Benefits Administration



Benefits Administration


We have configured the required set ups for Benefit management, however the bigger task in hand is to administer the benefits. Usually the Benefits Administration is done by the HR team with a team of dedicated members. The task in hand is to educate them about the system, again providing them expertise to maintain the system. In this section, we will be going through the most widely used set of transactions and learn about various steps involved with them.

 

Basic Forms

Let's go through the important forms and functions that are used in Benefits Administration. The most important and basic form is the "Benefits Service Center". This form holds the basic view only details of the Person's benefit. The details like:

  • Important Person and Assignment Data like, National Identifier, Employee Number, Business Group, Location, Organization, and People form DFF etc.
  • Address
  • Life Event Summary: Details on the Past, Current and Future Life Events with status.
  • Person types of the Person
  • Benefit Summary, indicating the different Compensation Objects and Person's eligibility/ enrolment in those.
  • A Details button to tell more about the Hire Dates, Term Dates/ reasons and Leave of Absences.
  • Two indicators telling about the Potential Life Events / Action items.

So, at a glance of this form, one can have a complete understanding of the person's current status, his enrolments and Life Events in place; however all these data are just “view only”. Let's go to other forms that can be used for updating details. Let's go through the Forms once.

 

Function Name

Commonly used User Function Name

Description

PERWSHRG-412

People Form

This is the link to the People Form. This is where the Personal details are saved.

BENBENAS

Person Benefit Assignment Form

This is the link to the Person Benefits assignment Form. This is where the Benefit Assignment details are saved.

BENPRBAL

Person Benefits Balances

The screen to view the Benefit Balances and their values attached to the person

BENDISPL

Display Participation Info

Shows Person's Eligibility, Electability and Enrolment as per Last Life Event. This is a view Only Screen, and helps in Troubleshooting.

BENDSPLE

Person Life Events

Shows the Potential and Life Events of the Person. Allows you to manage the Life Events related to one Person.

BENMNGLE

Process Life Events

Calls BENMNGLE. It Goes and Processes the latest Potential Life event with Occurred date < session (Date Tracked) date.

BEN_OLLE

Start On Line Life Event Workflow

This shows us the status of the Life Event Processing with the path it followed. It is currently not in use though.

BENEFXEB

Flex Program Enrollment

With this screen we can make enrolments in Flex Program for the Person.

BENENFEB

Non Flex Program Enrollment

With this screen we can make enrolments in Non-Flex Program for the Person.

BENEMSEB

Miscellaneous Plan Enrollment

With this screen we can make enrolments in Miscellaneous Plans for the Person.

BENESPEB

Savings Plan Enrollment

With this screen we can make enrolments in Saving Plans for the Person.

BENEDSGB

Dependent/Beneficiary Designation

This form helps us to designate Beneficiaries and Dependents in the Enrolled Plans. 

BENDSPER

Person Enrollment Results

This screen helps us to check the Current enrolment of the Participant, along with Rates, Coverage dates, Benefit Amounts etc.

BENEPRCM

Person Communications

This screen allows us to see the list of communications triggered/ sent on the Person.

BENEEAIB

Person Enrollment Action Items

This screen opens up the list of Pending Action Items for the Person.

BENPECRT

Person Enrollment Certifications

This screen opens up the list of Certifications for the Person.

BENWATIF

Whatif Eligibility Analysis

This helps in analyzing the Eligibility and Electability with a pseudo life event. Usually used to answer questions of Participants saying, what if any data changes, what impacts will it have on the eligibility.

BENEPCPD

Primary Care Provider

This screen can be used to enter the PCP details of a person.

BENSCMOD

Process Open Enrollment

This one kicks off the Open Life Event for the Person.

BENPRTIN

Person Participation Info

This is the screen to see all the Enrolment Opportunity details of the Person, like Eligibility, Electability, rates etc along with an option to Override Eligibility.

BENEOPEH

Override Plan Enrollment

This screen is to override the enrolments and rates.

BENCQBNF

COBRA Qualified Beneficiaries

With this screen we can enter and maintain the COBRA QB records of a Person.

BENCNTPT

Record Continuing Benefits Payments

This form allows us to track the Non-Payroll Payments. The Payments that are usually done by Check/Cheques. COBRA Benefit Payments are the best examples.

BENCRTOR

Court Order Form

This screen is to track the Court Orders attached to the Person.

BENRMBRQ

Reimbursement Requests

This screen manages the Reimbursements related to the Person.

 

All these screens might not be useful for our benefit administrators; however a lot of them will. So Oracle gives us a handle, through which we can keep the important forms handy. In "Benefits Service Centre", we can add links to these screens and then use the Service Centre as a one stop solution screen. We can access these screens from the Desktop Activities button on the Benefit Service centre. To do so, we can navigate to Online Activity Screen and add the required forms there. See Figure 6.48 – Service centre.

Responsibility: HRMS Manager

Navigation: Total Compensation -> General Definitions -> Authentication Activities.


(Figure 6.48 – Service centre)

Steps: We can add in the sequences and then add the Function Names from the List of Values. The User Function Name is free text. The Best practice is to add a number suffix to the User Function Name. That helps us use the number as a hot key for that function. 

Now, let's go to details, we will go and discuss the various processes one by one.

 

Triggering a Life Event

We are aware of the fact that, a Life event is triggered either through a Data Change or a Derived Factor. Here Data can be of any type, Personal, Employment, and Enrolment. So let's imagine a Person has a data change, for example, Address Change; what exactly happens after that is the discussion point here.

  • As soon as the data changes, the system looks for any Person changes/ Related Person Changes that are attached to the address fields, If a Person changes in found, it is evaluated.
  • If the Person change/ Related Person Change returns a Yes; system tries to find the attached Life Event and adds it to the potential Life events of the Person on which the change has occurred, considering the "Occurred Date Determination" Field on Life Event Reasons screen.
  • Now, if we open the Person Life Events screen, we will see the life event inserted on the "Potential Life Event" tab, with an Occurred date added there and a status as Detected. 
  • The notified date tells us the date on which the data change was notified (the actual system date, not the session/ date tracked date).
  • So all these happen automatically without any Manual Intervention. 

Now, as we have the Life Event triggered, let's see how the Processing takes place.

Processing a Life Event

Once the Life Event is triggered, the next task on hand is to process it. Once the system goes live, the Processing of life events becomes automatic, with a Concurrent request called "Participation Process: Life Event". This event can be scheduled to run every night, so that it can pick the detected and Unprocessed Life Events and process them, if the Occurred date is < = the system date.

However, if we want to do it manually, then how would we do it? Here are the steps:

  • The Potential event is present and the Occurred date < = the session/date track date.
  • Now, go and click on Process Life Events form.
  • The system then goes and checks if more than one Life events are triggered as of the same date, if none found, it goes to the next step, however if more than one life events found, the system tries to resolve the conflict by looking at the Override status, if one of them is found superior, it becomes the winner Life events, and all others are voided. If the conflict is not resolved by the override status, the system then looks for logic in the Collapse Life Events screen. If a record found to give a resultant on the triggered Life Events, the winner is decided, and all others are voided. If there is still no resolvability, then the system makes all the competitive Life Events Manual, and needs a user intervention to declare the winner, as the system failed to do so.
  • If the winner life event is decided, then the valuation Rule attached to the same is fired. The Evaluation rule might just change the occurred date or might even insert another Life event in that place, voiding the former one. If there is no Evaluation Rule, the system just continues with the Life Event.
  • The next task it does is looking at the "Causes Related Person Life Event". If there are any records found, the system goes and inserts the related life event to all the dependents of the Person.
  • Then the system looks at the Person's life event history and figures out, if there is any life event that should be backed out because this life event is being run in the date prior to the occurred date of the former. If any such Life events are found, they are backed out.
  • Finally, it should open up a summary page telling about the resultants of all the actions just happened right now. It will tell us the winner event name, the related Person and the triggered life events and also the backed out Life events.
  • The system will expect a nod from us; to do the same we can just press "Commit and Proceed".
  • Then the BENMNGLE does its job of evaluating eligibility, Electability, defaults, Coverage, rates, Premium and Required Certifications.
  • If there is enrolment Opportunities and a valid window present, then the Life Event goes to Started state, else the Life event is termed as Processed.
  • It then looks for communication Types to see, if there is any Communication to be sent.
  • Finally a summary page opens with the Enrolment window dates, automatic Benefits listings and details of Dropped / Modified Comp Objects if any. Another tab holds all the triggered communication types.
  • We might need to process some communication extracts in order to send the Pre-Enrolment Literatures out to the participants.

Saving Elections

Now, once the Life event is started and the enrolment period is open, we can go and make election for the Participant. In an ideal case, the triggering and processing of life events should happen automatically by data change and concurrent programs respectively. Once the LE is in started state, the Person should get a communication, and he should log in to the SSHR- Benefits application to make his elections; which we will be discussing in details later in this chapter. However at present we are looking in to the forms application, where a Benefits Administrator can go and make elections on behalf of a Person. Let's go through the steps.

  • Once the LE is in started state.
  • Go to the Benefits Service centre for the Person.
  • To check the Electability, Defaults, Rates, Certifications and enrolment window, we can go to "Person Life Events" Screen, and click on "Enrolment Opportunity" button, highlighting the Life Event in Concern.
  • The Electable choice button then leads us to the Choices and rates in the highlighted Program; and the enrolment period is right at the bottom of the screen. 
  • Now, time to make elections. Make sure the current date falls between the Enrolment windows; if needed, we can date track.
  • Go to Benefits elections screen, and we will be able to see all the Default choices there, Grouped by Plan types, Sorted on sequences.
  • Now, if we click on any one of the rows, a LOV opens with all the electable choices in that Plan type along with the benefit amount, rates (Communicated and Defined), Certification etc.
  • We can make a choice out of the Electable choices and repeat the same for all plan types. Once done, the elections can be saved.
  • Then we can click on the Designee button to validate existing designee and designate new dependents. The Designate Dependents screen shows only eligible dependent in the list, based on designation level, most preferable PTIP level.
  • Once the Elections are made, then the Life Event can be closed manually, from the "Person Life Events" Screen.
  • To manage the Life Event Closures manually, we can schedule the "Close Enrolments Process" to close the Life Event windows. The code that determines when to close the enrolment is based on the code we use in the Timing Screen of "Program Enrolment Requirement".

 

Validating Enrolments & Communications

Once the elections are saved, a participant's election can be seen in "Enrolment Results" Screen.  See Figure 6.49 – Enrolment Results. Here the Enrolments are listed in the order of Plan types with details like:


(Figure 6.49 – Enrolment Results)

Plan and Option

Name of the Comp Object

Life Event

Life Event with which the enrolment was made

Enrolment level

The Level of the Comp Object - Plan Option or Plan

Plan Type

Name of the Plan Type

Enrolment Method

Explicit / Automatic / Default

Suspended / Interim

Whether it's a suspended / interim enrolment

No Longer Eligible

Used with Coverage view by past date, to show if any of the enrolled plan (in Past) is not eligible anymore.

Override

To show if there are any overrides present with the enrolment record.

Coverage

Lists the current Coverage dates, along with the dates beginning which the Participant is enrolled in the Plan without getting de-enrolled.

Benefit

Displays the Benefit Amount / Coverage Amount; along with the Benefit Type.

Action Items

This button takes us to the list of action items and Certifications (if any).

Care Providers

Shows the list of PCPs attached to the enrolment

Designee

Shows the designated Dependents listed under the highlighted plan.

Excess Credits

This button shows the credit listings of the selected Plan.

Rates

This is the screen to see all the Rates related details of the Plan.

 

Now, let's go see the communications triggered on the Person. To do so, we will have to go to "Person Communications" screen on the Benefits service centre. See Figure 6.50 – Person Communications. Here the Communication types are listed with the following details:


(Figure 6.50 – Person Communications)

Type

Name of the Communication Type

Sequence

The instance of the Communication to the person, like, 1st, 2nd etc.

Inspect

Displays the Communication needs Inspection

Requested

This check box, if checked tells that the communication is requested.

To be sent date

Tells the date on which this should be sent.

Sent Date

Tells the date on which the communication was actually sent.

Can be requested until

The date until which the communication can be sent

Life Event Reason

The LE with which the communication was sent

Status

The status of the LE

Re Send Reason

A Reason that has to be entered in case we want the communication to be sent again.

Re Send Instruction

Any instructions to be put while resending.

Address

The Address on which the communication is being sent.

Resend

The button to resend the communication. Used in cases where the initial communication is not received / an updated one is needed. This is where is the sequence is updated to the next number.

Triggers

The trigger with which the Communication was triggered.

Usages

The usage row with which the communication was triggered.

 

Using SSHR for Benefits

SSHR or Self Service Human Resource is an interface for the Participants to manage their HR related data online. SSHR can be used to perform a lot of tasks, for products ranging from Payroll to Time and Labor. We will talk about the Benefits system now. 

The Personal and Employment related data can be viewed and updated by the Person by SSHR, so if anything is changing here, or by the HR department, the triggering of life event is taken care of. Again the Benefits link enables the Participants to add/ remove Contacts online.

Responsibility: Employee Self-Service

Navigation: Benefits

  • Once we click on the Benefits link, the "Dependents and Beneficiary" page opens.
  • The Add/Remove of Contacts can be done here.
  • Once Next is hit, the Participant sees the existing Benefits, and if the date falls between any Enrolment window, the Participant gets a chance to update his/her benefits.

The SSHR is an easy to use, user friendly interface provided to the Employees, Ex-Employees and contacts to add and maintain their personal and professional details, and Benefits as an application is part of it.