Latest revision as of 16:50, 19 December 2024

Benefit Plans Screen

The Benefit Plans screen allows you to set up all of the plans for the case.

You configure the following categories of settings for each case:

• General Information
• Payer products in the plan
• Rates
• Life events that trigger re-enrollment
• HTML screens that define the employee presentation
• Plan-specific application forms

To add a plan:

• Click the New button.

To delete a plan:

• Choose the plan from the list at the left and click the Delete button.

To change a plan:

1. Select it from the list at the left.
2. Choose which aspect of the plan you wish to change by clicking the appropriate tab and setting options.
3. Click Save after you are done with your changes.

General Tab - Benefit Plans

The General tab allows you to name the plan, specify the plan type and order, and set other general attributes of the plan.

To set up the general attributes for a plan:

1. Enter a plan name.
2. Enter the XML tag name. This should be a unique tag with no spaces that can be used in scripting and text banks
3. Select the Plan Type from the drop-down list.
4. Indicate the order number for the plan in the enrollment presented to the enroller or employee.
5. Set up these options as necessary: Core benefit, Keep underwriting answers private, and COBRA enabled.
6. Click Save when you have set up the options on the General tab.
7. Repeat steps 1 – 6 for each plan that you want to set up for the case.

General Tab (Benefit Plans) - Elements

The following table lists the element name and provides a description.

Plan Name 

Identify the name of the plan, such as Health or Dental.

XML Tag Name 

Required field; identifies the plan name and is used in the Text bank.

Type 

Identify which plan type this plan setup uses. If you have Decision Support turned on at the case level, you must select Health for your Medical plan to use Decision Support. This field is now required; it sets the "base" application instructions for the benefit plan.

Specifying a Plan Type also affects local application instructions, which can be created and edited on the Engage tab.

Engine 

Select the "engine" used for configuring the benefit plan's rates.

Rate selection display 

Select Side by Side to display each product's rates within a box, side by side to each product. Select Tabular to display rates for each product in a horizontal row on top of each other.

Order Number 

Indicate the presentation order of this plan. Numbering starts at 1, however, for ease of re-ordering set up to order by 10s.

Core Benefit 

Select this option if the plan is part of the core benefit package offered to the employee. Reporting uses this to identify which plans are part of the "core" benefits for an employee. The Voluntary Sales report is designed to report on only those benefit plans that are not marked as "core".

Keep underwriting answers private 

Select this option when you want to hide answers on application forms from administrative users who are not entitled to view Protected Health Information (PHI). When this option is selected, users will not be able to see or print the forms, since the forms could contain PHI.

COBRA enabled 

Select this option to identify the plan as one that COBRA-eligible employees can enroll in. This works with the COBRA pay group and COBRA job class that you (should) have set up for your case. The way that you administer COBRA plans is up to you; BenSelect will provide files to the carriers with the COBRA information, but you have to set up the case and plan with all COBRA information that is needed to identify employees who are coming into COBRA coverage and those going off of COBRA coverage.

Typically, COBRA-enabled plans work with COBRA rate groups and job classes, which are set up for monthly deductions/rates.

Most commonly-used plan engines

The engines listed here are the most commonly used plan types and will provide most, if not all, of the functionality for most cases.

DB1 (Defined Benefit, 1-tier) 

Standard enrollment engine for defined benefit plans having a single primary insured and a benefit amount, such as optional life insurance

DBN (Defined Benefit, N-tier) 

Standard enrollment engine for defined benefit plans having multiple tiers and a benefit amount, such as Critical Illness or Accidental Death and Dismemberment coverage.

NT (N-Tier, no benefit amount) 

Engine supporting enrollment of multi-tier benefit plans that have no benefit amount. This engine type is typically used for enrollment of medical and dental plans. Products are presented side-by-side so user can select desired product and tier.

SB1 (Salary-based benefit, 1-tier) 

Engine supporting enrollment of single-tier plans having a benefit amount based on employee salary. This engine is typically used to enroll group life and group disability products.

Membership plan 

Engine type for plans (such as Group Legal, Parking, etc) where enrollment merely involves option in or out.

FSA (Flexible Spending Account) 

Engine type supporting Flexible Spending Accounts. Engine allows selection (during setup) of rules to be applied for applicants who enter the plan during the year.

BenefitAgent Savings Plan 

Engine supporting enrollment of 401(k), 403(b), and other savings plans. Allows for employer matches.

Dummy 

Generic engine allowing entry of premium, benefit amount, coverage tier, and insured(s). This engine type is sometimes used as a placeholder to allow a benefit to be loaded into the system from the census.

Informational 

Information-only engine, used for displaying presentations during the enrollment; no coverage is created when using this engine type.

Plan types for Voluntary Product Builds

The plan types listed below are used primarily for custom product builds and require rate files.

BenefitAgent CI 

Enrollment engine accommodating pre-packaged voluntary products that have a benefit amount and multiple coverage tiers (such as Critical Illness). Engine allows one policy per primary insured.

BenefitAgent CORE 

Enrollment engine accommodating pre-packaged voluntary products that have no benefit amount and multiple coverage tiers. Products are displayed side-by-side on the application screen so the user can choose the desired product and coverage tiers. Engine allows one policy per primary insured.

BenefitAgent UL 

Enrollment engine accommodating pre-packaged voluntary products that have a benefit amount and one primary insured. This engine accommodates multiple policies per employee and family/child coverage riders.

Bridges

The plan types listed below provide "bridges", or access to other enrollment systems. You will typically need information from the carrier to which you are bridging to complete setup of these plans.

BenefitAgent Bridge (AFEnroll) 

Bridge to American Fidelity's enrollment system.

BenefitAgent Bridge (AllApp) 

Bridge to Allstate's AllApp enrollment system.

BenefitAgent Bridge (Harmony) 

Bridge to Colonial Life's Harmony enrollment system.

BenefitAgent Bridge (ING) 

Bridge to ING's enrollment system.

BenefitAgent Bridge (INGLink) 

Bridge to the INGLink enrollment system.

BenefitAgent Bridge (OneView) 

Bridge to Allstate's enrollment system that will present enrollment through OneView.

BenefitAgent Bridge (SmartApp) 

Bridge to Aflac's SmartApp and SNG enrollment system.

BenefitAgent Bridge (Texas Life) 

Bridge to Texas Life enrollment system.

BenefitAgent Bridge (UNUM) 

Bridge to UNUM's enrollment system.

Custom - Trustmark CI 

Custom engine accomodating enrollment in Trustmark Critical Illness. Bridges to Notepad enrollment system.

Custom - Trustmark UL 

Custom engine accomodating enrollment in Trustmark Critical Illness. Bridges to Notepad enrollment system.

BenefitFocus Bridge 

Bridge to BenefitFocus enrollment system.

Boston Mutual Bridge 

Bridge to Boston Mutual enrollment system.

Obsolete

The below plan types are obsolete custom enrollment engines. They are included in the list for legacy purposes, but should not be used on new builds.

Custom - Assurity STD

Custom - Assurity AE

Custom - GE DI

Custom - GE HI

Custom - GE LSC

Custom - GE TL