Flashcards in Benefits Event Setup - Chapter 4 Deck (66)
Once your benefit plans have been set up in the system what do you need to do?
You now have to identify them as being active for a defined period, as well as create the events and processing rules needed to manage and maintain your employee benefit elections.
What questions should be addressed when considering event set up for benefits?
1. Are new offerings planned?
2. What job changes or life changes will change eligibility?
3. What election changes can be made?
4. When does coverage begin and end for enrollment events?
5. Is coverage automatic?
There are three reasons a benefit plan or an entire coverage type might not open during certain types of events. What are they?
1. Benefit Plan is not included in the current benefit plan year definition and there is a benefit plan year as of the effective date of the event.
2. Coverage type is not included in the benefit event type that is being processed
3. Employee is not eligible for the benefit plan
What is the Plan Year Definition?
The benefit plans year definition is a collection of benefit plans that are active for a given period of time. When changes to the plan offerings occur., it is necessary to edit the existing benefit plan year definitions or create new ones. Ie. If your company offers open enrollment periods, the new plan year would begin with new elections.
When adding a new benefit plan, you will need to add it to the benefit plan year definition for the plan .... complete the sentence
to be included in any type of benefit event.
If a benefit plan is discontinued what should you do?
You remove it from the plan year definition so it is no longer an active plan. This is the first level of eligibility.
Can you have more than one plan year definition during the same period?
Yes, but they cannot share benefit plans. All active plans for the year would be in one plan year definition, while defined contribution plans could be in another with an extending end date (for example 12/31/2050)
How would you make a benefit plan year in Workday?
Use the create benefit plan year definition task.
What is an enrollment event?
The term refers to any event that results in a change of eligibility or entitles the employee to change existing elections.
Name some examples of enrollment events.
1. job changes such as hire or termination
2. Family changes such as marriage or birth of a child
3. Changes in benefit eligibility over time
4. dependent children losing eligibility based on age
5. Gaining eligibility because of time in a company
6. Open enrollment events
Name a few questions that should be asked to determine what enrollment events need to be created.
1. What events occur in an employee's personal life that allow benefit changes?
2. What job related changes will end benefit plan coverage
Name a task used for enrollment events
Maintain Enrollment Event Types setup (ie. Admin correction)
Name the fields in the benefit event types component (9).
1. Enrollment Offering Type
2. Worker Selectable
3. Route to benefit partner
5. Restricted to countries
6. COBRA eligibility reason
7. Reinstatement events
8. Reinstatement period time units
9. Unit of time
Explain the field enrollment offering type.
Here you would enter all the benefit coverage types (medical, dental, etc) that should be included in the enrollment event.
Explain the field worker selectable.
This checkbox enables workers to initiate the benefit event using the change benefits task.
If it is not turned on, the benefit partner, administrator, or other approved role must initiate the event on behalf of the employee. Regardless of the checkbox the benefit partner and administrator can always initiate events for employees.
Explain the Route to Benefits partner field.
Select this checkbox if the employee should not be allowed to enter the election changes for an enrollment event. Example terminations, or passive events such as an over age dependent.
Explain the inactive field.
Select this checkbox if you will no longer use this event type in the future.
Explain the restricted to countries.
Workday allows you to define enrollment events that are valid only in specific countries. The country on the benefit group is what determines the employee's benefit country. If the country is blank on the benefit group and there is a country restriction on the enrollment event type, that event will not be available to the benefit group.
Explain the Cobra Eligibility Reason field
This display field will be populated if the Maintain Cobra Eligibility Reasons has been configured with a COBRA reason that is mapped to a Benefit Event Type.
Explain the Reinstatement Event field
Check this box if this event will reinstate benefits that were terminated in a previous event. This is commonly used when an employee is returning from a leave or rehired. (Can we use for retirees). If you select reinstatement event checkbox, the following two fields will display -
1. Reinstatement period time units - define the period in which the reinstatement of benefits with no ability to edit should apply.
2. Unit of time - Option to select days, months or years
What three fields are used to define the number of days that employee has to enroll in benefits following an enrollment event?
1. Days to Enroll calculation
2. Day to enroll
3. Employee cannot report after days to enroll
If the Benefit Partner has not manually finalized an event can an employee continue entering benefit elections after the system-defined last day of enrollment.
YES. These are reminders to the employee.
Explain coordination of events in Workday.
Workday designed enrollment events to reprocess if events are entered into Workday out of order. This ensures that elections entered in an earlier enrollment will roll over into the next enrollment event, providing continuous coverage. There are instances when you want to control whether reprocessing will occur for certain events.
There are instances when you want to control whether reprocessing will occur for certain events. What checkbox would you select?
Do not reprocess future events.
Give an example of how Do not reprocess future events works.
Event A - July 1st
Event B - June 25th
Event A is done first. When event B is initiated, both events will remain open since event A will not reprocess due to the DO not reprocess checkbox being marked. If event B is created due to a change in benefit eligibility Event A will be 'placed on hold' and will then reprocess, ignoring the 'do not reprocess' settings.
Select the DO NOT Reprocess:
Event A is initiated first. When event B is initiated, both events will remain open since Event A will not reprocess.
What do you do when days to enroll has expired due to another event being processed?
Enter the number of days to extend an enrollment window in the 'days to enroll'
Events and reasons - If you have a modified a business process to include the change benefits for life event business process, use the event field to map the enrollment event to the event category. This means when this staffing event is run, workday will run and eligibility check. Where would you find this in Workday
Go to benefit event (ie. Hire) - scroll to the bottom of the benefit event - You will find the linked process at the bottom. If you have selected the reinstatement - make sure to include the appropriate event or event and reason combination (Hire employee and leave return)
Why would you use the restricted by reason field?
If you want the benefit eligibility check to run only when the business process includes specific reasons, then indicate those reasons here. If you leave the field blank, the benefits eligibility check will run every time the business process occurs.
Name the business processes that can include the Change Benefits For Life Event BP
Change Benefit Jobs
Change organization assignment for worker
Request Leave of Absence
Add Additional Job
End Additional Job
End International Assignment
Start International Assignment
Change Primary Address
Request Compensation Change
Request return from Leave of Absence
Manage Medicare Information
What kind of questions are addressed when setting up the enrollment event rules.
1. When an employee is hired, when does their medical coverage begin?
2. The first time an employee enrolls in insurance how much can they elect?
3. Is there a waiting period before coverage begins for a new employee?
The enrollment event rule is divided into ____ separate tabs and setup requires a thorough knowledge of the rules and regulations that control enrollment into your benefit plan offerings.
What are the section tabs for enrollment events?
1. Start or Waive coverage
2. Loss of coverage
3. Levels of change - currently covered
4. Levels of change - currently waiving
5. Levels of change - newly eligible
6. Coverage Rules
Start or Waive Coverage Tab
When coverage or a waive status begins, as well as when deduction begins, it is controlled on this tab.
Waiting Period Number - Enter the appropriate number. A wait period delays the start or effective date of coverage. This only applies to employees who currently do not have coverage. (Both elect and waive is considered coverage).
Waiting Period Units - Waiting periods can be in days, weeks, months or years. This is used in coordination with the waiting period number field.
Ignore Waiting Periods - If there is a waiting period that is being applied to an employee, you can override it for a specific event type. Otherwise the wait period will always be honored (how does one do this - Partial load).
Start or Waive Coverage Tab (continued) - Coverage Begin Date
Workday provides five common coverage begin options -
First of the month following event date.
First of the month on or after event date (if event falls on the first of the month, the coverage date will be the same as the event date).
On event date
On pay period begin after event date - coverage begins on the first day of the employee's following pay period following the election event
Pay period Begin on or After Event Date
Waiting periods and coverage benefit dates can be used together. The benefit group has a waiting period order configuration option. Name the two options.
1. Apply the waiting period and then the coverage begin
2. Apply the coverage begin and then the waiting period.
See chart page 137 for all options (could be tested on this)
Loss of coverage Tab determines when ...
Coverage or a waive status ends as well as deduction end due to an employee losing eligibility to all plans in the benefit coverage type. This occurs due to termination or a change in employee status that impacts eligibility.
Explain some of the fields in the Loss of Coverage tab -
1. Do not use auto-enroll - if auto enroll is selected on a benefit plan, eligible worker will be enrolled in the plan and the election cannot be removed. If this is an event that might terminate coverage, select this checkbox to allow the election to end.
2. Coverage end date
3. Deduction end date
4. Grace period number
5. Grace periods units
What coverage end dates are available on the loss of coverage tab?
Workday provides five common coverage end options:
1. Last day of the month
2. On Pay Period Begin After Event date
3. On the event date
4. On the half month - coverage will end on the 15th or the last day of the month.
5. Pay period end on or after event date
What deduction end dates are available on the loss of coverage tab?
Workday provides the following options
1. End of month containing event date
2. On coverage end date
3. On event date
4. Pay Period Before Coverage End date
5. Pay Period before event date
6. Pay Period containing coverage end date
7. Pay Period Containing Event date
8. Pay Period Following Coverage End date
9 Pay Period Following the event date
There is no proration. The deduction is either taken or not taken.
What does the grace period number and grace period units do on the loss of coverage tab?
Grace period number - Enter the appropriate number. A grace period extends benefit coverage beyond the coverage end date.
Grace period units - Grace periods can be in days, week, months, or years. This is used in coordination with the Waiting Period number field. (see chart on page 138)
What does the Extend Benefit Coverage task do?
In addition to the grace period, there is a task that enables you to extend benefits for individual employees beyond the last day of coverage for an event and coverage type. To access the extend benefits task, use the change benefits for life events related actions.
Insurance and levels of change - Currently covered, currently waiving and newly eligible. What do these allow and explain the three tabs.
Workday allows you to limit insurance coverage enrollment and coverage level increases during an enrollment event by specifying maximum amounts and levels of change for an enrollment event, as well as guaranteed issue amounts.
There are three tabs that address levels of change because rules can be different depending on if an employee is newly eligible to elect coverage, previously eligible but is currently waived, or currently covered and wants to change their coverage level.
What is a level?
A level is defined based on your insurance plan setup, with the smallest increment equal to level one.
Enrollment rules - Levels of change- Currently covered has multiple fields. These are not required. Name the 9 fields
1. Maximum Levels of change allowed/Maximum level allowed
2. Maximum amount of change allowed/Maximum amount allowed
3. Include all benefit plans in coverage type for EOI
4. Maximum levels of change allowed without EOI/Guaranteed levels without EOI
5. Maximum amount of change allowed without EOI
6 Guaranteed issue amount
7. Guaranteed issue multiplier
8. Set guaranteed issue rule
9. Default coverage if pending EOI
Maximum Levels of Change Allowed
Maximum Level allowed
Specify the maximum number of levels that workers can increase their insurance. If they elect over the guaranteed issue amount, they will need to provide evidence of insurability.
Maximum Amount of Change Allowed
Maximum Amount Allowed
Instead of a level of change, you can specify a maximum amount of change. If they elect over the guaranteed issue amount, they will need to provide EOI.
Include all benefit plans in coverage type for EOI
Instead of applying the EOI rule to an individual plan, you can include all plans within the coverage type.
Maximum Levels of change allowed without EOI
Guaranteed Levels without EOI
Specify the maximum number of levels that employees can increase their coverage without requiring EOI. This is referred to as the guaranteed issue amount.
Maximum Amount of Change allowed without EOI
Instead of a level of change, you can specify a maximum amount of change. This is referred to as the guaranteed issue amount.
Guaranteed Issue Amount
Unlike the max levels or amount of change fields this field does not consider your current level coverage. It sets an amount that does not change.
Guaranteed Issue Multiplier
Use a multiplier to establish a guaranteed issue amount for an employee's enrollment. This calculated amount does not consider your current coverage level. Salary is defined by the Salary Source field on the insurance coverage.
Set Guaranteed Issue Rule
This defines how the guaranteed issue amount or multiplier is applied when the value does not match the defined coverage levels. You can select
1. Closest Level Over
2. Closest Level Under
3. Guaranteed Amount
Default Coverage if Pending EOI
There are three options as to what coverage the employee will receive while an EOI request is pending. 1. current coverage amount
2. Elected coverage amount
3. Guaranteed issue amount
What happens if you indicate a coverage level, coverage amount or salary multiplier without requiring EOI?
With this configuration, the system applies the most restrictive of the limits.
Coverage RULES tab - What does it do?
(Text looks at currently enrolled coverage)
It allows the ability to control what election changes can be made by the employee. None are required.
Coverage Rules - Benefit Plan Changes allowed
What types of changes can occur for a specified event type? The numbers represent the priority of the rule when two events occur on the same day, resulting in a hybrid event:
Can select any plan: Employees can select any plan within the coverage type, including waive. Can also elect plans which the employee is currently waived.
Current Plan Only: Employee cannot change providers for coverage type or waive, but can increase or decrease coverage and possibly change dependents.
Current Plan or Option to decrease: Use for spending accounts. Can only decrease spending account contributions or waive.
Current Plan or Option to increase: Use for spending accounts. Can only increase spending account contributions or waive.
Current Plan or Option to waive: Employee can stay in the plan, waive, increase or decrease coverage.
No changes allowed: No changes to benefit plans allowed, but the current elects can be viewed on the enrollment page.
Only Beneficiary Changes Allowed: No changes to the plan coverage are allowed but employee can add or remove beneficiaries or change percentage allocations.
Only on Eligibility Change - Employee can change elections for coverage types in which they have gained or lost eligibility.
Coverage Rule - Health Care Coverage Target Changes Allowed
This controls the employee's ability to make changes to covered dependents. It is not a required field. The numbers represent the priority of the rule when two events occur on the same day, resulting in a hybrid event.
- Additional dependent allowed
- Continue with Current Dependents
- May remove dependents
Coverage Rule - Health Care Coverage Targets
If the value of coverage target changes allowed is Additional Dependents allowed or may remove dependents, this becomes a required field and you must specify the type of dependent to add or remove.
These rules are automatically applied when the Benefit Partner or Administrator finalizes a benefit event due to the employee not submitting their elections. The numbers represent the priority of the rule when two events occur on the same day, resulting in a hybrid event.
- Default to current elections, priority coverage or waive
- Default to current elections or waive
- Default to current provider/classification or waive (used when configuring a Medicare plan change event).
- Default to priority coverage or waive (Does not roll forward current elections)
- Default to Waive (Does not roll forward current elections)
- Reinstate previous elections, priority coverage or waive
- Reinstate previous elections or waive
How do Benefit Defaults components work?
The benefit component works as an extension of the enrollment event rule. Once you determine if an event type will use defaulting, you need to specify what that default should be. Each healthcare, insurance plan, additional benefit and retirement savings plan can have defaults with a default priority.
The default priority allows you to identify a plan and a coverage target as the default, as well as choose additional plan or plans for employees who are not eligible for the first priority default. 'Maintain benefit defaults'
On the retirement savings tab, there is a unique option available for defaulting. By entering a percent or amount as an employee contribution, it defaults this value into the election page. if the employee chooses an amount over or under the employee contribution default, the system will use that amount.
The effective date of a benefit plan year controls when a benefit plan will be available for enrollment. True or False
False - It is the plan year definition
The benefit plan year definition is a:
a. List of all plan
b. List of all plans that will be active for a period of time, defined by a start and end date
c. List of all active and discontinued plans
d. List of plans that you think are special
What are three controls included on a Benefit Event Type
Worker selectable , route to benefits partner, and days to enroll
For a change benefit election task to route to the benefit partner, simply select the route to benefit partner checkbox. True or False
The guaranteed issue amount is defined on the enrollment event rule. True or false