysis: Participant Enrollment Displays, for each participant, the benefit Reports and Analytics > Shared Folders >
Results - Weekly enrollments that they elected or where given by Benefits > Transactional Analysis Samples
default.
Real-Time Analysis: Totals by Life Event - Displays the status of the life events and their Reports and Analytics > Shared Folders >
Weekly corresponding counts in table and graph Benefits > Transactional Analysis Samples
formats.
Real-Time Analysis: Totals by Life Event Name Displays, by potential life event, the total for Reports and Analytics > Shared Folders >
for Potential Life Events - Weekly each status of the life event as well as the Benefits > Transactional Analysis Samples
cumulative total for all statuses of the life event.
Real-Time Analysis: Totals by Life Event Status Displays the status of the life events and Reports and Analytics > Shared Folders >
for Potential Life Events - Weekly their corresponding totals in table and graph Benefits > Transactional Analysis Samples
formats; the table includes a grand, cumulative
total of all life event statuses.
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Name or Type of Report or Analytic Description Navigation
Real-Time Analysis: Totals by Location - Displays, by location, the total for each status of Reports and Analytics > Shared Folders >
Potential Life Events- Weekly the life event as well as the cumulative total for Benefits > Transactional Analysis Samples
all statuses of the life event.
Process Parameters
Benefits process parameters control aspects of Oracle Fusion Benefits evaluation and reporting processes. You select
parameters to limit the persons and benefits objects for processing of eligibility evaluation, electable choices, and
enrollment information.
• The list of parameters that appears for each process depends on the process that you select.
• Required parameters have an asterisk before the description.
• Some parameters contain default values that you can override, as required.
Note: A person or benefits object must meet all criteria, based on the parameters you select, to be included in the
result of the evaluation process.
The following table describes the benefits process parameters:
Benefits Process Parameters Description
Common Processing Parameters These parameters are common to most benefits evaluation and reporting processes.
Effective Date
Used to determine eligibility, electability, and as a reference for deriving start and stop dates for
enrollment, coverage, and rates.
• For life event processes, the effective date is the date on which the life event occurred.
• For scheduled processes, the effective date is equal to the life event occurred date.
Validate
Specify whether to update the database with the process results.
Options are:
• Roll back - database will not be updated
This option enables you to view the results of the process without making changes to the
database.
• Save - database will be updated
A best practice is to run the process without updating the database and view the results in the audit
log. After you are satisfied with the results, rerun the process and select the parameter option that
saves the results to the database.
Organization Name
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Restrict processing to employees, and their related persons, whose primary assignment is associated
with the organization name that you select.
Benefits Group
Restrict processing to persons in the benefits group that you select.
Location
Restrict processing to employees, and their related persons, whose primary assignment is in the
location that you select.
Legal Entity
Restrict processing to active employees, and their related persons, in the legal entity that you select.
Person Name
Restrict processing to the identified person.
Person Type
Restrict processing to the person type that you select.
Person Selection Formula
Restrict processing to persons identified by the selected formula.
Person Number
Restrict processing to the person numbers that you provide.
Postal Code Range
Restrict processing to employees, and their related persons, whose primary assignment location is
included in the specified postal code range.
Life Event Parameters These parameters relate to life events, dates, and statuses.
Life Event
Restrict processing to persons who have the life event that you select.
Note:
This parameter applies only to life event processes and temporal processes.
Life Event Occurred Date
Restrict processing to persons with a life event that occurs on the date that you select.
From Occurred Date
Start of the date range for the following processes:
• Reopen Life Events

• Back Out Life Events
• Purge Backed-Out or Voided Life Event Data
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To Occurred Date
End of the date range for the following processes:
• Reopen Life Events

Apply Defaults
Specify whether to assign the default benefit object to participants during the evaluation process.
Resulting Status
Life event status after the Back Out Life Events process completes.
Options are:
• Unprocessed
• Voided
• Manual
Loss of Eligibility Tracking Life Event
Status of the tracking life event after the process determines that the designee is ineligible.
Options are:
• Set to Processed status

• Remain in Started status
Detect Temporal Events
Specify whether and which types of temporal events to include in the process.
Adjust Open Enrollment Window These parameters appear only for the Adjust Open Enrollment Window process.
Parameters
New Enrollment End Date
Last date on which a person can enroll in the program or plan.
New Processing End Date
Last date on which the benefits administrator can apply elections.
New Default Enrollment Date
When processing enrolls persons in the program or plan if they fail to make an election.
Number of Days to Extend
Number of days to extend the current open enrollment end date so that employees can make
elections.
Benefits Object Parameters These parameters relate to benefits programs, plans, and options, and include payroll.
Program Name
Restrict processing to participants and persons eligible for the specified program.
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Note:
Processing includes the program, plans in that program, and options in plan in the program.
Plan Name
Restrict processing to participants and persons eligible for the specified plan.
Plan Type
Restrict processing to participants and persons eligible for the specified plan type.
Note:
Processing includes all active plans and options in plan of the selected plan type.
Plans Not in Programs
Restrict evaluation processing of participants and persons eligible for plans not in program.
Only Programs
Restrict evaluation processing to participants and persons eligible for all programs only.
Option Name
Restrict processing to participants and persons eligible for the specified option.
Payroll
Restrict processing to employees, and their related persons, whose primary assignment is associated
with the payroll name that you select.
Compensation Object Selection Rule
Restrict processing by compensation object using the specified formula.
Purge Life Event Data Parameters These parameters apply to the Purge Backed-Out or Voided Life Event Data process only.
Life Event Type
Remove life events of the specified type.
Backed Out Status
Life event status for purging.
Options are:
• Voided
• Backed out
Note:
Selecting Backed out purges data related to both Backed out and Voided life events during
processing.
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Delete Life Events
Remove life events with a Voided or Backed out status.
Delete Voided Potential Life Events
Remove potential life events with a Voided status.
Void Potential Life Events with Status
Voids potential life events that belong to any of these statuses:
• Detected
• Manual
• Unprocessed
The audit report and log file contain statistics on the total number of life events deleted. It also
contains information about person numbers, life events deleted, life event name, life event occurred
date, and life event status.
Administrative Parameters Various processes use these parameters, except as noted.
Assigned Life Event Date
When the scheduled life event is assigned to participants.
Example: As an open life event or administrative life event
Audit Log
Create an audit log for the process.
Concurrent Request
Process run record request identification number that contains the data to be purged.
Note:
This description only applies to the Purge Participation Evaluation Audit Data process.
Close Enrollment Action Items These parameters apply to the Close Enrollment Action Items process.
Batch Name
Select a batch that you created using the Upload Enrollment Certifications workbook to close all action
items in that workbook.
Action Item
Select a specific action item to close.
Close Previous Optional Action Items
Select Yes to close optional action items that do not cause suspension. For example, you might want to
close For Your Information types of action items where it might not be necessary to see a certificate
before closing.
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Note:
To run the process correctly, you use either the Batch Name parameter, or the Action Item and
Close Previous Optional Action Items parameters.
Person Number Entry in Benefits Batch Processes

You can use a set of comma-separated person numbers in the Process tab of the Benefits batch processes.
For example, you can use this parameter if you want to quickly test your plan design changes against a sample set of
employees. This parameter is available for these processes:
• Evaluate Life Event Participation

• Evaluate Scheduled Event Participation
• Evaluate Temporal Event Participation
• Evaluate Unrestricted Event Participation
• Enroll in Default Benefits
• Close Enrollment
• Prepare Benefit Coverage Charge Data
• Re-evaluate Designee Eligibility
Here’s the list of points that you should consider when you enter person numbers:
• You can enter up to 2000 characters.

• The comma-separated person numbers should be in a single continuous text format.
• Don't enter person numbers with embedded commas. The process ignores such constructions. For example,
the person numbers 127,356 and 89,34 have embedded commas and these numbers are ignored.
• The list can have whitespaces, tab, line feed, and carriage feed characters embedded in the string, if you have
copied it from a spreadsheet. Such irrelevant characters are ignored or truncated during the processing if they
are surrounding the real person number within the comma delimitation.
• You can’t use the person number parameter along with any of these person-determining parameters:
◦ Person Name
◦ Person Selection rule
◦ Person Type
◦ Organization Name
◦ Benefits Group
◦ Location
◦ Postal Code Range
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◦ Legal Entity
Any auto-submitted process, such as Default Enrollment, will consider the values in the person number list. The log file
provides details on which person numbers were processed, and which ones weren't.
How You Purge Benefits Staging Data

Use the Purge Stage Data process to free up space and improve performance. The process deletes staging data that was
created as a result of benefit extracts and spreadsheet loaders.
You can find this process in the Evaluation and Reporting work area, Processes tab, Maintenance Processes section.
CAUTION: The process permanently removes data. You can't recover it.
Select the Source

You can remove staging data that belongs to either benefits extracts or spreadsheet loaders. In the Process Details
page, use the Source Type list. If you want to delete the data by batch, select the request ID or batch name from the
Source Key field, and submit the process.
Remove Data during a Specific Period

You can also enter a specific time period between which you want to delete the data. Use the From Date and To Date
fields. You can only delete data that's older than 6 months from today's date. This check is in place to prevent you from
accidentally deleting data that you might still require.
For example, assume that today's date is 1st January 2019. When you set the period from January 1, 2018 to December
31, 2018, the process deletes the data only up to June 30, 2018.
Advanced Logs for Purge Processes

Here's the list of purge process that you can find in the Processes tab in the Evaluation and Reporting work area:
• Purge Participation Evaluation Audit Data
• Purge Stage Data
You can use the process logs to understand how often you need to run these processes, and how much data is held
before and after each run. You can use these numbers along with the frequency of the current purge run to identify the
future frequency of running the respective purge processes. The count gives you an estimate of how much data gets
purged over a period.
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The Audit Log parameter should be set to Yes to see the enhanced logs. If the parameter is set as No, the log files show
only the basic details. You need to submit the processes from the Maintenance Processes section of the Processes tab
in the Evaluation and Reporting work area to set the Audit Log parameter.
Related Topics
• How You Purge Benefits Staging Data
Spreadsheet Loaders
Manage Person Benefit Groups in the Integrated Workbook
You can download person benefit group information to the integrated Microsoft Excel workbook. Use the integrated
workbook to view and edit person benefit group assignments for multiple persons and groups. Then, upload your
changes back into the application database.
The basic process for managing person benefit groups using the workbook is:
1. Generate and populate the workbook.

2. Edit, add, and delete person benefit groups in the workbook.
3. Upload edits.
4. Resolve errors.
Repeat these steps as many times as required to accommodate revisions.
Generating and Populating the Workbook

In the Evaluation and Reporting work area:
1. In the Upload Person Benefit Groups row of the Person Data Loaders tab, click the Go to Task button.
2. In the Upload Person Benefit Groups dialog box, enter a session effective date.
3. Click Prepare in Workbook.
Editing, Adding, and Deleting Person Benefit Groups in the Workbook

After the download is complete, view, edit, add, and delete existing person benefit group assignments.
• Edit the Benefits Group value.
The upload process ignores edits in any other columns.

• Insert a row to add a person benefit group assignment.
• Delete data from the application database using these steps:
a. Double-click the Mark for Deletion field in each workbook row that you want to delete.
b. Click Delete Selected Rows.
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Tip:
• You can't edit or enter the effective date in the workbook. To change the effective date, use one of these
methods:
◦ Generate a new workbook with the new session effective date.

◦ Edit the date directly in the application using the Manage Benefit Groups task in Plan Configuration work
area.
• You can't retrieve data deleted as part of the upload process.
Uploading Edits
After you complete your edits, click Upload.
The process:
1. Uploads into the application database the workbook rows marked as Changed
2. Uses the session effective date that you set when generating the workbook as the start date for any edits or
new group assignments that you entered in the workbook
3. End dates the prior group assignments as of the previous day for each edited row
4. Retains the history
5. Deletes permanently all of the related effective-dated records from the application database for each workbook
row that is marked for deletion
For each row marked for deletion in the workbook, the application permanently deletes all of the related effective-dated
records from the application database.
Resolving Errors
The upload process automatically updates the Status field in each workbook row. If there are errors that require review,
the process:
1. Rolls back the change in the application database

2. Sets the workbook row status to Upload Failed
3. Continues to the next workbook row
To view and resolve an error:
1. Double-click Update Failed in the Status field.

2. Fix any data issues in the workbook.
3. Upload the latest changes.
Related Topics
• What's the difference between Export to Excel and desktop integration for Excel?
• Guidelines for Using Desktop Integrated Excel Workbooks
• Set Up Desktop Integration for Excel
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Manage Person Benefit Balances in the Integrated Workbook

You can download person benefit balance information to the integrated Microsoft Excel workbook where you can add,
edit, and delete balances. Then, upload your changes back into the application database tables.
The basic process for managing person benefit balances using the workbook is:

2. Edit, add, and delete person benefit balances in the workbook.
3. Upload edits.
4. Resolve errors.

1. In the Upload Person Benefit Balances row of the Person Data Loaders tab, click the Go to Task button.
2. In the Upload Person Benefit Balances dialog box, enter a session effective date.
Editing, Adding, and Deleting Person Benefit Balances in the Workbook

After the download completes, view, edit, add, and delete person benefit balances.
• Edit the Value, Primary Assignment, and Benefits Relationship values.

• Insert a row to add a person balance.
For each new balance, you must enter a value in either the Primary Assignment or Benefits Relationship
field, but not both.
a. Double-click the Mark for Deletion field in each workbook row that you want to delete from the
application database.
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Tip:
methods:

◦ Edit the date directly in the application using these steps:
i. Search for the person in the Benefits Service Center page.

ii. Click the Person Benefit Balances task.
You can't edit or enter the effective date in the workbook. To change the effective date, you must generate a new
workbook with the new session effective date. You can also edit the date directly in the application. Search for the
person in the Benefits Service Center page, then use the Person Benefit Balances task.
Uploading Edits
The process:
1. Uploads to the application tables only those rows marked as Changed

2. Uses the session effective date that you set when you generated the workbook as the start date for any edits or
new person benefit balances that you entered in the workbook
3. End dates prior balances as of the previous day for each edited row
row that's marked for deletion
Generate a new workbook after the successful upload to verify your edits.
Related Topics
Manage Person Habits in the Integrated Workbook

You can download person habit information, such as disability tobacco usage, to the integrated Microsoft Excel
workbook. Use the integrated workbook to view and edit the data and upload the changes to the database.
The basic process for managing person habits data using the workbook is:
2. Edit, add, and delete person habits in the workbook.
3. Upload edits.
4. Resolve errors
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1. On the Person Data Loaders tab in the Evaluation and Reporting work area, click Prepare Person Habits in
Workbook.
2. In the generated workbook, enter the session effective date.
3. Click Download to retrieve the records that are effective as of the date that you entered in step 1.
Editing, Adding, and Deleting Person Habits in the Workbook

After the download completes, you can view, edit, add, and delete existing person habits data.
• Edit the Student Status, Disability Status, Disability Type, Tobacco Use, Covered in Another Plan, and Plan
values only.
• Insert a row to add habit data for a new person.
To identify the person, you must enter either the person number or these three values, in their respective fields:
◦ First name
◦ Last name
◦ Date of birth
As denoted in the column header, person type is required for each new row.
Tip:
methods:

◦ Edit the date by searching for the person in the Benefits Service Center page and then opening the
Manage Contacts page.
• You can verify disability status and tobacco usage for only participants in the application user interface. To
verify disability status and tobacco usage for dependents, you must:
a. Generate the integrated workbook.

b. Download the person habit information for the relevant dependents.
Uploading Edits
After you complete your edits, click Upload to load into the application database the rows that are marked as Changed.
The process:
new rows that you entered in the workbook
2. End dates the prior data row as of the previous day
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4. Deletes permanently all of the related effective-dated records from the application database
Resolving Errors
the process:


Related Topics
Upload Bill Payments Using the Integrated Workbook

Use the Upload Billing Payments integrated Microsoft Excel workbook to record and adjust benefit billing payments for
multiple participants. Then, upload your changes back into the application database.
Perform these basic steps to manage bill payments using the workbook:

2. Record payment information.
3. Upload the data.
4. Resolve errors if required.

Perform these steps:
1. In the Evaluation and Reporting work area, Person Data Loaders tab, click the Go to Task button in the Upload
Billing Payments row.
Enter each payment record or adjustment record in a new row in the spreadsheet.
Uploading Edits
After you complete entering data, in the Billing tab that is available on the Excel toolbar, click Upload.
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Resolving Errors
the process:


Overview of Managing Benefit Enrollments in the Integrated

Workbook
You can enroll participants in various programs, plans, and options using the integrated Microsoft Excel workbook. You
can also designate dependents and beneficiaries in participant-enrolled plans.
The high-level process for managing benefit enrollments using the integrated workbook is:
1. Prepare and upload data to interim table, resolving any identified workbook errors.
2. Upload enrollments batch to database tables, resolving any identified processing errors.
Preparing and Uploading Enrollment Workbook Data to Interim Tables

You can process multiple life events by entering different effective dates in different workbook rows to handle
successive historical changes for an individual. This preserves and uploads legacy historical data.
The Upload Benefit Enrollments batch process uses the effective date when:
• Fetching person details

• Validating dependents
• Processing participant life events
The basic process for preparing and uploading workbook data to interim tables is:
1. Generate the workbook.

2. Create a batch of enrollment data.
3. Upload edits into the interim database table.
4. Resolve workbook data errors.
The details of this process are covered in the Uploading Enrollment Workbook Data to Interim Tables: Procedure topic.
Uploading Enrollments Batch to Database Tables

After you upload your changes to an interim database, you run the Upload Benefit Enrollments batch process.
The participant enrollment portion of this batch process:
1. Creates a potential life event
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2. Processes this life event

3. Creates enrollments
4. Populates rates and coverage amounts
5. Closes life events
The basic process for uploading workbook data to the application tables with the batch process is:
1. Run the Upload Benefit Enrollments batch process.

2. Download the enrollment processing results and fix any errors.
3. Review the results and reprocess.
The details of this process are covered in the Uploading Benefit Enrollments Batch to Database Tables: Procedure topic.
Related Topics
• Upload Enrollment Workbook Data to Interim Tables
• Upload Benefit Enrollments Batch to Database Tables
Benefit Enrollment Integrated Workbook Columns

This topic details the information required when you enter batch records in the integrated Microsoft Excel workbook for
benefit enrollments.
1. After completing the integrated workbook, you upload the rows to an interim batch table.
2. After all workbook rows upload without errors, you run the Upload Benefit Enrollments batch process in the
Evaluation and Reporting work area.
Workbook Column Explanations

Required fields are marked with an asterisk, *, and you must enter a value for them.
Note: Values that you enter in name fields must exactly match the values already in the application. This applies to
names of participants, programs, plans, options, dependents, beneficiaries, and life events.
Column Description
Changed Marked automatically when you edit or add a row in the workbook
The upload process loads only these rows to the interim batch table.
Mark for Deletion Double-click this cell to mark the row for deletion.
When you click Delete Selected Rows, the upload deletes the data from the interim batch tables so
that it’s not available for the batch process.
Status Provided automatically by the upload process for each row after it loads the data into the interim batch
table
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Column Description
For rows with errors, click Upload Error to see the details.
*Enrollment Type Enter this value based on the person for whom you’re entering the data.
Valid values are:
• Participant Enrollment
• Dependent Designation
• Beneficiary Designation
*Effective Date Used when:

Enter the date in your standard local format.
*Person Number PARTICIPANT_PERSON_NUMBER, a unique numeric identifier for the participant for whom to process
the enrollment changes
Additional Person Identifier Reserved for the application, don't use.
Program Name Must be valid as of the effective date.
Plan Name Must be valid as of the effective date.
Plan Disenrolled From Reserved for the application, don't use.
Option Must be valid as of the effective date.
Option Disenrolled From Reserved for the application, don't use.
*Life Event Must be valid as of the effective date.
*Life Event Occurred Date Benefits processing derives the existence of a started life event based on the combination of this date
and the specified life event.
Original Participant Enrollment Date Doesn't affect processing, the upload updates the field for the participant enrollment record.
Create Potential Life Event Yes: The process determines whether the participant has a potential life event for the combination of
the life event name, life event occurred date, and benefit relationship. If there is no valid potential life
event, it creates and processes one.
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Column Description
No: The process doesn't create the potential event or process life events automatically. You must
manually add the life event using the Potential Life Event tab.
*Benefit Relationship Must be valid for the participant as of the effective date
Benefits processing derives a valid started life event for the participant based on this value.
Rate Amount If you enter a rate amount, ensure that there is no value in coverage amount.
Coverage Amount If you enter a coverage amount, ensure that there is no value in rate amount.
Disenrolled Coverage Amount Reserved for the application, don't use.
Date of Birth Dependent's or beneficiary's date of birth
Beneficiary Organizations and Trusts Enter the name of the existing beneficiary organization or trust. If the beneficiary organization or trust
doesn't exist as of the effective date, the beneficiary designation process fails.
To create the organization or trust, which you can then use in the workbook, use the Beneficiary
Organizations task in the Benefits Service Center page.
Primary Beneficiary Percentage If you enter a percentage amount, ensure that there is no value in beneficiary amount.
Contingent Beneficiary Percentage If you enter a percentage amount, ensure that there is no value in beneficiary amount.
Beneficiary Amount If you enter a beneficiary amount, ensure that there is no value in beneficiary percentage.
Close Life Event Date Date on which you want to close the life event
*Close Life Event Yes: The process attempts to close the life event that it’s processing, which is useful if it’s processing
multiple life events for the same participant, dependent, or beneficiary.
No: The process doesn't close the life event, leaving it in the started state.
Suspended results or pending action items don't allow the life event to close. In such cases, it remains
unchanged and you must close this event before attempting to process the next event.
Batch Line ID Don't modify.
Uniquely identifies the batch line, which is referenced in error messages.
Message Don't modify.
Describes any errors that occurred during the Upload Benefits Enrollments batch process.
Reprocess the batch after correcting the errors.
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Column Description
Row Batch Status Don't modify.
Indicates the Upload Benefits Enrollments batch processing status for the row, such as COMPLETE or
ERROR.
Key Don't modify.
Internal value used for Upload Benefits Enrollments batch processing.
Related Topics
• Overview of Managing Benefit Enrollments in the Integrated Workbook
Options to Reevaluate Eligibility of Designees for Enrollment

When a dependent is found ineligible by the Reevaluate Designee Eligibility process, it creates a Loss of Eligibility
tracking life event for the participant. You can determine how you want to evaluate the Loss of Eligibility life event;
select one of these life event statuses on the Process Details page:
• Set to Processed status

• Remain in Started status
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Here’s a diagram that illustrates, at a high level, how you can configure the Reevaluate Designee Eligibility process to
handle Loss of Eligibility tracking life event:
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Option 1: Set to Processed Status

You select this option if you don’t want to provide participants the ability to change their benefits due to loss of
eligibility, and you want them to continue with the same rate-level deductions. You select this option from the Loss of
Eligibility Tracking life Event list on the Process Details page.
No processing happens on the Loss of Eligibility tracking event. The process end dates only the dependent coverage
record that was found ineligible. Other than the ineligible dependent coverage record, nothing else is changed. For
example, the participant doesn’t get unenrolled from any offerings.
When the Reevaluate Designee Eligibility process end dates the ineligible dependent coverage record, it considers only
the effective end date, and not the end-date rule specific to the Loss of Eligibility life event. The process considers the
setup in the Designation Requirements train stop, General tab for the plan, or plan type in program. If the end date rule
isn’t specified in the General tab, the process considers the Event date or One day before the event date, as the end
date.
When the Reevaluate Designee Eligibility process end dates the ineligible dependent coverage, it closes the tracking life
event and sets its status to Processed. The life event only indicates the occurrence of the loss of eligibility, but it doesn’t
evaluate for any enrollment opportunities. The participant’s coverage in the same plan or option continues.
Option 2: Remain in Started Status

If you want to evaluate the Loss of Eligibility tracking event for enrollment opportunities, select Remain in Started
Status from the Loss of Eligibility Tracking Life Event list on the Process Details page.
The Loss of Eligibility tracking life event is created as a regular life event. The process doesn’t end date the dependent
coverage record that was found ineligible. It only identifies the ineligible dependent and the date to create the Loss of
Eligibility tracking life event.
As the dependent has already lost further eligibility, the coverage needs to be end dated. Note that the participant's
eligibility into the various plans gets reevaluated and there will be impact if family member code rules exist. So, along
with the dependent coverage, the participant coverage needs to be end dated. The end dates are calculated based on
the Loss of Eligibility Life Event setup defined in the Designation Requirements and Enrollment train stops in the plan
configuration work area.
Based on how frequently you run the Reevaluate Designee Eligibility process, you need to decide whether you want to
change the derived factor setup, or the coverage end date setup. If you run the process daily, you can set up the event to
be triggered based on the date of birth. The coverage dates are processed accordingly. If you run the process monthly,
you can set up the event to be triggered at the end of the month or on the first day of the next month so that all the
ineligible dependents lose their coverage in the current month.
Impact of Derived Factors on Option 2 (Remain in Started Status)

Suppose you’re using a derived factor for a person’s age. If the derived factor is set to the As of Event rule, then the
Loss of Eligibility life event will use the date of birth as the end date for the coverage. But if you want the coverage to
end on the last day of the month, then you have 2 options. You can change the Previous Dependent Coverage End Date
rule to End of Month, and the Start date rule, to First of Next Month.
The other option is to continue with the Participant enrollment coverage end date rule, but make sure you define the
date rules for enrollment specific to the Loss Of Eligibility event in the Life event tab. Note that the change might impact
the employee’s coverage start and dates.
If the derived factor is set to End of month or First of next month, you can use that setup for ending the dependent
coverage, but the life event will trigger not on the date of birth, but will be based on the derived factor's determination
rule.
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The way you set up the derived factors or the coverage end date should be on the basis of how frequently you run the
Reevaluate Designee Eligibility process. If it’s daily, then we recommend you get the event triggered on the date of birth
and get the coverage dates processed accordingly.
If the frequency is monthly, then we recommend you use the End of Month rule or First of next month rule in the
derived factor. This way, all the dependents losing eligibility in the current month can be detected and processed in a
single run per month.
Guidelines to Test Benefits Formulas

Use the Evaluate Formulas and Eligibility Profiles task in the Plan Configuration work area to test whether a benefits
formula works as expected for a sample participant.
This topic covers the following aspects:

• Authoring formulas
• Restrictions
• Available contexts
• Formula results
Note: The formula evaluation tool does not change any data when you test a formula.
Authoring Formulas
You create formulas using the Define Formula task in the Plan Configurationwork area.
Restrictions
You cannot test formulas designed to act on data that is not saved to the database yet. For example, you cannot test
these formula types:
• Person Change Causes Life Event

• Post Election Edit
You cannot test formulas designed to act on input values received from a process that the formula calls at runtime. For
example, you can't test the Rate Periodization formula type. You can still use this tool to test such formulas by creating a
version that contains fixed input values available in the code.
Available Contexts
You must provide values to the following contexts to test any benefits formula:
• Effective date
• Person name
• Benefits relationship
You can also provide values to these contexts depending on the formula type:
• Life event name
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• Program name
• Plan name
• Option name
Formula Results
The Formula tab displays the results of the last five formula submissions. The Results window displays the name of the
return variable defined in the formula and its value. To view more details, you can download and view the generated log
file.
FAQs for Evaluation and Reporting

Can I upload benefit group assignments for multiple persons at
one time?
Yes.
1. Use the integrated Microsoft Excel workbook to view and edit person benefit group assignments for multiple
persons and groups.
2. Upload your changes back into the application database.
To generate the integrated workbook, in the Evaluation and Reporting work area:
1. Select the Person Data Loaders tab.

2. In the Upload Person Benefit Groups task row, click the Go to Task button.
Related Topics
• Manage Person Benefit Groups in the Integrated Workbook
Can I upload benefit balances for multiple persons at one time?

Yes.
1. Use the integrated Microsoft Excel workbook to:
◦ View and edit the benefit balance value, primary assignment, and benefits relationship entries for
multiple persons.
◦ Add and delete person benefit balances.
2. Upload your changes back into the application database.
To generate the workbook, in the Evaluation and Reporting work area:
1. Select the Person Data Loaders tab.

2. In the Upload Person Benefit Balances task row, click the Go to Task button.
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Related Topics
• Manage Person Benefit Balances in the Integrated Workbook
Can I upload student and disability status for multiple persons at

one time?
Yes.
1. Use the integrated Microsoft Excel workbook to view and edit student and disability status, disability type,
tobacco usage, and other plan coverage details for multiple persons.
2. Upload your changes into the application database.
1. Select the Person Data Uploads tab.
2. In the Upload Person Habits task row, click the Go to Task button.
Related Topics
• Manage Person Habits in the Integrated Workbook
Can I upload enrollment data in a batch?

Yes.
1. Use the integrated Microsoft Excel workbook to:
◦ Enroll participants in various programs, plans, and options.

◦ Designate dependents and beneficiaries in participant-enrolled plans.
2. Upload your changes into an interim database.
1. Select the Enrollment Uploads tab.
2. Click Prepare Enrollment Batch in Workbook.
What benefits processes can I schedule on the Schedule Processes

page?
Scheduled processes do tasks that are too complex or time-consuming to do manually, for example importing data or
updating many records.
You can schedule the following processes:

• Evaluate Life Event Participation
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• Evaluate Temporal Event Participation

• Evaluate Unrestricted Event Participation
• Back Out Unrestricted Life Events
• Close Enrollment
• Reevaluate Designee Eligibility
Note: You can schedule these processes from the Processes tab of the Evaluation and Reporting work area too.
How can I view more details on the results of a benefits process?

In the Evaluation and Reporting work area, Monitor Process Request section, click the Report icon of the life event or
enrollment process.
The Results section indicates the number of person records that:
• Processed successfully
• Didn't process
• Processed with errors
If the person records processed with errors and you want to find out more, click the number indicating the number of
records with errors. The following key fields appear depending on the process that was run:
• Person details, such as number, name, processing status

• Job details, such as name and process date
• Life event name
• Life event occurred date
• Error message code
• Error message
Experienced users can also look at the log file in the Monitor Process Request section. The log file provides in-depth
details of each person record that was processed. To access the log file, you click the Log File icon of the process. In the
window that appears, click the log file link to download it.
Related Topics
57
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Using Benefits Manage Document Uploads
4 Manage Document Uploads
Upload Supporting Documents

Depending on how document uploads were configured for your enterprise, participants and administrators can upload
documents from several areas to address pending actions.
If you're a participant, you can upload documents directly from the pending actions self-service page. Or you can
upload using the Documents link on the landing page.
If you're an administrator, you can upload documents on behalf of a participant from the Benefits Service Center page.
1. On the dashboard, search for and select the person you want to upload the documents for.
2. On the person's benefit summary page, click the number for Documents Pending Approval, or scroll directly
to the Certification section.
3. Set the filter to All.
4. Click the document link to open its details.
5. Click Add Attachment to complete uploading the required documents.
6. Save and close the page.
Note: These steps work only if there's relevant configuration in place to enable participants to upload documents
from the pending actions page. If there is no configuration in place, you can always use Document Records page from
the Person Management work area.
Review and Approve Documents

You review and approve documents from the Benefits Service Center page.
1. On the dashboard, click People with documents waiting to be approved. You can even search for a specific
person.
2. Click the person link to open the person's benefits summary.
3. Click the number that you see for Documents Pending Approval.
4. In the Certification section, click the document link to open its details, and then click the attachment to
download or open the document.
5. When you're done reviewing the document, click Save and Close to get back to the previous page.
6. In the Actions menu, select Approved or Rejected.
7. If you're approving the document, set the received date. Otherwise, set the denied date and select a reason.
Enter any comments if required.
8. Click Submit.
Note: After you approve or reject a document, you can't change its status. If you're using a third party application to
manage document approvals, you still need to set the received or denied date in the document details page.
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How You Resolve Participant Queries on Document

Approvals
The Benefits Service Center should help you resolve most queries you receive regarding document uploads.
For instance, if a participant wants to know why their document was rejected, you navigate to the Certification section
on the Benefits Summary page. Set the filter to Rejected to see the documents that were rejected. To see more details,
click the document link.
You can even use the Person Benefits diagnostic report from the diagnostic dashboard. This report, apart from other
details, displays the entire list of documents that were uploaded for a person across life events. You can access these
details outside an enrollment window too. You don't need to use an effective date to search for the documents.
How can I change the validity period for documents?

If you're setting up document uploads, you can set the documents validity period in the Document Uploads step when
you create or edit a plan.
The validity period impacts all documents of that type and you need to reprocess the relevant life event to see this
change.
You can also change the validity period of a specific document during an enrollment window. On the Benefits Summary
page, in the Certifications section, click the document link and change the validity period.
Typically, you might want to extend the validity period if you know that there's an upcoming enrollment opportunity
that requires the same supporting document. Set a new date in the Valid Until field. When you do this, you can reuse
the same document authorization without requiring participants to upload the document again.
In another example, if the plan policy changes and you need to approve documents afresh, you can end the document's
validity by shortening the validity period. Participants can then upload a new document so that you can review it again.
How You Manage Missing Certifications

You can resolve the pending actions in the self-service page when you can’t provide the certificates for various reasons.
Pending certification can lead to suspension of coverage. You can use the Declare Missing Certification button in the
Pending Actions page to resolve pending actions.
The Declare Missing Certification button appears only when:

• The life event is in started state.
• The effective date is within the enrollment window.
• The pending certification is just for the participant. The button doesn’t appear for the designation action items
for dependent or beneficiary. It also doesn't appear for the missing date of birth or social security number
action items.
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• Document of records is configured for certification and the document is not uploaded. When the document is
loaded, the button doesn't appear.
Enable Participants to Declare Missing Certifications

Here’s how you allow participants to declare that they can't provide a certificate:
1. On the Home Page, click Benefits Administration > Plan Configuration.

2. In the Tasks panel drawer, click Self-Service Configuration.
3. Select the Allow employees to declare that they can't provide a certificate check box in the Pending Actions
section.
4. Click Save.
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62
Using Benefits Enroll in Benefits
5 Enroll in Benefits
Overview of the Benefits Work Area

Participants enroll in benefits during open enrollment or when they have a qualifying life event. They can elect or
change unrestricted enrollments at any time.
Participants can:
• Compare current and potential benefits

• Make selections
• View and accept configured terms and conditions
• Elect coverage for themselves and their dependents
• Select primary care physicians for applicable plans
• View and print a confirmation statement
• Complete additional certification or designation action items specified on the confirmation statement
Participants elect benefits by clicking Me - Benefits.
Related Topics
How You Enroll in Benefits

The benefits enrollment process consists of three major steps.
Participants should complete the steps in the following order:
Open the self-service Benefits Service Center page by selecting Benefits under Me on the Navigator menu.
Add Contacts and Beneficiary Organizations

Before you start electing benefits, add or update all persons or organizations that you plan to designate as dependents
or beneficiaries.
• Add persons in the Contacts section.

• Add beneficiary organizations or trusts in the Beneficiary Organizations section.
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Provide all information required to determine the eligibility of each contact or organization. This ensures that the
contacts and organizations are available for designation when you elect benefits.
Elect Benefits
Click Change Benefit Elections. This button is available only if an opportunity exists for you to make elections, such as:
Sample
• During an open enrollment period
• If you have a qualifying life event
Electing benefits involves:
• Selecting benefits offerings

• Designating beneficiaries and dependents as appropriate for each offering
Additional information, such as a contribution or investment amount, might be required, depending on the offering
type.
When you finish making elections, you can review the information and make changes before submitting.
Review and Resolve Action Items

After submitting your elections, carefully review the Pending Action Items section to determine if you must:
• Provide any additional information, such as proof of good health or other documents or certifications
• Select a primary care physician
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Note: Enrollment processing might suspend a benefits offering if you don't complete required action items. Contact
your benefits department if you have any questions about resolving specific action items.
Related Topics
Examples of Entering Contact Start Date for Benefits

Designation Purposes
Watch video
This topic provides examples to help you decide the best effective start date to use so that you and your dependents
qualify for benefits.
• The first two examples relate to dependents:
◦ Adding your newborn

◦ Updating a contact relationship
• The final example relates to updating the effective start date because of an event.
Adding Your Newborn

The following table contains two scenarios related to newborns and provides the best effective start date for each.
Scenario Effective Start Date to Enter
• Your hire date is January 1, 2014. Your newborn's birth date

• Your child was born on January 15,
2014.
• Your child was born on December 15, Your hire date

2013.
• Your hire date is January 1, 2014.
Updating a Contact Relationship

The following table contains one scenario related to changing a contact relationship and the best effective start date.
• Your hire date is January 1, 2014. Marriage date
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• On February 1, 2014, you married

Jane Smith, an existing contact with
a current relationship of friend.
Updating the Effective Start Date Because of an Event

The following table contains two scenarios related to a relocation event and provides the best effective start date for
each.
• Your hire date is January 1, 2014. When you update your address details, enter the date that you relocated to the new address.
• You relocated to a new address on
February 28, 2014.
• Your hire date is January 1, 2014. When you update your address details, enter your hire date.
• You relocated to a new address on
November 21, 2013.
Considerations for Using the Change Beneficiaries Page

You need to remember these key points when you enable participants to use the Change Beneficiaries page.
• If participants have enrolled in benefits that allow beneficiary designations, they can change beneficiary details
even if there isn't an enrollment window open. In other words, they can update beneficiary designations for the
latest processed life event.
• Participants can change the percentage of allocation for existing beneficiaries, remove a primary or contingent
beneficiary, and adjust the allocation percentage.
• Participants can designate new contacts. But they can do this only if they added the contacts before the latest
processed life event date. For example, participant A added a dependent contact on Apr 1, 2022. You process
a life event on Apr 5, 2022. The participant makes some elections, but forgets to designate the dependent
contact. The enrollment window closes on Apr 7, 2022. The participant can still use the Change Beneficiaries
page to designate the dependent. However, if the participant adds a contact after Apr 7, 2022, they won't see
the contact in the Change Beneficiaries page.
• All new designations start from the coverage start date of the plan.
• As these beneficiary changes happen outside of the enrollment window, the application doesn't generate
any beneficiary-related pending actions. If an enrollment had generated a pending action to designate
beneficiaries, the action will automatically close when participants complete their designations.
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How You Can Update Beneficiary Designations

Depending on the status of the enrollment window and how your benefits application is set up, you can change your
beneficiaries from either the Benefits page or the Change Beneficiaries Page.
Watch video
On the Benefits page, you can make updates to your beneficiaries only if a relevant enrollment window is open.
Depending on setup, you can use the Change Beneficiaries page to change beneficiaries even after an enrollment
window has closed. To get to this page, click Search, enter Change Beneficiaries, and select the action.
You can change beneficiaries on the Change Beneficiaries page only if you are already enrolled in benefits that allow
beneficiary designations. You can't use this page when there's already an enrollment window that has started. In that
case, you can go to the Benefits page.
If you need to add a beneficiary based on a previous life event, you need to contact your administrator. They need to
back out the started event and then you can use the Change Beneficiaries page to update your designations.
Enable Participants to Update Beneficiary Designations

Anytime
Participants can update their beneficiaries, outside of an enrollment window, using the standalone Change Beneficiaries
page. However, you need to enable a quick action for participants to access that page.
1. Log in as a user who has administrative privileges.

2. On the Home Page, click Configuration > Structure.
3. Create a sandbox with Structure and Page Composer as the tools, and then open the sandbox.
4. Open the sandbox.
5. From the Tools menu, click Structure. Then, click Me.
6. Select the Quick Actions tab, Benefits.
7. Select Change Beneficiaries and select Yes from the Visible list to enable the Change Beneficiaries tile.
8. Ensure that you select the Add as a quick action link on home page check box.
9. Select Yes for Mobile Enabled.
10. Click Save and Close.
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FAQs for Self Service Elections

How can I quickly get to the benefits enrollment pages?
You can open the self-service Benefits Service Center page by selecting Benefits under Me on the Navigator menu to
start the enrollment.
Also, you can directly navigate to the enrollment pages by using the People to Cover quick action and by integrating the
People to Cover quick action as a task in a checklist.
Here's how you directly navigate to the enrollment pages using the People to Cover quick action:
1. Click Me on the Home page.

2. Click the Show More link.
3. Select People to Cover under Benefits.
4. Click Continue to navigate to the enrollment flow.
How can I view my past and future benefits enrollments?

Use the Effective Date field in the Enrollment Summary page. You can select a date between three years in the past from
the current date up to one year in the future to see your enrollments.
What happens if I don't resolve action items by their due date?

It depends on the specific benefits offering. Failure to provide required information might result in enrollment
suspension.
Provide all action items as quickly as possible after submitting benefits updates. Contact your benefits department if
you require more information about specific action items.
How can I designate beneficiaries?

Designating beneficiaries is a two-step process in the Benefits work area, which you open by clicking Me - Benefits on
the Home page.
1. Add all contacts, beneficiary organizations, and trusts on the People to Cover page.
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2. When you have an opportunity to change your benefits, select specific benefits offerings and designate
beneficiaries for those offerings.
If you designate more than one beneficiary for an offering, enter the percentage of the total benefit to assign to
each one.
If your beneficiaries don't appear in the list of beneficiaries during benefit selection, return to the Overview
page and add them as contacts.
Employees can designate or change beneficiaries using the anytime beneficiary flow for life events that are not visible
in Self-Service Benefits. For example, you may not want employees to change enrollments from Self-Service Benefits
but allow changes to beneficiary designations for events like salary change. You need to enable a quick action for
employees to access the Change Beneficiaries page.
Related Topics
• How can I designate dependents?
• Enable Participants to Update Beneficiary Designations Anytime
How can I designate dependents?

Designating persons as dependents is a two-step process in the Benefits work area, which you open by selecting
Benefits under Me on the Navigator menu.
1. Add all persons as contacts on the Overview page.

2. When you have an opportunity to change your benefits, select specific benefits offerings and designate eligible
contacts as dependents for those offerings.
If your dependents don't appear in the list of eligible dependents during benefit selection, return to the Overview page
and add them as contacts or provide any missing eligibility information.
Related Topics
• How can I designate beneficiaries?
Why is my flex credit usage unchanged for some benefit

offerings?
You might have selected benefit offerings that the flex credits program does not cover. Check your flex credit program
details or ask your benefits administrator for more information.
How can I delete a benefits document that I added?

Use the Edit action in the Document Records task to open the document record. Then, open the Attachments dialog box
and use the Delete Attachment icon to delete the document.
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What's the purpose of the relationship start date on the self

service benefits contacts page?
The relationship start date determines the contact's effective start date for benefits when participants designate them
in a benefit offering. For example, if you want to enter your newborn as a contact, you enter the child's birth date as the
relationship start date.
How can I integrate the People to Cover quick action as a task in a

checklist?
The People to Cover quick action can be integrated as a task within a master checklist, which enables users to complete
enrollment as part of the assigned checklist tasks.
For example, you can embed the quick action as a task within newhire checklist, so that the employee can navigate
directly to the benefits enrollment area from the checklist tasks. You can use the Checklist Templates task in the Setup
and Maintenance work area to embed the quick action as a task.
After you embed the quick action task in the checklist template, participants can use these steps to navigate to the
enrollment flow using the checklist tasks:
1. Click Me, Checklist Tasks on the Home page.

2. Click Current Tasks.
3. Select the name of the task that you embedded in the checklist.
4. Click Go to Task in the page that appears.
5. Click Continue to navigate to the enrollment flow.
Related Topics
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Using Benefits Prepare for Open Enrollment
6 Prepare for Open Enrollment

Overview of Benefits Open Enrollment
The benefits open enrollment process comprises three phases: preparation, the enrollment period, and post enrollment
activities. This chapter provides a sample timeline, checklists, and instructions to guide you through the phases of open
enrollment.
Open Enrollment Period Opportunities

The open enrollment period is an opportunity for eligible participants to:
• Enroll in a plan if not currently enrolled

• Change coverage from one plan to another
• Change enrollment status of eligible family members
• Decline coverages
Open enrollment is also an opportunity for your organization to:
• Modify plan configuration

• Update rates
• End benefits offerings
• Start new benefits offerings
Sample Open Enrollment Timeline

This sample timeline and the instructions in this chapter assume the following dates and rules:
• Open enrollment elections are effective on the event date, January 1.

• Coverages and rates start on the event date, January 1.
• Previous year coverages and rates end one day before the event date.
You must thoroughly test the open enrollment procedures using your configuration if either of the following conditions
is true:
• Your organization's open enrollment is effective on any other date within the year.
• You apply different coverage and rate start and end date rules to meet your business requirements.
The following timeline outlines suggested activities before, during, and after an open enrollment period that lasts
throughout the month of November.
Month Details
September and October Update plan configuration
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Month Details
Run a trial open enrollment:
• Test performance
• Test self-service enrollment
November 1 Run the open event processing:

Throughout November Elect benefits:
• Participants enter elections using the self-service guided process.

• Benefits administrators enter elections in the Benefits Service Center page.
December 2 -- 15 • Benefits administrators can still enter elections as necessary by setting a session effective date
within the enrollment period of November.
December 15 Run the Close Enrollment process to close all elections.
Phase One Checklist: Before the Open Enrollment Period Starts

Follow these steps to prepare for the open enrollment period:
Task Work Area
Check payroll calendars. Contact payroll administrator
Check plan year periods. Plan Configuration
Assess and update eligibility profiles and Plan Configuration

derived factors.
Prepare program and plan configurations: Plan Configuration
• End existing plans no longer offered.

• Add new plans.
• Add new options to existing plans.
Add the open scheduled life event to the Plan Configuration

program or plan not in program.
Manage standard and variable rates: Plan Configuration
• Add rates to new benefits objects.

• Modify rates on existing benefits
objects.
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Task Work Area
• Modify elements on existing rates.

• Modify flex credit offerings.
Start new coverage for flexible spending Plan Configuration

accounts (FSA)
Configure enrollment and rate display. Plan Configuration
Identify and resolve in-progress life events: Evaluation and Reporting
• Identify conflicting and incomplete Enrollment

life events
• Identify and finalize open action
items and suspensions
• Evaluate and resolve temporal event
participation
Process trial open enrollment. Evaluation and Reporting
• Test trial open enrollment. Enrollment
Me - Benefits (Self-Service)
• Analyze and tune performance. Evaluation and Reporting
Phase Two Checklist: During the Open Enrollment Period

Follow these steps to administer the open enrollment period:
Task Work Area
Generate the Participant Enrollment Reports and Analytics

Results report.
Manage the open enrollment period. Evaluation and Reporting
• Run the Evaluate Scheduled Event

Participation and Enroll in Default
Benefits processes.
• Monitor processes and resolve errors. Evaluation and Reporting
• Enter enrollments. Me - Benefits (Self-Service)
Enrollment
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Task Work Area
• Process life events that occur during Enrollment

the open enrollment period.
Manage and close the open enrollment Evaluation and Reporting

window.

Results report.
Phase Three Checklist: After the Open Enrollment Period Ends

Follow these steps to complete the open enrollment activities:
Task Work Area
Verify enrollment. Enrollment
Investigate incorrect enrollments. Enrollment
Close action items and certifications. Enrollment
Enter overrides. Enrollment
Inactivate plans that are no longer offered. Plan Configuration
Process life events that occur after open Enrollment

enrollment.
Related Topics
• Set Up and Process an Open Enrollment Period
Prepare Program and Plan Configuration for Open

Enrollment
Ensure that you have completed the tasks mentioned in this topic when you prepare program and plan configurations
for open enrollment.
1. Verify periods for payroll calendars and year periods for programs and plans.
2. Check derived factors and eligibility profiles.
3. Inactivate existing plans and options that are ending.
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4. Create options and plans and add to existing plans and programs.
5. Check default enrollment rules.
6. Check unrestricted processing enablement.
Verify Periods for Payroll Calendars and Year Periods for Programs and
Plans
Check with the payroll administrator:
• That the payroll periods for your benefits plans extend through the entire new plan year
• Whether the upcoming plan year has standard 52 or 26 pay periods or nonstandard 53 or 27 pay periods,
respectively, if using biweekly or weekly period types
In the Setup and Maintenance work area, Verify that a year period exists for the new plan year. Create year periods as
required using the Manage Year Periods task. In the Plan Configuration work area:
• Verify that all active programs and plans include the correct year periods using the Basic Details pages.
• If your business calculates communicated rates using pay periods, check that the correct communicated rate
frequency is selected based on the pay periods in the upcoming plan year.
Communicated Rate Frequency Description
Per pay period Uses the number of pay end dates derived from the payroll definition.
Example: A weekly payroll might result in 53 end dates in the calendar year.
Estimated per pay period Uses the standard number of periods corresponding to the period type value selected in the
payroll definition, regardless of the number of pay end dates in the calendar year.
Example: Communicated rate calculations use the fixed number of 52 weekly periods, even for
years with the nonstandard 53 weekly periods.
Per pay period with element frequency Uses the frequency rules of the payroll element associated with the standard rate to determine
rules the number of deductions in the calendar year.
Example: One of your benefit deductions occurs only on the first biweekly payroll in each
month.
If you use this communicated rate frequency, select Per-pay-period amount as the value passed
to payroll.
Check Derived Factors and Eligibility Profiles

Check and edit existing eligibility configuration and add missing eligibility configuration as required. Use the tasks
under Manage Eligibility in the Tasks panel drawer of the Plan Configuration work area.
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Examples:
• You created benefit offerings for spousal and child life that require new age derived factors.
• You have new requirements that require you to edit length of service derived factors.
• You evaluate eligibility profiles associated with benefits objects requiring many manual participation overrides
to determine how to better include and exclude participants.
Adjusting the eligibility profiles based on your analysis reduces or ends the manual overrides.
• Your service areas are changing, so you must modify the existing postal codes and service areas accordingly.
Inactivate Existing Plans and Options That Are Ending

Inactivate plans or options that you no longer offer in the new plan year to stop existing participant enrollments and
prevent new enrollments. Before you inactivate a plan, ensure that you disenroll all participants from the plan.
To inactivate a plan, do these steps in the Plan Configuration work area:
1. Search for the programs or plans that contain the plans or options that are ending.
Tip: Use the effective start date of the upcoming plan year as your effective as-of date.
◦ The effective as-of date becomes the session effective date at the top of the edit pages.
◦ The session effective date becomes the new effective start date for plans and options that you
update, after you save your changes.
2. On the edit Basic Details page, select the plan or option that you want to end.
3. Update the plan or option, setting the status to Inactive and saving your change.
Check that the effective start date for when the plan or option becomes inactive changed to the session
effective date at the top of the page, for example, January 1, 2016.
4. On the Enrollment page, select the plan or option that you want to end.
5. Update the Enrollment section on the General tab, setting the enrollment rule to Current - lose only; new -
nothing and saving your change.
Check that the updated plan or option:
◦ Enrollment field contains a check mark
◦ Effective start date changed to the session effective date for the page, such as January 1, 2016
Processing the open event with these settings disenrolls all existing plan or option participants on the new effective
start date and no new participants can enroll in it.
Create Options and Plans and Add To Existing Plans and Programs
Create the option or plan for the upcoming plan year in the Plan Configuration work area.
Object Settings
Options and plans • Set the session effective date at the top of the create page to the first day of a plan year at least a
few years earlier, for example, January 1, 2000.
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Object Settings
• Set the option or plan status to Pending.
Plans • Add year periods that include the current plan year and the upcoming plan year.
Example: If the upcoming plan year starts January 1, 2016, then, at minimum, add year periods
from January 1, 2015 to December 31, 2015 and January 1, 2016 to December 31, 2016.
Add the new objects to the relevant plans and programs.
Parent Object Steps for Adding the New Option or Plan
• Plan to which you want to add the 1. Set the session effective date at the top of the Basic Details page to the first day of the current
new option plan year, for example, January 1, 2015.
2. Add the new option or plan, setting the status to Pending and click Save.
• Program to which you want to add
the new plan
The effective start date should be the first day of the current plan year.
3. Set the session effective date at the top of the edit program page to the first day of the upcoming
plan year, for example, January 1, 2016.
4. Update the option or plan status to Active for the newly added option or plan and click Save.
◦ The newly added option or plan status should have changed from Pending to Active.
◦ The effective start date should now be the first day of the upcoming plan year.
Plan not in program to which you want to 1. Set the session effective date using the current plan year, set the status, and add year periods,
add the new option just as you do when creating plans.
2. Follow steps 3 and 4 in the preceding row to set a new session effective date using the upcoming
plan year and update the plan status to Active.
Check Default Enrollment Setup

For all active programs, plans, and options, check that the selected enrollment methods and default enrollment rules are
still valid for your latest program and plan designs.
• Check on the General and Life Event tabs of the edit program or plan Enrollment pages.
Where the default enrollment rule is New - default; current - same enrollment and rates, the processing is as follows:
• Participants who are new to an electable benefits object receive the default plan or option.
• Currently enrolled participants who make no explicit election changes retain their same enrollment.
Enrollment processing recomputes rates based on the plan configuration. If you entered the coverage or rate at
the time of enrollment, then participants retain the current benefit and rate amount by default.
Tip: Use the Automatic enrollment method when you don't want workers to change the default elections that you set.
Check Unrestricted Processing Enablement

To allow enrollment in unrestricted plans during open enrollment, you must disable the regular unrestricted processing.
Otherwise, the regular unrestricted processing backs out the unrestricted open enrollments.
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Use the Manage Self-Service Configuration task in the Plan Configuration work area to set unrestricted processing
enablement to Not during open enrollment.
Note: Unrestricted programs and plans run on entirely different business relationships than the regular, life event
driven programs and plans. This means that you can process an unrestricted life event on the same day that you
process a regular life event.
Related Topics
• Eligibility Profiles
• How Default Enrollment Rules Are Calculated
• How Enrollment Rules Are Calculated
Options to Configure Open Enrollment Period

When you add an open scheduled event to a program or to plans not in program, you must specify the dates and
enrollment rules for processing.
This topic discusses:
• Adding the open scheduled event

• Creating the enrollment period
◦ Recommendations for enrollment period date and rule selections

◦ Additional information about the assigned life event date selection
◦ Additional information about the close enrollment period date rule selection
• Selecting the reinstatement rule
Adding the Open Scheduled Event

To add the open event, in the Plan Configuration work area:
1. Open the Enrollment page for the program or plan not in program.
2. In the hierarchy, select the program or plan not in program, then select the Scheduled tab.
3. Select Open from the list, which by default is set to create an Administrative event.
4. In the Periods section, click Create.
5. Create the enrollment period.
Creating the Enrollment Period

This table lists the configurable fields with a description and sample recommended value.
The sample dates assume an open enrollment period throughout the month of November, with the elections taking
effect on January 1 of the following year.
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Field Description Sample Recommended Values
Enrollment Period Start Date First day of the open enrollment period. November 1, 2015
Enrollment Period End Date Last day of the open enrollment period. November 30, 2015
Assign Defaults Date Date on which default benefits assignments are November 1, 2015
made.
Typically, this is the same date as the open

enrollment period start date so that participants
can minimally see their waive or prior elections
when enrolling.
Assigned Life Event Date Effective date of the Open event. The date as January 1, 2016
of which eligibility is evaluated and rates are
determined.
For the open event, this date is typically the first

day of the new benefit year.
Processing Cutoff Date The last day on which the benefits professional December 15, 2015
can make election changes on behalf of the
participant.
Close Enrollment Period Date Rule Occurrence that causes the Open event to When processing ends
advance from the started to processed phase.
Year Period Year in which benefit elections are effective. January 1, 2016 to December 31, 2016
Period Determination Rule How enrollment periods are determined when: Later of enrollment period start or future start
• Backing out and reprocessing an event

• The event occurs within the enrollment
window of another life event.
Coverage Start Date Select the rule that meets your business Event
requirements.
Example: Select Event if you want the coverage

for the benefit plan to start on the assigned
life event date, which is January 1, 2016 in this
scenario.
Previous Coverage End Date Select the rule that meets your business 1 day before event
requirements.
Example: If you select Event as the

coverage start date rule, then also select the
corresponding 1 day before event rule to end
the previous coverage the day before the
assigned life event date. In this scenario, the
event date is January 1, 2016, so the previous
coverage end date is December 31, 2015.
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Field Description Sample Recommended Values
Rate Start Date Select the rule that meets your business Event
requirements.
Example: Select Event if you want the rates

for the benefit plan to start on the assigned
life event date, which is January 1, 2016 in this
scenario.
Previous Rate End Date Select the rule that meets your business 1 day before event
requirements.
Example: If you select Event as the rate start

date rule, then select the corresponding 1 day
before event rule to end the previous rate the
day before the assigned life event date. In this
scenario, the event date is January 1, 2016, so
the previous rate end date is December 31, 2015.
Selecting the Assigned Life Event Date

The event date is important for the evaluation of derived factors based on age, such as imputed income.
Example: Imputed income calculation in the US uses the participant's age as of the end of the current year. So for the
plan year 2016, the calculation uses the participant's age as of December 31, 2016.
If the assigned life event date is in late December of 2015 for the 2016 plan year, the person's age would be calculated as
of December 31, 2015. This age would be incorrect for imputed income purposes.
Selecting the Close Enrollment Period Date Rule

Specify the date that fits your business requirement for the open event. The following table provides example rule
selections and when you might select them:
Rule When to Select
When processing ends When there is a time between the end of the participant's enrollment period and the date of the open
event.
This enables you to make adjustments before the event is closed.
When enrollment period ends If there are no additional processing days after the enrollment period ends.
Selecting the Reinstatement Rule

During an open enrollment period, a reinstatement rule enables you to restore elections if:
• The open event was accidentally backed out

• An intervening life event backs out the open event
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The default reinstatement rule that applies for any life event that you create is Reinstate all if no electability change in
event.
The default rule restores elections only if there are no changes to the open enrollment electable choices between the
dates that you:
• Backed out the open event

• Reprocessed the open event
You can reinstate elections only if you backed out the life event using the Unprocessed status.
Related Topics
• Reinstatement Rules
• How Default Enrollment Rules Are Calculated
• How Enrollment Rules Are Calculated
Reinstatement Rules
Use reinstatement rules to control how life event processing restores participant elections when you back out and
reprocess a life event.
You select reinstatement rules on the Life Event tab of the Enrollment page when you create or edit a program or plan in
the Plan Configuration work area.
Example: You back out an open enrollment event for a participant to make changes to some benefit offerings and then
you reprocess the open event. Reprocessing restores the original participant elections, depending on the reinstatement
rule that you configured for the open event.
Note: Reprocessing a backed out life event restores participant elections only if you backed out the life event using
the Unprocessed status.
Reinstatement Rules
The following table identifies and describes each reinstatement rule as well as when to use it.
Rule Description When to Use
Reinstate All If No Electability Change In Life Restore elections if there is no change in the When changes in electable choices might
Event electable choice data between the dates when influence the participant's election decisions
you backed out and reprocessed the life event. and you want the participant to review and
make new elections.
Example: If a rate value or definition changes,
reprocessing doesn't restore the elections. Reprocessing uses this rule if you don't make a
selection.
Reinstate If No Change for the Backed Out Restore elections if the participant's original When participants don't have to reconsider
Enrollment elections remain the same after you reprocess their original election decisions because of
the life event. new electable choices or changes to electable
choices that they didn't choose originally.
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Rule Description When to Use
Reinstate If Electability Exists for the Backed Restore elections as long as the participant is When you:
Out Result eligible for the electable choices.
• Want to apply any changes to the
Example: You changed the value of an activity participant's original elections without
rate that the participant originally elected. providing an opportunity for participants
Reprocessing the life event restores those to review the changes
elections with the new rate, as long as the
participant is eligible for that electable choice. • Don't want participants to review any new
electable choices
CAUTION:
If an activity rate increases, the participants'
election automatically increases in cost
and the participant might not have an
opportunity to reevaluate the election.
Reinstate If Electability Exists for the Backed This rule is similar to the Reinstate If When you want to apply any changes to the
Out Result, Else Apply Defaults Electability Exists for the Backed Out Result. participants original elections without requiring
The rule reinstates the elections if electable the participant to review these changes.
choices exist. If they don't exist, the participant
is enrolled using the configured defaults. If the participant no longer has electability for
some elections, you want to make the elections
anyway by using the defaults instead.
Never Reinstate Doesn't restore elections. When you:
• Don't want to restore participant elections

after reprocessing the life event
• Want to use a specific life event to make
adjustments or corrections to a benefit
offering and you want participants to
reevaluate their original elections
Related Topics
• Examples of Reinstatement Rules
• Examples of How Intervening Life Events Impact Reinstatement Rules
• Reinstatement Rules to Restore Participant Elections with Overridden Rates
Options to Configure Open Enrollment Rates

When preparing benefits offerings for open enrollment, create rates for new benefits offerings and update rates for
existing offerings as required.
Consider these aspects of creating and updating rates in the Plan Configuration work area:
• Creating rates for new benefits offerings
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• Updating existing standard rates

• Updating existing variable rates
• Updating elements for existing rates
• Updating flex credit offerings
• Editing rates in the integrated workbooks
• Configuring rate display for self-service enrollment
Creating Rates for New Benefits Offerings

Ensure that the rates that you create have the same effective start date as your new benefit offerings. On the Create
Standard Rates page, edit the session effective date to match the effective start date of the corresponding new plan or
option.
Updating Existing Standard Rates

Update existing standard rates if there are any changes to rate calculations or other details.
1. Use the Manage Rates task to search for the standard rate as of the first day of your new plan year.
Searching by this date sets the session effective date for the rate updates.
2. Select the standard rate and make changes to the calculations using the Update action.
Updating Existing Variable Rates

There are two possible scenarios to consider when you update existing variable rates:
• You want to edit the calculation details for an existing variable rate profile. In this case, follow these steps:
a. On the Manage Variable Rate Profiles page, search for the variable rate profile effective as of the start
date of the new plan year, typically January 1.
Searching by this date sets the session effective date for the rate updates.
b. Make changes to the variable rate calculations using the Update action.
No updates are necessary on the corresponding standard rates page, because the revised calculation
goes into effect on the effective start date of the revised variable rate profile.
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• You want to attach a different variable rate profile to the standard rate.
Example: You now want to use two age band variable rate profiles for the same age range where you formerly
used just one profile.
In this case, follow these steps:
a. Search for the standard rate using the effective as of date that is one day before the effective start date of
the new variable rate.
Example: If the new variable rate is effective on 01 January 2016, search for the corresponding standard
rate as of 31 December 2015.
b. Edit the rate using the Update action.
The session effective date reflects 31 December 2015.
On the Edit Standard Rate page, end-date the unwanted variable rate profile in the Variable Rates section
and click Save and Close.
c. Search again for the standard rate, this time setting the Effective As-Of Date to the effective start date
of the new variable rate, which sets the session effective date.
In this example, the date is January 1, 2016.

d. Edit the rate using the Update action, adding the new variable rate profiles to the rate.
Updating Elements for Existing Rates

Consider whether any of your rates require a different payroll element.
Example: You formerly used a single payroll element for all medical plans, but for the next plan year you require a
distinct element for each medical plan.
• If you must attach a different element to an existing standard rate, search for the rate as of the first day of the
new plan year. Then, use the Update action to attach the new element.
• The association of the current payroll element with the rate is end-dated effective the day before the first day of
the new plan year.
Updating Flex Credit Offerings

Update existing flex credit shell plans if there are any changes to:
• Flex credit calculation methods

• Spending options
• Excess credit calculations
Use the Manage Flex Credits Configuration task to search for the flex credit shell plan as of the first day of your new
plan year.
• Searching by this date sets the session effective date for the flex shell plan updates.
• Select the flex shell plan and make changes using the Update action.
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Editing Rates in Integrated Workbooks

You can use the Microsoft Excel integrated workbook available on the:
• Standard rates search page to edit and upload multiple standard rates at once
• Variable rate profiles search page to:
a. Create, edit, and upload multiple variable rate profiles.
b. Associate them with existing standard rates.
Configuring Rate Display for Self-Service Enrollment

You can configure the name and visibility of rate columns on each step in the self-service enrollment guided process.
Use the Configure Plan Type Grouping Display task.
Related Topics
• Configure Enrollment Display
• Manage Standard Benefit Rates in the Integrated Workbook
• Manage Variable Benefit Rates in the Integrated Workbook
• Variable Rates Options
Restart Coverage for Flexible Spending Accounts

This topic covers how to configure flexible spending accounts (FSA), which might have requirements to start new on a
certain date. For example, FSA plans in the US, such as health care and dependent care reimbursement, typically must
start new every calendar year.
FSA plans also typically require explicit entry of the enrollment amount, even if the participant:
• Enrolled in the previous year
• Plans to continue the same coverage level for the following year
The coverage of a currently enrolled participant should end on December 31 and restart on January 1.
Configure the FSA Plan

In the Plan Configuration work area:
1. On the Edit Program Enrollment page, select the FSA plan from the program hierarchy.
2. On the Scheduled tab, select the Open event.
3. In the Session Effective Date field, select the first day of the new benefit year, typically January 1.
4. In the Enrollment Method field, select Explicit.
5. In the Enrollment Rule field, select Current - keep or choose, starts new; new - can choose. This rule ensures
that current participants must explicitly reelect coverage amounts, even though their coverage amounts might
stay the same. The coverage ends at the configured end date for the processed life event and restarts the next
day.
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6. Select one of the following default enrollment rules, depending on your plan configuration.
Default Enrollment Rule Usage Conditions
New - nothing; current - nothing Typical default enrollment rule to force participants with current year coverage to reelect
coverage for the new plan year.
New - default; current - default If your FSA plan configuration includes a waive plan or option, select this default enrollment
rule on the waive plan or option.
New - default; current - same If the standard rate for the FSA object has a default of zero.
enrollment but default rate
7. In the Reports and Analytics work area, check the setup using the Participant Enrollment Results Report.
a. View the report results as of one day before processing the open event. The results provide a list of
current enrollees in each FSA plan, and their current elected amount.
b. Run the same report after the open enrollment period ends to verify that coverage was reelected, or
ended, according to participant elections.
Test Procedure in a Test Instance

Follow these steps after you set up the enrollment rules in a test instance:
1. Process the open event in the Evaluation and Reporting work area as of the first day of your new plan year.
2. Search for the enrollment information of a current FSA plan participant. Select Enrollment under Benefits on
the Navigator menu to search for and select the participant and open the Benefits Service Center page.
3. For this date, verify that the Enrollment Results page:
◦ Doesn't display the existing enrollment in the FSA plan

◦ Does display existing enrollment in other benefit plans, which is expected
4. On the Enrollment page, explicitly select the FSA plan and specify the coverage amount, to enroll again for the
new plan year.
5. Verify that the coverage start date is the first day of your plan year and the original coverage start date is as
expected.
6. Select the first day of your new plan year as the session effective date.
7. Verify that the Enrollment Results page shows that coverage:
◦ Ended on the last day of the previous plan year

◦ Restarted on the first day of the new plan year
You can follow the same procedure to test the self-service enrollment for a worker by using this method to open the
worker's self-service enrollment pages:
1. On the Manage Self-Service Enrollment Configuration page, verify that Parameter Display is selected.
2. Select Benefits under Me on the Navigator menu.
3. Search for and select the person.
4. Click Continue.
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Configure Enrollment Display

You can configure how to group and display plans on each step in the self-service guided enrollment process and each
administrator enrollment tab.
This topic covers how to:
1. Group plans for enrollment.

2. Configure the enrollment display.
3. Configure the rate display.
Group Plans for Enrollment

Group plan types into display categories in the Manage Plan Types task. You can group plan types together for display
by assigning the same display category to multiple plan types. For each plan type, specify a category in which to display
plans:
• Self-service enrollment steps

• Administrative enrollment tabs
When you create plans, you assign each to a plan type. Each plan inherits the enrollment display category of its
assigned plan type.
Example Enrollment Groupings

You could group several different life insurance plan types together into a single Life Insurance display category. For a
single plan type, you can select a different category for self-service display compared to the administrative display.
Configure Enrollment Display

Use the Manage Plan Grouping page to configure the visibility and display names of plan type enrollment categories.
Category Possible Configurations
Self-service enrollment guided process • Change the names of the plan type category groupings, which correspond to self-service
steps enrollment step names
• Control whether each step is visible
• Enter a description of the plan grouping to associate with the selected enrollment display name
Participants see this description during self-service enrollment.
You can modify only the name and visibility of plan groupings, you can't create groupings here.
Configure Rate Display

Use the Rate Column Display button to configure the name and visibility of rate columns on each step in the self-service
enrollment guided process.
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Related Topics
• Rate Display Configuration Options
• Display Only Eligible Offerings for Enrollment
Identify and Resolve In-Progress Life Events Before Open

Enrollment
On a given day, you can process only one life event in a single benefits relationship for a participant. The Evaluate
Scheduled Event Participation process doesn't start an open event for a participant who has an existing life event that
isn't fully processed.
Therefore, process and resolve in advance all existing life events that would conflict with the open life event.
To resolve yet-to-close, in-progress life events:

1. Identify incomplete life events.
2. Resolve incomplete life events.
3. Identify and finalize open action items.
4. Evaluate and resolve detected temporal events.
Identify Conflicting and Incomplete Life Events

Incomplete and conflicting life events include events that are:
• Detected for participants, but not yet processed

• Started or processed, but not closed
• Suspended, awaiting fulfillment of action items
• Detected by temporal processing
To identify participants with incomplete events that require resolution, use one of these reports:
• On the Evaluation and Reporting work area Life Events tab, search by specifying the event status and other
report parameters.
Example: You can search for all life events in the Detected status and view by legal employer.
Click the Details button to see the list of participant names for each employer.
• View the Totals by Life Event summary report for life events that aren't processed.
in the Reports and Analytics work area, search for the Participant Enrollment Results report and click More.
Resolve Life Events

To resolve the in-progress life events for each participant, use the Person Life Events task in the Benefits Service Center
page. Follow these steps:
1. On the Potential Life Events tab, resolve all life events in the Detected or Unprocessed status by taking one of
these actions:
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◦ Delete the life event.

◦ Process the life event.
◦ Void the life event, if it doesn't require processing, by changing the status to Voided.
2. On the Life Events tab, resolve the life events that are in the Started status, as shown in the following table.:
Enrollment Period Passed? Available Resolution Actions
Yes Close the life event.
a. Select the started event.

b. Select the Close action.
c. Specify a date.
No a. Process the life event for the participant.

b. Allow enrollment if applicable.
c. Process the Open event separately for these participants.
Note: You can also use the Close Enrollment process in the Election Processes section of the Evaluation and
Reporting Work area to close enrollment for a large group of participants. However, even though you closed
enrollment for the prior event, any suspensions caused by unfulfilled action items conflict with open event creation.
Identify and Finalize Open Action Items and Suspensions

While a participant has a life event with enrollment suspended because of an unfulfilled action item, the next life event
can't process for that participant. Therefore, you must resolve and close the open and suspended action items for each
participant before you process the open event.
To finalize open action items and suspensions:
1. In the Evaluation and Reporting work area, run the Manage Action Items process.
View the process report to see a list of participants with pending action items.
2. Follow up with those participants to complete their action items.
3. On the Enrollments page in the Benefits Service Center page, click Manage Enrollment Activities.
4. Depending on what item the participant is fulfilling, select the election and in the Enrollment Activities section:
◦ Enter and save the dependent or beneficiary information.

◦ Enter and save the received date for the certification.
5. On the Action Items tab, confirm that your action or certification shows as completed and the date of
completion.
6. Close the life event.
Evaluate and Resolve Temporal Events

The Evaluate Scheduled Event Participation process can detect life events triggered by temporal events, such as age or
salary change, based on selected process parameters.
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If the event date of a detected temporal event is prior to the open event date, the open event fails to process for that
participant. If your organization uses temporal processing to create detected events, you can minimize such conflicts:
1. Run the Evaluate Temporal Event Participation process a few days before open event processing.
2. Resolve as many of the detected temporal events as possible before processing the Open event.
FAQs for Open Enrollment Preparations

How can I disenroll all participants from a plan?
Use the Manage Eligibility Profiles task to create an eligibility profile. You can configure it to exclude participants who
satisfy the eligibility profile. Then, attach the eligibility profile to the plan.
In the benefits service center, when you process the relevant life event and eligibility is evaluated, all participants will be
disenrolled from the plan.
Another way is to configure any life event that is linked with the plan and set the enrollment code to Current - lose only;
new - nothing. When you process that life event, all participants will be disenrolled from the plan.
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Using Benefits Manage Open Enrollment
7 Manage Open Enrollment

Overview of Benefits Open Enrollment
The benefits open enrollment process comprises three phases: preparation, the enrollment period, and post enrollment
activities. This chapter provides a sample timeline, checklists, and instructions to guide you through the phases of open
enrollment.
Open Enrollment Period Opportunities

The open enrollment period is an opportunity for eligible participants to:
• Enroll in a plan if not currently enrolled

• Change coverage from one plan to another
• Change enrollment status of eligible family members
• Decline coverages
Open enrollment is also an opportunity for your organization to:
• Modify plan configuration

• Update rates
• End benefits offerings
• Start new benefits offerings
Sample Open Enrollment Timeline

This sample timeline and the instructions in this chapter assume the following dates and rules:
• Open enrollment elections are effective on the event date, January 1.

• Coverages and rates start on the event date, January 1.
• Previous year coverages and rates end one day before the event date.
You must thoroughly test the open enrollment procedures using your configuration if either of the following conditions
is true:
• Your organization's open enrollment is effective on any other date within the year.
• You apply different coverage and rate start and end date rules to meet your business requirements.
The following timeline outlines suggested activities before, during, and after an open enrollment period that lasts
throughout the month of November.
Month Details
September and October Update plan configuration
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Month Details
Run a trial open enrollment:
• Test performance
• Test self-service enrollment
November 1 Run the open event processing:

Throughout November Elect benefits:
• Participants enter elections using the self-service guided process.

• Benefits administrators enter elections in the Benefits Service Center page.
December 2 -- 15 • Benefits administrators can still enter elections as necessary by setting a session effective date
within the enrollment period of November.
December 15 Run the Close Enrollment process to close all elections.
Phase One Checklist: Before the Open Enrollment Period Starts

Follow these steps to prepare for the open enrollment period:
Task Work Area
Check payroll calendars. Contact payroll administrator
Check plan year periods. Plan Configuration
Assess and update eligibility profiles and Plan Configuration

derived factors.
Prepare program and plan configurations: Plan Configuration
• End existing plans no longer offered.

• Add new plans.
• Add new options to existing plans.
Add the open scheduled life event to the Plan Configuration

program or plan not in program.
Manage standard and variable rates: Plan Configuration
• Add rates to new benefits objects.

• Modify rates on existing benefits
objects.
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Task Work Area
• Modify elements on existing rates.

• Modify flex credit offerings.
Start new coverage for flexible spending Plan Configuration

accounts (FSA)
Configure enrollment and rate display. Plan Configuration
Identify and resolve in-progress life events: Evaluation and Reporting
• Identify conflicting and incomplete Enrollment

life events
• Identify and finalize open action
items and suspensions
• Evaluate and resolve temporal event
participation
Process trial open enrollment. Evaluation and Reporting
• Test trial open enrollment. Enrollment
Me - Benefits (Self-Service)
• Analyze and tune performance. Evaluation and Reporting
Phase Two Checklist: During the Open Enrollment Period

Follow these steps to administer the open enrollment period:
Task Work Area

Results report.
Manage the open enrollment period. Evaluation and Reporting
• Run the Evaluate Scheduled Event

Benefits processes.
• Monitor processes and resolve errors. Evaluation and Reporting
• Enter enrollments. Me - Benefits (Self-Service)
Enrollment
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Task Work Area
• Process life events that occur during Enrollment

the open enrollment period.
Manage and close the open enrollment Evaluation and Reporting

window.

Results report.
Phase Three Checklist: After the Open Enrollment Period Ends

Follow these steps to complete the open enrollment activities:
Task Work Area
Verify enrollment. Enrollment
Investigate incorrect enrollments. Enrollment
Close action items and certifications. Enrollment
Enter overrides. Enrollment
Inactivate plans that are no longer offered. Plan Configuration
Process life events that occur after open Enrollment

enrollment.
Related Topics
• Set Up and Process an Open Enrollment Period
Process Trial Open Enrollment

One month before your actual open enrollment, run a trial open enrollment in a test instance to tune performance and
validate plan configuration for the upcoming plan year.
At this point, in your production instance, you have:

• Prepared your programs and plans
• Updated your standard and variable rates
• Configured enrollment and rate display
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• Configured flexible spending account plans to start new coverage

• Closed in-progress life events
• Finalized and closed action items
• Processed and resolved temporal event participation
Now, you create a separate test instance from this production instance with all or a representative sample of your
participants and manage your trial open enrollment.
The trial open enrollment mimics many aspects of the actual open enrollment process, as shown with the following
basic high-level tasks:
Task Work Area Phase I Trial Open Enrollment Phase II Actual Open Enrollment
Generate the Participant Reports and Analytics Identify test participants. Compare enrollments before and
Enrollment Results report. after open enrollment.
Identify any in-progress life

events and resolve them before
processing open enrollment.
Run the Evaluate Scheduled Event Evaluation and Reporting Yes Yes
Benefits processes.
Monitor processes and resolve any Evaluation and Reporting Yes Yes
errors.
Enrollment
Identify and fix performance Evaluation and Reporting Yes Refine as required.
issues.
Iteratively, check plan configuration Evaluation and Reporting Yes Validate on an exception basis.
and rates using sample employees
and fix errors as required. Enrollment
1. Back out the open life event. Self-Service

2. Correct setup.
Plan Configuration
3. Rerun the open event.
Enter enrollments. Self-Service On a test basis Yes
Enrollment
Identify and Fix Performance Issues

It's difficult to determine the amount of time it takes to process a single person due to the variables that can impact
performance. These variables include:
• Complexity in plan configuration

• Hardware
• Network usage
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• Optimized table usage

• General database tuning
Poor performance times often result from not running table statistics on a regular basis. In the Evaluation and Reporting
work area:
• Check that the threads parameter is set to the number of processors for the computer, at a minimum.
• Check that the chunk size is appropriate to the quantity of rows that processes are writing to the database.
Use a smaller value when writing many rows, such as when processing participants and converting annual
enrollments.
• Analyze and adjust your maximum error threshold as required using the Manage Batch Parameters task.
Example: If you process your trial open enrollment using your entire participant population, processes might
fail because they reached the maximum errors threshold.
• Analyze all index column statistics and gather column, schema, and table statistics before the following
processes.
◦ Evaluate Scheduled Event Participation

◦ Enroll in Default Benefits
◦ Close Enrollment
Related Topics
• How Participants and Administrators Enter Enrollments
• Scheduled Event Participation Process Options
• Monitor Processes and Resolve Errors
Manage Open Enrollment Period

Process your open scheduled event so that participants can make their benefits elections.
At this point, you have:
• Completed your trial open enrollment where you validated your:
◦ Programs and plans

◦ Standard and variable rates
◦ Enrollment and rate display configuration
• Configured flexible spending plans to start new coverage

• Closed unprocessed life events
• Finalized and closed action items
• Processed and resolved temporal event participation
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During your trial open enrollment, you focused on performance and validation. Now during your actual open enrollment
period, you focus on monitoring and managing the:
• Open enrollment period

• Participant enrollments
• Intervening life events
Task Work Area Phase I Trial Open Enrollment Phase II Actual Open Enrollment
Generate the Participant Reports and Analytics Identify test participants. Compare enrollments before and
Enrollment Results report. after open enrollment.
Identify any in-progress life

events and resolve them before
processing open enrollment.
Run the Evaluate Scheduled Event Evaluation and Reporting Yes Yes
Benefits processes.
Monitor processes and resolve any Evaluation and Reporting Yes Yes
errors.
Enrollment
Identify and fix performance Yes Refine as required.

issues.
Iteratively, check plan configuration Evaluation and Reporting Yes Validate on an exception basis.
and rates using sample employees
and fix errors as required. Plan Configuration
1. Back out the open life event.

2. Correct setup.
3. Rerun the open event.
Enter enrollments. Self-Service On a test basis Yes
Enrollment
Process life events that occur Enrollment Not applicable Yes

during the open enrollment period.
Manage the open enrollment Evaluation and Reporting Not applicable Yes
window.
Close open enrollment. Evaluation and Reporting Not applicable Yes
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Related Topics
• How You Manage an Open Enrollment Window
• Examples of Processing Life Events That Occur During Open Enrollment
Scheduled Event Participation Process Options

When preparing to submit the Evaluate Scheduled Event Participation process in the Evaluation and Reporting work
area, pay particular attention to setting the following key parameters.
Parameter Comments
Effective Date Select the first day of your open enrollment period, for example, November 1, 2015.
Detect Temporal Events Regardless of whether you decide to detect all, some, or no temporal life events, during processing the
open event evaluates each participant's:
• Age
• Length of service
• Salary
• Other temporal factors
Person Type To exclude terminated participants, select Employee or Participant.
Life Event Occurred Date Select the date as of which to evaluate eligibility and determine rates.
For the open event, this date is typically the first day of the new benefit year, for example, January 1,
2016.
Life Event Select Open.
Apply Defaults Select Yes to run the Enroll in Default Benefits process automatically after the Evaluate Scheduled
Event Participation process completes so that participants can view their default enrollments when
they enroll.
Select No to apply default enrollments later using the Enroll in Default Benefits process.
Example: You might run the process after participants finish electing their enrollments and before you
close the enrollment period.
Audit Log Select Yes only for troubleshooting. It causes the application to generate detailed audit logs.
Processing stops for any process generating an audit log, after that log becomes full.
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Parameter Comments
Select No to generate only summary information if you are processing your entire participant
population.
Tip: To limit the population processed, you can set additional parameters, such as Benefits Group, Location, Legal
Entity, and others, or write a person selection formula.
Process Default Enrollments

Depending on how you configured your programs and plans, the Enroll in Default Benefits process does the following:
• Enrolls participants using their current enrollments if they make no explicit election choices
• Assigns participants new default enrollments
• Changes current elections to a new default election
Example: You have a dependent care spending plan configuration that sets current participants to nothing or a
waive plan or option.
Monitor Processes and Resolve Errors

When processing open enrollment, always check the process-generated log files to identify and fix any errors in your
trial and production instances.
• You identify and fix many issues during the trial open enrollment, which reduces, but does not eliminate, issues
raised during the actual open enrollment.
• Run the Restart Participation Evaluation and Back Out Life Events processes, as required.
Use the Evaluation and Reporting work area.
This topic covers:

• Monitoring processing
• Restarting participation evaluation
• Backing out life events
Monitor Processing
Use the Monitor Process Request section of the Overview page to view the percentage of completion for processes and
the process-generated logs and reports.
Example: The Evaluate Scheduled Event Participation process:
• Log files identify who failed and how to fix the issue
• Summary report provides an overall summary of the following:
◦ Participants that processed successfully, in error, or were unprocessed
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◦ Open life events with a Started status
If you can't run a process that generates an audit log, then in the Maintenance Processes section:
1. Run the Purge Participation Evaluation Audit Data process.
The purge process protects ongoing activities by purging data only from completed batch processes. Purging
the audit logs does not affect life event or election information.
2. Restart the interrupted process.
CAUTION: You want to generate audit logs only during trial open enrollment. Check that production processes do not
generate audit logs, especially for batch processes that use the entire participant population.
Restart Participation Evaluation

Run the Restart Participation Evaluation process after fixing errors, such as errors resulting from reaching the maximum
allowable errors or full audit logs.
Back Out Life Events

If the open event must be backed out for the entire participant population or a select group of participants, run the Back
Out Life Events process for the Open life event. You do this most typically during the trial open enrollment to retest
edited plan configurations.
When backing out open life events, set the resulting life event status to:
• Unprocessed to include it for future processing

• Voided to exclude it from any further processing
Life Events That Occur During Open Enrollment Period

You must act on any intervening life events that occur during an open enrollment period. This topic explains what
causes intervening life events, provides an example, and lists reports to detect them.
Causes of Intervening Life Events

Any of the following actions can generate intervening life events based on their setup:
• The Evaluate Temporal Event Participation process detects temporal life events for workers, such as grade or
age changes.
• The administrator or participant adds a contact, for example, a spouse or child, using the Contacts page.
• The administrator adds a life event manually using the Person Life Events page in the Benefits Service Center
page.
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Example of Intervening Life Event

Scenario: During the open enrollment period, a participant experiences a gain dependent life event that affects
eligibility for electable choices.
The administrator or specialist must:
1. Allow the life event to back out the open event.

2. Take steps to process the intervening life event.
3. Reprocess the open event.
Reports to Detect Intervening Events

Use the sources in the following table to review evaluation processing results and identify intervening life events:
Population Processed Life Event Report Location
All participants or selected population Life Event tab on the Summary page of the Evaluation and Reporting work area
1. Search for events in the Detected status with other report parameters.
2. Click Details to view the participant list.
Specific participant Use the Person Life Events task in the Benefits Service Center page
1. Select the Potential Life Events tab.

2. View any detected or unprocessed life events for that worker.
Related Topics
Examples of Processing Life Events That Occur During

Open Enrollment
This topic provides three intervening life event scenarios along with the steps to process and resolve each event.
The following intervening life event scenarios share common open enrollment dates:
• Life event changes electability
• Life event doesn't change electability
• Life event added manually
You can remove the processing of a life event performed by participation evaluation processing, and you can prevent
further processing of a life event.
• Close a life event to prevent further processing.
• Back out a life event to roll back any updates generated by the participation evaluation processing, such as
updates to eligibility, rates, and automatic de-enrollments
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• Void a life event to roll back any updates and prevent further processing by participation evaluation processing.
Common Open Enrollment Dates

All examples in this topic assume the following main dates:
• The open enrollment period is from November 1 to 28, 2015.

• The new plan year starts January 1, 2016.
• Coverage and rates for elections made during the open enrollment period start on January 1, 2016.
Life Event Changes Electability

Scenario:
• A participant gains a spouse on November 20, 2015 and reports the event to the benefits administrator who
updates the contact information.
◦ Evaluation processing detects the gain dependent life event.

◦ The life event provides new electable choices, with rates and coverage effective November 20, 2015.
• New electable choices are also currently available for open enrollment.
To resolve this event:
1. Evaluate the gain dependent life event for the participant in the Benefits Service Center using the Process Life
Event task.
Allow the life event to back out the open enrollment event for that participant. The status of the life event
changes to Started.
2. Ask the participant to make elections based on the gain dependent life event.
◦ Participants open self-service enrollment by selecting Benefits under Me on the Navigator menu.
◦ Benefits professionals can make elections on the participant's behalf in the Benefits Service Center using
the Enrollments task.
3. Close the gain dependent life event for the participant in the Benefits Service Center using the Life Events tab
of the Person Life Events task.
The status of the life event changes to Processed.
4. Reprocess the open enrollment for that participant using the Process Open Enrollment task.
Ask the participant to make elections.
Life Event Doesn't Change Electability

Scenario: A participant changes address on November 13, 2015, but remains in the same postal code.
• The process detects an address change life event for the participant and backs out the open event.
• You know that this address change doesn't affect rates, coverages, or electable choices, so you want to void it.
To resolve this event, in the Benefits Service Center:
1. Void the address change event using the Person Life Events task.
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a. On the Life Events tab, select the event.

b. On the Actions menu, select Back out event.
c. In the Potential Life Event Status field, select Voided.
2. Reprocess open enrollment for that participant using the Process Open Enrollment task.
The reinstatement rule restores any open enrollment elections already made.
Life Event Added Manually

Scenario: A participant gains a child on November 20, 2015.
• The participant reports the event to the benefits specialist.

• The specialist:
a. Adds a gain dependent life event manually in the Benefits Service Center using the Person Life Events
task.
b. Sets the life event status to Manual.
To resolve this event, in the Benefits Service Center:
1. Change the status of the gain dependent life event to Unprocessed.

Use the Potential Life Events tab of the Person Life Events task.
2. Evaluate the gain dependent life event using the Process Life Event task.
◦ Allow the gain dependent life event to back out the open enrollment event for that participant.
◦ The status of the gain dependent life event changes to Started.
◦ The event provides new electable choices, with rates and coverage effective on the date of childbirth.
3. Continue as in steps 2 -- 5 of the first scenario, Life Event Changes Electability.
How Participants and Administrators Enter Enrollments

Multiple methods exist for entering enrollments and the open enrollment process typically uses all of them.
• Participants make their elections using the self-service enrollment guided process.
If participants have election opportunities, they can click Me - Benefits on the Home page.
Tip: In your trial environment, you must first select Parameter Display on the Manage Self-Service
Enrollment Configuration page before you can make elections as a participant.
• Benefits administrators enter enrollments for specific participants in the Enrollments work area.
a. Benefits professionals can generate a Benefit Enrollment document on the Manage Person Life Events
page and send it to participants.
b. Participants can use the document to make their election choices and return the completed document.
c. Benefits professionals use the completed document to enter the participant elections into the
Enrollments page in the Benefits Service Center page.
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• Benefits administrators can make default enrollments for participants who didn't elect any benefits. They use
the Enroll in Default Benefits process in the Evaluation and Reporting work area.
The Enroll in Default Benefits process might have already run automatically depending on whether you elected
to apply defaults as part of the Evaluate Scheduled Event Participation process.
Set Up and Process an Open Enrollment Period

This example contains a basic scenario with setup steps to define an open enrollment period and run the process to
evaluate scheduled event participation.
The following table summarizes key decisions in this scenario.
Decisions to Consider In This Example
Are there any new offerings that you want Yes, add the InFusion Vision plan to the InFusion Wellness program.
to add for the open enrollment period?
What are the start and end dates for the Starts November 1, 2015. Ends November 15, 2015.
open enrollment period?
When do you want eligibility to be Start date of the new plan year, which is January 1, 2016 in this example.
evaluated and new rates determined based
on elections?
When do you want the new coverage to Start date of the event
start?
When do you want the previous coverage One day before the event
to end?
When do you want the new rates to Start date of the event
become effective?
When do you want previous rates to end? One day before the event
Task Summary
1. Add the new plan to the program.
2. Define the open enrollment period for the program.
3. Process the open event as of the first day of the open enrollment period.
4. Check the enrollment page of a sample worker to verify that all electable choices appear as expected.
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Prerequisites
In the Plan Configuration work area, ensure that you created a:
1. Plan type called InFusion Wellness
Use the Manage Plan Types task to create the plan type.
2. Program called InFusion Wellness with the following configuration:
Field Value
Program Type Core
Year Periods Year periods for the current plan year and the new plan year:
◦ January 1, 2015 to December 31, 2015
3. Plan called InFusion Vision with the following configuration:
Field Value
Plan Type InFusion Wellness
Usage In program
Year Periods Year periods for the current plan year and the new plan year:
Adding the Plan to the Program

Use the Plan Configuration work area to complete this task with the default values for fields unless the steps specify
other values.
1. In the Tasks panel drawer, click Benefit Program Details to open the Manage Benefit Program Details.
2. In the Search Results table, click InFusion Wellness.
3. In the Session Effective Date field, select the first day of the current plan year, for example, January 1, 2015.
4. In the Plans and Plan Types section, click Select and Add Plan.
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5. Complete the fields, as shown in this table.

Note: The Basic Details page of programs shows only the active plans and plan types in a program by
default. You can display both active and inactive plans by selecting View All Plans from the View menu.
Field Value
Sequence Enter a unique sequence based on the sequence of existing plans in your program.
Plan InFusion Vision
Status Pending
6. Click OK to return to the Edit Program Basic Details page.

7. Click Save.
8. Review the effective start date of the plan that you added.
The date should be the first day of the current plan year, for example, January 1, 2015.
9. In the Session Effective Date field, select the first day of the new plan year, for example, January 1, 2016.
10. In the Plans and Plan Types section, select the InFusion Vision plan.
11. On the Edit menu, select Update.
12. Set the plan status to Active.
13. Click OK to return to the Edit Program Basic Details page.
14. Click Save.
15. Review the status and effective date of the InFusion Vision plan.
The status should be Active and the effective date should be the first day of the new plan year, for example,
January 1, 2016.
Defining the Open Enrollment Period

1. Click the Enrollment step.
2. Select the InFusion Wellness program in the hierarchy.
3. On the Scheduled tab, select Open, the default event is Administrative.
4. In the Periods section, click Create.
5. Complete the fields, as shown in this table.
Field Value
Enrollment Period Start Date November 1, 2015
Enrollment Period End Date November 15, 2015
Close Enrollment Period Date Rule When enrollment period ends
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Field Value
Assigned Life Event Date January 1, 2016
Year Period January 1, 2016 to December 31, 2016
Coverage Start Date Event
Previous Coverage End Date One day before the event
Rate Start Date Event
Previous Rate End Date One day before the event
6. Click OK to return to the Edit Program Enrollment page.

7. Click Save and Close to return to the Programs tab.
Processing the Open Event

Use the Evaluation and Reporting work area to complete these steps with the default values for fields unless the steps
specify other values.
1. Select the Processes tab.

2. In the Evaluate Scheduled Event Participation row of the Evaluation Summary Process Life Events table, click
the Submit icon button.
3. In the Parameters section, complete the fields as shown in this table.
Field Value
Effective Date The first day of the open enrollment period, for example, November 1, 2015
Life Event Occurred Date The first day of the new plan year, for example, January 1, 2016
Life Event Open
4. Select additional parameters to limit processing to a test population.

5. Click Submit.
6. In the Monitor Process Request section, search for the process that you submitted and verify that it completed
successfully.
7. Click the View Report icon button of the process that you submitted.
8. On the process details page, check the Results section to see how many worker records processed successfully
and how many processed with errors.
Click the number to view details about the specific worker records that processed.
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9. In the Benefits Service Center page of any worker in the processed test population:
a. Click the Enrollments task.

b. Verify that the new InFusion Vision plan appears as an electable choice.
Related Topics
• Prepare Program and Plan Configuration for Open Enrollment
How You Manage an Open Enrollment Window

The day after your open enrollment period ends, run the Close Enrollment process in the Evaluation and Reporting work
area. If necessary, you can extend or adjust the open enrollment window.
Tip: If you haven't already done so, run the Enroll in Default Benefits process before closing enrollment.
Close Enrollment
To close enrollment:
1. Optionally, run the Close Enrollment process with the:
◦ Validate parameter set to Roll back - database will not be updated

◦ Audit Log parameter optionally set to Yes.
Analyze the generated logs and reports. Investigate and fix any errors.
2. Run the Close Enrollment process with the
◦ Validate parameter set to Save - database will be updated

◦ Audit Log parameter set to No
Extend Open Enrollment

You can extend an open enrollment period when unexpected delays require additional days for certain participant
population segments, or the entire population, to complete their annual enrollment selections.
In the Evaluation and Reporting work area use the Adjust Open Enrollment Window process to:
• Update the enrollment period end date, processing end date, and default enrollment date
• Provide an appropriate number of extension days
The generated log file displays the details of the new enrollment period for all participants.
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If you ran the Close Enrollment process and you now want to reopen the event, you can run the Reopen Life Event
process, selecting the event and the population parameters.
Tip: Use the Reopen Life Event process, selecting the Open event, with the Adjust Open Enrollment Window process
to extend the annual enrollment window after reopening a closed Open scheduled event.
Extend Open Enrollment Window

You can extend the open enrollment window without closing any open life events to give more time to employees to
make their choices.
You can use the View Enrollment Opportunities option in Benefits Service Center to extend the open enrollment
window. Here's how you do it:
1. On the Home page, click Benefits Administration > Enrollment, to open the Benefits Service Center work
area.
2. Open the Benefits Summary page of the participant in the Benefits Service Center.
3. In the Evaluated Life Event section, click Actions (ellipses), View Enrollment Opportunities.
4. Click Edit in the Enrollment Opportunities section, follow the prompts to extend the dates, and save the
changes.
How You Manage Tasks After the Open Enrollment

Closes
Now that your open enrollment period is closed, you're ready to perform the following tasks in the production instance.
• Verify enrollment.
• Investigate incorrect enrollments.
• Close action items and certifications.
• Enter overrides.
• Inactivate plans that are no longer offered.
• Process intervening life events that occur after the open enrollment period.
Verify Enrollment
Generate the Participant Enrollment Results report in the Reports and Analytics work area and compare it with the same
report that you generated before you opened enrollment.
Use the preenrollment and postenrollment reports as well as the reports on the Life Events tab of the Evaluation and
Reporting work area to verify that:
• Participants are no longer enrolled in plans that aren't offered in the new plan year
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• Eligibility evaluated correctly

• Rates and premiums changes are reflected for the new plan year
• Default plan and option enrollments processed correctly
• Coverage restarted for flexible spending plans
• Enrollment included any other plan configuration changes
• Element entry values are correct for benefit elements
Also verify interim assignments and suspensions, action items and certifications, payroll results, and third-party
interfaces.
Investigate Incorrect Elections

For any elections that failed during open enrollment:
• Analyze the issue to determine if the failure occurred for one participant, many, or all.
• Review the setup of the benefit objects involved to determine if there:
◦ Was an oversight in making plan configuration changes
◦ Were incorrect data on an employee
Close Action Items and Certifications

To indicate that participants have fulfilled outstanding action items and certifications:
1. On the Enrollments page in the Benefits Service Center page, click Manage Enrollment Activities to open the
Manage Enrollment Activities page.
2. Depending on what item the participant is fulfilling, select the election and in the Enrollment Activities section
enter and save the:
◦ Dependent or beneficiary information
◦ Received date for the certification
3. On the Action Items tab, confirm that your action or certification shows as completed and the date of
completion.
4. To close unresolved action items and certifications, in the Evaluation and Reporting work area run the Manage
Action Items process.
Note: The application doesn't process the next life event until all unresolved action items for the prior life event are
resolved, even if the prior life event has a Closed status.
Enter Overrides
In the Benefits Service Center page, use the following tasks:
Task Description Examples
Eligibility Override Maintain override information for a potential • A few employees live outside of a service
participant who's otherwise ineligible for a area, but work inside the service area and
particular program or plan.
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Task Description Examples
your provider allows for this eligibility

override.
• Special approval has been given to
continue coverage for dependents who
exceed the plan age limits.
Enrollment Override Override election information. • An employee received a special rate for a
certain length of time.
You might have to override eligibility first, to
specify that a participant can enroll in a plan or • Certain retirees have grandfathered rates
option for which the participant was originally that you don't want to change during the
ineligible. annual open enrollment.
CAUTION: Exercise caution when you override eligibility or enrollment so that the enrollment record doesn't extend
indefinitely, for example, when you terminate an employee. Ensure that you enter the through date when you override
eligibility, and the coverage end date, when you override an enrollment record.
Inactivate Plans That Are No Longer Offered

To inactivate plans:
1. Disenroll all participants from the plans and options that are no longer offered.
2. Verify in the Plan Configuration work area that these plans and options inactivate at the start of the new plan
year.
For any plans and options that you haven't already scheduled to inactivate:
1. Set the session effective date to the first day of the new plan year.
2. Change the status to Inactive.
Process Intervening Life Events That Occur After the Open Enrollment
Period
You must act on any intervening life events that might occur after an open enrollment period, and before the start date
of the new plan year.
Example: A participant experiences an address change life event after the open enrollment period. As a result, the
participant:
• Might no longer be eligible for the elections made during the open enrollment period
• Might be eligible for other offerings
The benefits administrator must:
1. Process the intervening life event and allow it to back out the open event.
2. Ask the participant to make necessary elections if required.
3. Reprocess the open event as of any date within the open enrollment period if the intervening life event affects
the eligibility of the open enrollment elections.
4. Work with the participant to make or update elections using the Benefits Service Center page.
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Related Topics
Remove Incorrect Person Data in Non-Production

Environments
You use the Delete Person Benefits diagnostic report to remove incorrect data for a person in a nonproduction
environment.
You need to first run the report in the Validation mode. Then, you run it in the Commit mode. In the Validation mode,
you get to review the person’s life event data. It also generates an authorization key. Then, you run the report in the
Commit mode by using the authorization key to remove the data permanently.
1. Click the signed in user's icon, and click Run Diagnostics Tests in the Troubleshooting section.
2. Search for and run the Delete Person Benefits Diagnostic Test report using these parameters:
Field Details
Person Number Enter the person number whose data you want to view.
Commit Mode N, to indicate that you don't want to commit the data.
Authorization Key Leave this field empty.
Delete Benefit Relations N, to indicate that you don't want to delete benefits relationships at this time.
3. When the report is available, click the Report icon, and make a note of the authorization key. You need this key when
you run the report again, in the commit mode to delete the data.
Note: The authorization key is valid only for 1 hour.
4. Search for and run the Delete Person Benefits Diagnostic Test report using these parameters:
Field Details
Person Number Enter the person number whose data you want to delete.
Commit Mode Y, to indicate that you want to commit the data.
Authorization Key Enter the authorization key that you received when you ran the report in the validation mode.
Delete Benefit Relations Enter Y only if you want to delete the data from the benefits relationship tables too. Otherwise, enter
N.
5. When the report is available, click the Report icon to see the summary of data that you deleted.
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Using Benefits Billing
8 Billing
Overview of Billing in Benefits

An enterprise providing a benefit to a participant might want to bill the participant directly instead of deducting the cost
from the payroll. Such participants might include retirees or those who are on absence without pay.
The enterprise might require that the participant make payments to keep the benefit. Use the billing tasks to generate
bills and record payments as shown in the following figure.
Defining Billing Periods

Use the Year Periods and Billing Calendars task available in the Plan Configuration work area. You must create a billing
calendar before you generate bills for participants. Billing calendars contain monthly billing periods, payment due dates,
and overdue dates, for the number of years that you specify. Typically a single billing calendar is sufficient for your
billing requirements. However, depending on your enterprise policy, you might want to maintain separate calendars for
different types of participants, such as retirees, and employees on unpaid leave.
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Recording Payments for Individual Participants

When you receive payment from the participant for a bill, you use the Benefit Coverage Payments task to record the
payment. You can record partial payments, complete payments, and overpayments for a generated bill. The application
automatically allocates the amount you record to any open charges. The allocation is done sequentially, on the basis of
cost. You can also record payments without a bill, especially when participants make payments before you generate the
bill. Once you record a complete payment, the bill status changes to Fully Paid.
Using Processes to Prepare and Generate Bills for Multiple Participants

You can prepare and generate charges for multiple participants simultaneously using the following processes that exist
in the Evaluation and Reporting work area, Billing Processes section:
• Prepare Benefit Coverage Charge Data

• Generate Benefit Coverage Charges
Recording Payments for Multiple Participants

At a high level, follow these steps to record payments for multiple participants:
1. Use the Upload Billing Payments workbook available in the Person Data Loaders tab of the Evaluation and
Reporting work area. You enter your payments for multiple participants in this worksheet and upload.
2. Use the Allocate and Reconcile Payments process in the Evaluation and Reporting work area to process the
payments you entered in the worksheet. If required, use the Benefit Coverage Payments task to review the
payments for a specific participant.
Related Topics
• Guidelines to Use Benefits Billing Processes
Guidelines to Use Benefits Billing Processes

The benefits billing processes are available in the Evaluation and Reporting work area, Processes tab, Billing Processes
section.
Consider the following points before you run the processes:

• Prerequisites to prepare and generate charges for multiple participants
• Process sequence to prepare and generate charges
• Process for allocating and reconciling payments
Prerequisites to Prepare and Generate Charges for Multiple Participants

You must create a benefits group and assign it to participants whom you want to generate charges for a billing period:
1. Create benefit groups using the Benefit Groups task in the Plan Configuration work area.
2. Use the Upload Person Benefit Groups task in the Evaluation and Reporting work area to assign that benefits
group to multiple participants. When you run the processes, you select the benefits group to process all the
participants in that group.
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Process Sequence to Prepare and Generate Charges

You must run the processes in the following order:
1. Prepare Benefit Coverage Charge Data process

2. Generate Benefit Coverage Charges process
Before you run the Generate Benefit Coverage Charges process for a participant, you can still review the charges and
make changes using the Benefit Coverage Charges task.
Process for Allocating and Reconciling Payments

After you record and upload payments or adjustments using the Upload Billing Payments workbook, you must run
the Allocate and Reconcile Payments process. This process allocates and adjusts the payments appropriately for all
the records that were uploaded using the workbook. You can verify the updated payment records using the Benefit
Coverage Payments task.
Apply Credits to Participants

You can apply credits to participants against any outstanding bill when you review their existing credit balances in
Benefits Service Center.
For example, the benefits administrator generates health coverage charges of $500 for June. The participant overpays
$1000 and expects the excess credit of $500 to be used for the July bill. You can use the new Pay with Credits option on
the Billing page of Benefits Service Center to apply the credits.
For multiple credit adjustments, you can use the Upload Billing Payments workbook available in the Person Data
Loaders tab of the Evaluation and Reporting work area.
Here’s how you apply credits to participants through Benefits Service Center:
1. On the Home Page, click Benefits Administration > Enrollment.

3. Select the Billing task from the side panel.
4. In the Payments section, select Add, and click Pay with Credits.
5. Follow the prompts to apply credits. You can apply only the amount that is less than or equal to the previous credits.
The balance amount after applying the credit appears as the current credit.
Related Topics
• Upload Bill Payments Using the Integrated Workbook
Refund Excess Credits to Participants

You can refund the excess credit amount against bills.
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The refund amount should be less than or equal to the available credit. Refunds are processed only if the outstanding
bills are all fully paid.
For example, a participant was planning to take an approved long-term unpaid leave of absence and overpays some
amount for the upcoming bills. The participant later decides not to take their unpaid leave and requests a refund of the
extra amount that they had paid. You can use the new Refund option on the Billing page of Benefits Service Center to
refund excess credits.
To refund multiple participants, you can use the Upload Billing Payments workbook available in the Person Data Loaders
tab of the Evaluation and Reporting work area.
Here’s how you refund the excess credit amount:
1. On the Home Page, click Benefits Administration > Enrollment.

3. Select the Billing task from the side panel.
4. In the Payments section, select Add, and click Refund.
5. Follow the prompts to refund the excess credits. The refund amount should be less than or equal to the previous
credits. The balance amount after the refund appears as current credit.
Related Topics
• Upload Bill Payments Using the Integrated Workbook
FAQs for Billing

How do benefit coverage payments settle open charges in the
record payment page?
When you enter an amount and press TAB, the application settles the highest outstanding bill amount first, and then
the rest in descending order of value.
If there are outstanding charges from other billing periods, then the application settles the earliest charges first before
settling the latest billing period's charges.
For example, the following charges appear in the Record Payment page:
• InFusion Dental (20 USD) for the billing period of August 2016
• InFusion Eye Care (50 USD) for the billing period of September 2016
• InFusion Medical (200 USD) for the billing period of September 2016
The participant pays 250 USD on October 1, 2016. The application settles the charges as listed in the following table:
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Sequence Offering Settlement Amount Reason
1 Dental 20 USD The application settles this charge

first as it is an outstanding charge
from an earlier billing period.
2 Medical 200 USD The application settles this charge

next as it is the costliest charge in
the latest billing period.
3 Eye Care 30 USD The application does not settle

this charge as the payment is
insufficient to settle the charge
completely. The amount due is 20
USD.
What happens if the benefits participant overpays or makes a

partial payment?
Overpayments appear in the Current Credit field on the Record Payment page. For example, if the bill amount is 95 USD
and the participant pays 100 USD, the excess amount of 5 USD appears in the Current Credit field.
The credit is automatically subtracted from subsequent charges and prorated for the rest of the year.
Underpayments appear in the Current Arrears field. For example, if the bill amount is 100 USD and the participant pays
75 USD, the outstanding amount of 25 USD appears in the Current Arrears field. The arrears are automatically added to
subsequent bills and prorated for the rest of the year. Any outstanding amount at the end of the year is automatically
carried over to the next year and appears in that year's bills.
How can I make adjustments to a benefit participant's due

amount?
In the Benefits Service Center page of the participant, open the Benefit Coverage Payments task, Record Payment
without Bill or Make Adjustments page. Select the Arrears option and enter the due amount.
If you want to make adjustments to multiple participants simultaneously, use the Upload Billing Payments integrated
workbook. This workbook is available in the Person Data Loaders tab of the Evaluation and Reporting work area. This
is the same workbook you use to record payments for multiple participants. Then, use the Allocate and Reconcile
Payments process to update the payments you recorded. This process is available in the Processes tab, Billing Processes
section.
The Review Benefit Coverages Payments page displays the payments or adjustments that you entered in the
spreadsheet for a specific participant.
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How can I change the billing address of a benefits participant?

The primary address of a participant is the default billing address. You can change the billing address from the Benefits
Service Center page of the participant.
Here's how you change the billing address:
1. Open the Benefit Coverage Charges task, Billed Enrollments tab.

2. Check the session effective date.
3. From the Actions menu, click Update.
4. Deselect the Use primary address check box.
5. Enter the address in the fields that appear, and save your changes.
What's the difference between the hold billing option and the stop
billing option?
You select the Hold billing calculation check box to keep charges for a particular offering on hold for that billing period.
The check box is available in the Review Benefit Coverage Charges page.
Typically, you might want to hold a plan or bill for a short period of time while you are in discussion with an individual
employee or retiree. The charges on hold apply only to a specific billing period. They continue to appear as normal
charges in subsequent bills you generate.
The Stop billing check box, available in the Billed Enrollments tab, cancels current and subsequent billing for selected
plan types. The corresponding charges cease to appear in bills.
Why are some charges missing in benefit coverage bills?

On the Benefit Coverage Charges page, select the billing period and check if the Hold Billing Calculation check box
is selected for the charges that aren't appearing. Also, in the Billing Periods tab, check if the Stop Billing check box is
selected.
Related Topics
• What's the difference between the hold billing option and the stop billing option?
How can I bill participants if they were enrolled late in a benefits

billing cycle?
You must manually calculate the amount for the past billing periods. You then enter the amount due using the Arrears
option in the Record Payment without Bill page.
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Alternatively, you prepare the bill using the Benefit Coverage Charges page and edit the charges before you generate
the bill.
How can I determine a benefits participant's due amount?

In the Benefits Service Center page of the participant, open the Manage Benefit Coverage Payments page. Subtract the
Payments value from the Amount Due value to determine the total amount due.
Alternatively, from the Create menu, click Record Payment. In the billing table, the total amount due value appears in
the Amount Due column of the most recent billing entry.
Why can't I edit any of the benefit charges for a billing period?
You can't edit bills that are already generated. A bill with an Unpaid status indicates a generated bill. You can edit bills
that have the Open status.
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Using Benefits Integrated Workbooks for Loading Data
9 Integrated Workbooks for Loading Data
Overview of Managing Benefits Objects in Integrated

Workbooks
Use integrated Microsoft Excel workbooks to manage multiple records at one time for various Benefits objects.
Here's the list of Benefits objects that you can manage in Integrated Workbooks:
• Enrollments
• Rates and variable rates
• Derived factors
• Reporting groups
• Benefit balances
• Benefit groups
• Person habits
• Postal code ranges and service areas
• Regulations
• ACA Override Upload
• Upload Billing Payments
Examples
In the application, when managing person habits, you must enter the Benefits Service Center page for each person
individually. With the integrated workbook, you can manage the person habits for multiple persons at one time and
upload the data.
Rather than searching for each rate individually when preparing for your next open enrollment period, you can
download them to the integrated workbook. Make your edits in the workbook and upload them back to the application.
Manage Person Benefit Groups in the Integrated

Workbook
You can download person benefit group information to the integrated Microsoft Excel workbook. Use the integrated
workbook to view and edit person benefit group assignments for multiple persons and groups. Then, upload your
changes back into the application database.
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The basic process for managing person benefit groups using the workbook is:
2. Edit, add, and delete person benefit groups in the workbook.
3. Upload edits.
4. Resolve errors.

1. In the Upload Person Benefit Groups row of the Person Data Loaders tab, click the Go to Task button.
2. In the Upload Person Benefit Groups dialog box, enter a session effective date.
Editing, Adding, and Deleting Person Benefit Groups in the Workbook

After the download is complete, view, edit, add, and delete existing person benefit group assignments.
• Edit the Benefits Group value.

• Insert a row to add a person benefit group assignment.
a. Double-click the Mark for Deletion field in each workbook row that you want to delete.
Tip:
methods:

◦ Edit the date directly in the application using the Manage Benefit Groups task in Plan Configuration work
area.
Uploading Edits
The process:
1. Uploads into the application database the workbook rows marked as Changed
2. Uses the session effective date that you set when generating the workbook as the start date for any edits or
new group assignments that you entered in the workbook
3. End dates the prior group assignments as of the previous day for each edited row
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row that is marked for deletion
For each row marked for deletion in the workbook, the application permanently deletes all of the related effective-dated
records from the application database.
Resolving Errors
the process:


Related Topics
Manage Person Benefit Balances in the Integrated

Workbook
You can download person benefit balance information to the integrated Microsoft Excel workbook where you can add,
edit, and delete balances. Then, upload your changes back into the application database tables.
The basic process for managing person benefit balances using the workbook is:
2. Edit, add, and delete person benefit balances in the workbook.
3. Upload edits.
4. Resolve errors.

1. In the Upload Person Benefit Balances row of the Person Data Loaders tab, click the Go to Task button.
2. In the Upload Person Benefit Balances dialog box, enter a session effective date.
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Editing, Adding, and Deleting Person Benefit Balances in the Workbook

After the download completes, view, edit, add, and delete person benefit balances.
• Edit the Value, Primary Assignment, and Benefits Relationship values.

• Insert a row to add a person balance.
For each new balance, you must enter a value in either the Primary Assignment or Benefits Relationship
field, but not both.
a. Double-click the Mark for Deletion field in each workbook row that you want to delete from the
application database.
Tip:
methods:

◦ Edit the date directly in the application using these steps:
i. Search for the person in the Benefits Service Center page.

ii. Click the Person Benefit Balances task.
You can't edit or enter the effective date in the workbook. To change the effective date, you must generate a new
workbook with the new session effective date. You can also edit the date directly in the application. Search for the
person in the Benefits Service Center page, then use the Person Benefit Balances task.
Uploading Edits
The process:
1. Uploads to the application tables only those rows marked as Changed

new person benefit balances that you entered in the workbook
3. End dates prior balances as of the previous day for each edited row
row that's marked for deletion
Generate a new workbook after the successful upload to verify your edits.
124
Related Topics
Manage Person Habits in the Integrated Workbook

You can download person habit information, such as disability tobacco usage, to the integrated Microsoft Excel
workbook. Use the integrated workbook to view and edit the data and upload the changes to the database.
The basic process for managing person habits data using the workbook is:

2. Edit, add, and delete person habits in the workbook.
3. Upload edits.
4. Resolve errors

1. On the Person Data Loaders tab in the Evaluation and Reporting work area, click Prepare Person Habits in
Workbook.
2. In the generated workbook, enter the session effective date.
3. Click Download to retrieve the records that are effective as of the date that you entered in step 1.
Editing, Adding, and Deleting Person Habits in the Workbook

After the download completes, you can view, edit, add, and delete existing person habits data.
• Edit the Student Status, Disability Status, Disability Type, Tobacco Use, Covered in Another Plan, and Plan
values only.

• Insert a row to add habit data for a new person.
To identify the person, you must enter either the person number or these three values, in their respective fields:
◦ First name
◦ Last name
◦ Date of birth
As denoted in the column header, person type is required for each new row.
125
Tip:
methods:

◦ Edit the date by searching for the person in the Benefits Service Center page and then opening the
Manage Contacts page.
• You can verify disability status and tobacco usage for only participants in the application user interface. To
verify disability status and tobacco usage for dependents, you must:
a. Generate the integrated workbook.

b. Download the person habit information for the relevant dependents.
Uploading Edits
After you complete your edits, click Upload to load into the application database the rows that are marked as Changed.
The process:
new rows that you entered in the workbook
2. End dates the prior data row as of the previous day
4. Deletes permanently all of the related effective-dated records from the application database
Resolving Errors
the process:


Related Topics
126
Overview of Managing Benefit Enrollments in the

Integrated Workbook
The high-level process for managing benefit enrollments using the integrated workbook is:
1. Prepare and upload data to interim table, resolving any identified workbook errors.
2. Upload enrollments batch to database tables, resolving any identified processing errors.
Preparing and Uploading Enrollment Workbook Data to Interim Tables

You can process multiple life events by entering different effective dates in different workbook rows to handle
successive historical changes for an individual. This preserves and uploads legacy historical data.
The Upload Benefit Enrollments batch process uses the effective date when:


The details of this process are covered in the Uploading Enrollment Workbook Data to Interim Tables: Procedure topic.
Uploading Enrollments Batch to Database Tables

After you upload your changes to an interim database, you run the Upload Benefit Enrollments batch process.
The participant enrollment portion of this batch process:
1. Creates a potential life event

2. Processes this life event
3. Creates enrollments
4. Populates rates and coverage amounts
5. Closes life events
The basic process for uploading workbook data to the application tables with the batch process is:

The details of this process are covered in the Uploading Benefit Enrollments Batch to Database Tables: Procedure topic.
127
Related Topics
Benefit Enrollment Integrated Workbook Columns

This topic details the information required when you enter batch records in the integrated Microsoft Excel workbook for
benefit enrollments.
1. After completing the integrated workbook, you upload the rows to an interim batch table.
2. After all workbook rows upload without errors, you run the Upload Benefit Enrollments batch process in the
Evaluation and Reporting work area.
Workbook Column Explanations

Required fields are marked with an asterisk, *, and you must enter a value for them.
Note: Values that you enter in name fields must exactly match the values already in the application. This applies to
names of participants, programs, plans, options, dependents, beneficiaries, and life events.
Column Description
Changed Marked automatically when you edit or add a row in the workbook
The upload process loads only these rows to the interim batch table.
Mark for Deletion Double-click this cell to mark the row for deletion.
When you click Delete Selected Rows, the upload deletes the data from the interim batch tables so
that it’s not available for the batch process.
Status Provided automatically by the upload process for each row after it loads the data into the interim batch
table
For rows with errors, click Upload Error to see the details.
*Enrollment Type Enter this value based on the person for whom you’re entering the data.
Valid values are:
• Participant Enrollment
• Dependent Designation
• Beneficiary Designation
128
Column Description
*Effective Date Used when:

*Person Number PARTICIPANT_PERSON_NUMBER, a unique numeric identifier for the participant for whom to process
the enrollment changes
Additional Person Identifier Reserved for the application, don't use.
Program Name Must be valid as of the effective date.
Plan Name Must be valid as of the effective date.
Plan Disenrolled From Reserved for the application, don't use.
Option Must be valid as of the effective date.
Option Disenrolled From Reserved for the application, don't use.
*Life Event Must be valid as of the effective date.
*Life Event Occurred Date Benefits processing derives the existence of a started life event based on the combination of this date
and the specified life event.
Original Participant Enrollment Date Doesn't affect processing, the upload updates the field for the participant enrollment record.
Create Potential Life Event Yes: The process determines whether the participant has a potential life event for the combination of
the life event name, life event occurred date, and benefit relationship. If there is no valid potential life
event, it creates and processes one.
No: The process doesn't create the potential event or process life events automatically. You must
manually add the life event using the Potential Life Event tab.
*Benefit Relationship Must be valid for the participant as of the effective date
Benefits processing derives a valid started life event for the participant based on this value.
Rate Amount If you enter a rate amount, ensure that there is no value in coverage amount.
129
Column Description
Coverage Amount If you enter a coverage amount, ensure that there is no value in rate amount.
Disenrolled Coverage Amount Reserved for the application, don't use.
Date of Birth Dependent's or beneficiary's date of birth
Beneficiary Organizations and Trusts Enter the name of the existing beneficiary organization or trust. If the beneficiary organization or trust
doesn't exist as of the effective date, the beneficiary designation process fails.
To create the organization or trust, which you can then use in the workbook, use the Beneficiary
Organizations task in the Benefits Service Center page.
Primary Beneficiary Percentage If you enter a percentage amount, ensure that there is no value in beneficiary amount.
Contingent Beneficiary Percentage If you enter a percentage amount, ensure that there is no value in beneficiary amount.
Beneficiary Amount If you enter a beneficiary amount, ensure that there is no value in beneficiary percentage.
Close Life Event Date Date on which you want to close the life event
*Close Life Event Yes: The process attempts to close the life event that it’s processing, which is useful if it’s processing
multiple life events for the same participant, dependent, or beneficiary.
No: The process doesn't close the life event, leaving it in the started state.
Suspended results or pending action items don't allow the life event to close. In such cases, it remains
unchanged and you must close this event before attempting to process the next event.
Batch Line ID Don't modify.
Uniquely identifies the batch line, which is referenced in error messages.
Message Don't modify.
Describes any errors that occurred during the Upload Benefits Enrollments batch process.
Reprocess the batch after correcting the errors.
Row Batch Status Don't modify.
Indicates the Upload Benefits Enrollments batch processing status for the row, such as COMPLETE or
ERROR.
Key Don't modify.
Internal value used for Upload Benefits Enrollments batch processing.
130
Column Description
Related Topics
Upload Enrollment Workbook Data to Interim Tables

Prerequisites
You must verify that the relevant plan and program configuration is set up and working correctly before uploading
enrollment data using the workbook.
Generating the Workbook

To generate the workbook:
1. On the Enrollment Uploads tab of the Evaluation and Reporting work area Overview page, click Prepare
Enrollment Batch in Workbook.
2. In the Batch Name cell, enter a name for the enrollment batch.
3. Enter the batch lines.
Creating a Batch of Enrollment Data

Enter data in the workbook following these guidelines:
• Create and upload batches of fewer than 500 rows.

More than 500 rows negatively affects performance, and you can only download 500 rows at a time to fix
errors.
• Enter plan, program, participant last, participant first, and option names exactly as they are in the application
database.
The names that you enter also must be valid as of the effective date and for the specified life event.
• Enter values in all of the required cells in a row; otherwise, the upload process skips the row.
Required cells are Enrollment Type, Effective Date, Person Number, Participant Last Name, Participant First
Name, Life Event, and Benefit Relationship.
131
If you select Yes in Close Life Event, then Close Life Event Date becomes a required cell.
• Enter one of these valid values for Enrollment Type:
◦ Participant Enrollment
◦ Dependent Designation
◦ Beneficiary Designation
• Enter a valid participant name in every row, even if the enrollment type is for dependent or beneficiary.
• Press Enter or click out of the current cell to ensure that the workbook recognizes your entry as a change.
This includes the Batch Name cell.
To delete records from the application database tables:
1. Double-click the Mark for Deletion cell in each workbook row that you want to delete.
2. Click Delete Selected Rows.
Uploading Edits into the Interim Database Table

After you complete your edits:
1. Click the Batch Name cell.

2. Click another cell.
3. Click Upload.
If the batch:
• Doesn't exist, the upload process creates a batch

• Already exists, the upload process updates the batch lines
It uploads into the interim database table only the rows that are marked as Changed.
The upload process also deletes permanently all of the related effective-dated records from the interim database table
for each workbook row marked for deletion. This makes the deleted records unavailable for enrollment processing.
Resolving Errors
the process:


132
Next Steps
Next, you must upload your workbook data batch to the database tables. The details of this process are covered in the
Uploading Benefit Enrollments Batch to Database Tables: Procedure topic.
Related Topics
• Benefit Enrollment Integrated Workbook Columns
Upload Benefit Enrollments Batch to Database Tables

Use the Upload Benefit Enrollments batch process to update the application database with enrollment data that you
uploaded to interim tables from the integrated Microsoft Excel workbook.
The basic process for updating the database tables using the batch process is:
Prerequisites
You must first upload your enrollment data batch to the interim tables. The details of this process are covered in the
Uploading Enrollment Workbook Data to Interim Tables: Procedure topic.
Running the Upload Benefit Enrollments Batch Process

After uploading the batch lines:
1. In the Evaluation and Reporting work area, select the Processes tab.
2. In the Upload Benefit Enrollments row of the Election Processes section, click Submit.
3. In the Parameters section Batch Name field, select the name that corresponds to the name that you entered in
your workbook.
4. Click Submit.
Note the request number in the Confirmation dialog box when the request completes processing to review log
files for details.
For each participant, the Upload Benefit Enrollments batch process completes:
1. All participant enrollments

2. All dependent designations
3. All beneficiary designations
The process then moves to the next participant.
133
Resolving Enrollment Process Errors

If there are any errors that require review, the process rolls back and continues to the next participant, dependent, or
beneficiary.
If a participant enrollment fails, the batch process skips the associated designations, since they may be dependent on
the participant enrollment completing without issues.
Reviewing the Results and Reprocessing

To view any data issues with the batch lines and the rows that show errors in the Row Batch Status cell, you download
the batch details into the workbook.
1. In the Enrollment Uploads tab of the Evaluation and Reporting work area Overview page, click Prepare
Enrollment Batch in Workbook.
2. Enter the name of the existing batch that you want to review.
3. Click Download.
The workbook downloads all of the batch rows, not just the rows with errors.
4. View messages in the Message cells.
Each message generally has a line ID indicating the row that is causing issues.
5. Fix the issue with each specified row.
6. Upload the batch again for reprocessing.
In the Audit Log field, if you select Yes when uploading the batch data, the upload process adds any error or
information messages for each line to the audit log.
Related Topics
Manage Benefit Enrollment Certifications in the

Integrated Workbook
Use the Upload Enrollment Certifications integrated workbook to upload details of certifications received from
participants, dependents, and beneficiaries en masse.
The basic process to manage certifications in the workbook is:
• Generate the workbook.

• Record certifications.
• Upload data.
• Resolve errors.
134
Generating the Workbook

In the Evaluation and Reporting work area, Person Data Loaders tab, click Go to Task on the Upload Enrollment
Certifications row.
Recording Certifications
The workbook columns and choice lists are the same as the fields and choice lists on the Enrollment Activities page in
the Benefits Service Center page. Enter a row for each certification for each participant. You can enter multiple action
items with several certifications for participants with several dependents or beneficiaries. However, each certification's
details must exist as a single row.
Uploading Data
After you complete the edits, in the Enrollment Certifications Upload tab, click Upload to load into the application table
those rows that are marked as Changed.
Note: You can't edit certifications in the workbook after they upload successfully. However, you can edit certification
details on the Enrollment Activities page.
Resolving Errors
The upload process automatically updates the Status field in each workbook row.
If there are errors that require review, the process:
1. Rolls back the change in the application


FAQs for Integrated Workbooks

How can I prevent time outs when using person-related integrated
workbooks in benefits?
Set the Event field in the benefit balances workbook and the benefit groups workbook to No. If you set the Event field to
Yes, then the application creates life events for every record that the spreadsheet loader uploads.
This could cause time outs especially when you're loading a large set of data. Set the Event filter to No to skip creating
life events, thus reducing the chance of a time out.
135
136
Using Benefits Benefits Setup Maintenance
10 Benefits Setup Maintenance
Maintenance Setup Tasks in Benefits: Overview

The rest of the chapters in this guide outline the tasks in the Plan Configuration work area that you can use to add and
maintain setup information.
Update configurations of benefits objects, including:
• Eligibility
• Life events
• Rates and coverages
• Flex credits
You can also configure display of information in the self service enrollment guided process, and export and import plan
configurations.
137
Using Benefits Benefits Setup Maintenance
138
Using Benefits Court Orders
11 Court Orders
Overview of Benefit Court Order Administration

You can comply with, record, and view US Qualified Medical Child Support Orders (QMCSO). Use the Benefit Court
Orders task in the Benefits Service Center page.
This topic covers the following aspects:

• Enforce dependent enrollment
• Upload scanned documents, such as financial assessments and original court orders
• View court order details during enrollment
Enforce Dependent Enrollment
In the Create or Edit Benefit Court Orders page, select and add dependents identified in the court order. For each
dependent, determine the plan or plan type that they must enroll in. The default configuration prevents participants
opting out their dependents from enrollment during an active court order. Once the participant designates a dependent
in a plan, they can't delete or end date the dependent. When a court sends a release or the dependent ages out, you
must enter an end date to stop the court order enforcement.
Upload Scanned Documents
Use the Document Records section to upload scanned financial assessments and the original court order for reference
purposes.
View Court Order Details During Enrollment
Use the Enrollment Results page to view court order details. You can also check whether or not a dependent is covered.
You can print this page for record keeping.
Participants can view their court order details from the Benefits Confirmation Summary Report page in the self-service
pages. The report provides details of the court order, such as the order identification, the plan types or plans included in
the court order, and dependents.
Related Topics
• How do I trigger person life events on creating, updating, or deleting a court order?
FAQs for Court Orders

How do I trigger person life events on creating, updating, or
deleting a court order?
Use the Manage Life Events task. In the Create Person Change window, you can configure life events to trigger on all
user editable fields available on both the master and dependent level tables.
139
Using Benefits Court Orders
• BEN_CRT_ORDER_F
• BEN_CRT_ORDR_PL_DPNT
How can I stop benefit court order enforcement if dependent

enrollment is no longer required?
In the Edit Benefit Court Order page, Select and Add Dependents section, enter an end date.
How can administrators view a participant's court order?

Go to the Benefits Service Center page of the participant. The court order details appear in the Benefit Court Orders
section in the Enrollment Results page.
How can participants view their court order details?

On the Benefits Confirmation Summary Report page that appears after a participant submits their elections. The report
provides details of the court order, such as the order identification, the plan types or plans included in the court order,
and the covered dependents.
140
Using Benefits Benefit Plan Comparison
12 Benefit Plan Comparison
Overview of Plan Comparison

You can compare the different features of your health, vision, and dental plans to decide on the best plan before you
enroll. For example, to compare the cost of the plans and options, how they work, and the coinsurance.
You can view and launch plan comparison from the self-service landing page or from quick actions. You can compare
up to 3 plans at a time.
Compare Benefits Plans

You can compare different features of your plans to decide on the best plan before you enroll.
Here's how you compare different plans:
1. Click Me - Benefits on the Home page.

2. Select the appropriate tile for plan comparison.
3. Select the plans that you want to compare from the Select Plan to Compare drop-down list.
FAQ for Benefit Plan Comparison

How can I see the estimated cost of the options during plan
comparison?
Click the Information icon that's next to the Estimated Cost value.
141
Using Benefits Benefit Plan Comparison
142

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2 Maintain Benefits Enrollments 3

3 Manage Benefits Processing and Uploads 33

4 Manage Document Uploads 59

6 Prepare for Open Enrollment 71

7 Manage Open Enrollment 91

9 Integrated Workbooks for Loading Data 121

10 Benefits Setup Maintenance 137

11 Court Orders 139

12 Benefit Plan Comparison 141

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Overview of Using Benefits

The Manage Benefits business process contains the following activities:

• Manage Benefit Plans, Programs, and Events

Activity Work Areas

Manage Benefit Plans, Programs, and Plan Configuration

Maintain Benefits Enrollments Enrollment

Evaluation and Reporting

Reports and Analytics

Elect Benefits Me, Benefits

Manage Benefit Plans, Programs, and Events

Maintain Benefits Enrollments

• Person enrollment summary

• Change benefit elections

2 Maintain Benefits Enrollments

Overview of Benefits Service Center

Using the Benefits Service Center page, benefits professionals can:

Enrollments generate action items that help benefits professionals administer:

• Certification requirements, such as proof of student status or proof of good health

Overview of the My Dashboard Page

How You Adjust the Timeline

How You Learn More About Benefits Activities

How You View the Benefits Summary for a Specific Person

How You Configure the My Dashboard Page

Configuration aspect How to configure

Reword the activity Enter a new name in the Meaning field.

Row Limit on Benefits Dashboard Counts

Calculation of Row Limits

Value You Set Value Used for Calculations

50000 or less. The value you set.

More than 50000. 50000

Any non-numeric values. For example, 50000

Values include special characters. For 50000

Apply Row Limit on Benefits Dashboard Counts

Steps to set the maximum row limit

Overview of the Benefits Summary Page

Number Area Details

1 Side Panel This panel contains supporting tasks related

Number Area Details

3 Scorecard You can see the counts of various benefits

Click the count to open a page or navigate to a