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Base Benefits & Benefits Administration

Amol Thatte

Agenda

Introduction Setups

• Base Benefits • Benefits Administration

Enrollment Processes• Open Enrollment • Event Maintenance • On Demand Event Maintenance

Vacation Accrual FMLA Administration FSA COBRA Administration

PeopleSoft Benefits

• Peoplesoft’s provides different ways to organizations to offer complete end-to-end benefit solution for their employees.

SuppliersSuppliers

BaseBenefits

BaseBenefits

BenefitsAdmin

BenefitsAdmin

eBenefitseBenefitsSelf Service

Enrollment Tracking

Provider Lookups, Plan InfoCarrier Reporting

Automated Enrollment

Integration

Base Benefits

NA

PAYROLL

BEN

ADMIN

Deduction Codes

Pay Calendar

Retro Benefit Deduction

Eligibility Rules

Event Rules

Employee Elections

Leave AccrualsBenefit Program

Base Benefits Overview

Base Benefits provides the foundation for managing your employee benefit plans:

Create unlimited plans for every type of benefits (health, life, AD&D, savings, leave, pension, retirement, FSA, Vacation Buy/Sell)

Enter various rate types (flat amounts, age or service-based, etc.)

Track information on benefit providers Enroll employees and dependents in benefit plans Identify and track coverage for dependents and

beneficiaries Track and automatically update leave balances Combine benefit plans into programs for eligibility

purposes Identify highly compensated employees and perform

nondiscrimination testing

Base Benefits Overview

• Base Benefits consists setup as well as employee data: Setup Data

• Program Details• Plan Details• Premium Costs• Calculation Rules

Employee Data• Benefit Elections• Dependent/ Beneficiaries data

Process Overview

Set up Benefit Plansand Supporting

Tables

Include Benefit Plansin Benefit Programs

Assign Employees toBenefit Programs

Calculate Rates andBenefit Deductions

Identify benefit plansIdentify plan providers

Define Available CoveragesEstablish Rate Tables

Establish Calculations RulesDefine Payroll Deductions

Include benefit plans in oneor more benefit programs

Enroll employees in benefit plansSpecify employee coverage

electionsDesignate dependents or

beneficiaries

Calculate Deductions usingPeopleSoft Payroll

ORUse a stand-alone deductioncalculation for other payroll

systems

Setup Data

Emp. Data

Payroll

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Setup Data

Base Benefit Setup

Basic Setups

Provider/ Vendor

Benefit Plan

Plan Specific Table

Calculation Rules

Rates of the Plan

Deduction Code

Plan Type

Limit Table

Provider/ Vendor Table

• Provider/ Vendors are set up in the Financial System

• These Vendors are referenced in the Base Benefits module

• The Vendor Table in Finance is kept in sync with the Vendor Table in HRMS system

Provider/Vendor Table

Benefit Plan Table

• Benefit Plan Table is used to identify: Plan Type

• Plan type are numeric codes which is used to control processing

Provider• Picks up the Vendor set up in the

System Default Deduction Code

• The deduction code attached in the Benefit Plan Table gets defaulted in the Benefit Program Table

Benefit Plan Table

Plan Specific Details

• Health Plans Medical Plan Dental Plan Vision Plan

• Life and AD/D Benefit Plans• Disability Plans• Savings Plans

403 (b) 457

• Leave Plans Sick Leave Plan Vacation Plan Optional Holiday Plan

• FMLA Plans• FSA Plans

Dependent Care – HUMC Dependent Care – Non HUMC

• Pension Plans Qualified Non-Qualified

Health Plan Table

Savings Plan Table

Rate Table

• Flat Rate Table This table is used to define flat amounts for the Benefit

Plan• Salary Rate Table

The Salary Rate Table defines rates based on a percentage of the employee's salary

• Age Graded Rate Table The Age-Graded Rate Table enables you to define rates

based on the age, sex, and smoker/nonsmoker status of an employee

• Service Rate Table Use the Service Rate Table to define rates based on length

of service • Calculation Rules Table

Calculation Rules allow you to define special rules that the organization wants to establish for certain Benefit Plans

Benefit Program Table

• Benefit Program Table brings together the following details that relates to the Benefit Plan such as: Deduction Codes Coverage Codes Eligibility Rules Event Rules Rates Calculation rules

• Default Benefit Programs are assigned to the employees on the Benefit Program Participation Page of Job Data

Benefit Program Table

Benefit Program Table

Benefit Program Table

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Employee Data

Assigning Benefit Program

• Only one benefit program is allowed per employee.

• The benefit program needs to be verified manually as employee will be eligible only for the plans associated with their benefit program.

Assigning Dependents/Beneficiaries

• Dependents can be of three types Dependents Benefiticiaries Both

• Dependents can be enrolled in all plans• Beneficiaries can not be enrolled in Medical plans• Number of maximum dependents allowed is defined at

Benefit Program level.

Dependent/Beneficiary

Assigning benefit plans

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Benefits Administration

Ben Admin Overview

Benefits Administration allows you to:

• Automate Benefits Administration Business Processes (Event Maintenance, Open Enrollment, FSA Administration)

• Calculate benefit costs and coverage amounts independent of PeopleSoft Enterprise Payroll for North America.

• Establish the foundation for implementing self-service enrollment using PeopleSoft Enterprise eBenefits.

• Define flexible spending account (FSA) information for employees.

• Process healthcare and dependent care FSA claims.• Track and view claim and payment data.

Ben Admin Overview

• Benefits Administration consists setup as well as Processing of benefits data: Setup Data

• Program Details• Eligibility Rules• Event Rules• OE Setup

Processing of Benefits Data• Event Maintenance• Open Enrollment

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Benefits Administration Setup

Eligibility Rules

Location Officer Code Pay Group Regular/

Temporary Regulatory Region Salary Grade Service Months Standard Hours State Union Code

Age Benefit Status Eligibility Config Field

1-9 EmplId Override Employee Class Employee Type FLSA Status FTE Full/Part Time Elig fields 1 - 9

•Based on eligibility, benefit program gets assigned during event maintenance and Open Enrollment. •The following criteria are provided by PeopleSoft:

Eligibility Rules

Event Classes

• Event classes group the types of events the Benefits Administration system recognizes for event processing

• Event Class Table is used to define the types or classes of events you want the Benefits Administration system to recognize

• PeopleSoft provides a following list of Event Classes: Family Status Change Hire Miscellaneous Open Enrollment Snapshot Termination

Event Class

Event Rules

• Event Rules work at the Plan Type level and tell the system The eligible options Employee X can actually

choose, based on the type of event that has occurred

The plan types it affects When new coverage will begin

• Each event rule you define typically includes a different set of processing rules for each defined event class

Open Enrollment

• Open Enrollment is for Annual and mid-year benefits enrollment.

• During Open Enrollment, employee can choose the benefits based on the eligibility.

• Employee can also continue with the elections he/she has made last year.

Preparation of Open Enrollment

• Double Check the Base Benefit and Benefit Administration Set Up in order to avoid errors at a later stage

• Set up Pay Calendars • Identify Group Ids • Define Open Enrollment Id• Define Schedules

Pay Calendars

• Setting up Pay Calendars Pay Calendars is a mandatory set up in North

American Payroll The Pay Calendars are required to be set up

for all the Pay Groups Used to calculate coverage and deduction

begin and end dates for the employees

• The Group Ids are defined to decentralize the benefits population leading to more control over managing the employees

• The Group Ids are attached to the employees on the Job Data – Benefit Program Participation Page

• Assign the Group Id to the Benefit Administration processing schedule

Benefit Administration Group Id

Benefit Administration Group Id

• Open Enrollment Id The Open Enrollment Id is associated with the

Processing Schedule Defines the benefit programs to be processed

and Enrollment Begin Dt and Enrollment End Dt.

Open Enrollment Id

Open Enrollment Id

Schedule Table

• Benefit Administration Processes are grouped and identified by the schedules

• At least one schedule for Open Enrollment and one for Event Maintenance has to be defined

• Identify the following on the Schedule Table: Company BAS Group Id

• Associate the Open Enrollment Id with the Schedule

Schedule Table

Open Enrollment Process

• The Open Enrollment Process has been divided into different stages

• The complete OE process takes about 8-10 weeks depend on the number of bas group ids and OE ids

• The OE Process keeps track of each participant by tracking the stage and status within each stage

• There are typically four stages: Assigned Prepared Elect Enrolled

Determine Eligibility and Calculations

Produce Enrollment Forms

to Employees

Enter Elections

Validate ElectionsAnd Load Employee

Benefits

Generate Confirmation Forms

Assign Benefit Programs, Prepare Plan Options, Costs and Credits

Notify Employees

The employee returns the completed enrollment form and their selections are entered into the system

Ben Admin validates the election against appropriate tables and eligibility rules. On validation the elections are loaded in the PeopleSoft Tables

Confirmation Statements are generated for the employees

Open Enrollment

Assigned

Prepared

Elect Enroll

RUN Control

• The Schedule and Checkpoint Restart page It is used to identify the Open Enrollment, Event Maintenance

for which you're planning to run the Benefits Administration process

• The Participants Lists page It is used if you want to add a specific set of employees to the

schedule you're processing • The OE/Snapshot page

It is used to enter reprocessing information for Open Enrollment or Snapshot schedules

Also this page is used to tell the system to schedule new participants for a specific Open Enrollment, or to finalize and/or apply defaults for participants in the schedule who have been processed with errors

• The Passive Event Processing page It is used to identify the passive events that have occurred

between a defined period of time and create an entry of that event in the BAS_ACTIVITY table

Schedule Summary

• Schedule Summary After a run of the Benefits Administration

process, the Schedule Summary page is referred to

• Review employee counts for all the available status values

• To get a big picture of where the schedule population is at in processing terms

Event Summary

• Processing Controls Update Page This page is used to review the status of the

events The events can be searched either on the

Schedule Id or on both Schedule Id and Employee Id

• Event Status Update The Event Status Update page is used to

reprocess individual participant events by updating the event status

BAS Activity Table

• Used to: Review the unprocessed activities that are

currently triggered for the employees Insert manual events for Event Maintenance

processing Delete unprocessed activities

Event Maintenance

• Event Maintenance is similar to Open Enrollment Process, the only difference is: Nature of the events

• Job related events • Hire• Promotion

• Non Job related events • Address Change • Marital Status

• Passive events • Age Limit

Event Maintenance

The way the events are triggered • Through Employee Data Changes • Manually inserting Events into BAS

Activity Table

On Demand Event Maintenance

• On-Demand Event Maintenance allows any end-user to process an employee individually and produce the appropriate statements immediately

• A single screen is provided to carry out all the tasks for enrollment viz. Prepare Options Generating Enrollment Statement Election Entry Validating and Finalizing Elections Generating Confirmation Statements

Employee Benefits Summary

• The Employee Benefits Summary can be viewed using the following page: Benefits Summary (Pay Dedns) Page

• It displays deduction information on all benefit plans that an employee is enrolled in.

Reprocessing

• Reprocessing becomes necessary in situations: Event is processed out of order Errors in the election entry

• The events can be reprocessed to any of the stages of the Benefits Administration cycle preceding the stage that the event is currently in

• The individual events as well as the entire schedule can be reprocessed by updating the event status on the Event Status Update Page or the Run Control Page

Vacation Accrual

• Leave Accrual Process Purpose of the Leave Accrual Process is to

maintain employee leave balances The number of hours to be accrued is

specified on the Leave Plan Table The process is run a minimum of once per

award frequency defined on the Leave Plan Table

• Leave Balances The Leave Balances can be seen on the Leave

Accrual Balances Page

FSA

• Flexible spending accounts (FSAs) are before-tax employee savings plans that can be used for certain approved expenses, such as health care or dependent care.

• The following are pre-defined plans 60 – FSA Health Care for US 61 - FSA Dependent Care for US 65 – FSA Health Care for Canada 66 – FSA Dependent Care for Canada

FSA

• Employee will specify the annual contribution for each plan during open enrollment.

• Payroll will deduct the amount in each payroll based on annual contribution specified by employee and number of pay cycles

• Employee then submit the bills for health care/dependent care and amount will be reimbursed by issuing separate check.

• At the end of the year, the unclaimed amount will be lost.

FMLA Administration

• Request Page is used to request for FMLA Leave. It consists of the following information: Begin Date Return Date Leave Reason Leave Type

• A workflow is triggered to notify the Benefits Administrator for every new FMLA Leave request

FMLA Administration

• The Eligibility Page is used to determine eligibility and entitlement for the Employees It displays the number of hours the employee

is eligible for along with the number of service weeks the employee has worked for

FMLA Administration

• History page is used to schedule and track FMLA leave for your employees.

• It provides with two scheduling options: If the employee will be taking leave on an

irregular and intermittent basis, you can manually enter the hours of leave they'll be taking for each day and week of their scheduled leave

If, on the other hand, the employee will be taking leave on a regular weekly schedule, you can use the Schedule Leave button to schedule leave on a weekly basis

FMLA Administration

• Mark Paid Leave Page This page enables you to designate a specific

number of days at the start of the FMLA protected leave period as covered by the employee's own paid leave

This option can be used if the organization's policies require that paid leave be substituted and exhausted before FMLA protected leave begins

FMLA Administration

• Activity Page assists you in the task of tracking FMLA leave plan activity This page is used to log significant events that

affect the FMLA plan such as• Employee inquiries • Requests for extensions • Sending and receiving of notices and

medical documents

COBRA Administration

• For COBRA Administration to be enabled, check the COBRA Administration box on the Installation Table

• Identify the Plan Types that are applicable for COBRA coverage on the Benefit Program Table

• Define COBRA Events • Attach COBRA Action to the Action Reason Codes

COBRA Event Rules

• On the COBRA Event Rules following things are identified: COBRA Period Begin Date Months of Coverage Additional Coverage in terms of disability Maximum Days to notify of the event COBRA Qualified dependents

COBRA Administration

• There are two types of COBRA Events Initial Event

• A COBRA event is an initial event if no other active COBRA events occurred previously to the person affected by the event in question

Secondary Event • An event must meet the following requirements for

it to qualify as a secondary COBRA event:• The employee and/or dependent must currently

be enrolled in COBRA coverage as a result of an initial COBRA event

• The initial COBRA event must be one of the COBRA event classifications associated with a change to an employee's job status

• The secondary event must be one of the COBRA event classifications that involves loss of coverage for the employee's dependent

COBRA Administration

• Each time an event is triggered it gets added to the COBRA Activity Table

COBRA Administration

• Once the event is triggered COBRA Process is run using the COBRA Process Run Control Page

• Identify COBRA Beneficiaries • Generate notification letters to the Beneficiaries

using the COBRA Initial Qualify Letter Page

Thank You