PeopleSoft Benefits Administration Process:

PeopleSoft Benefits Administration Process:

Let’s talk about Ben Admin Process at high-level. We know that that are different phases to process Ben Admin.

The PeopleSoft Benefits Administration application is used to manage employee benefits. The process is designed to automate all aspects of benefit processing. It is a four phase process that determines population, determines benefit program eligibility, prepares enrollment options, and validates and loads elections. The information entered and processed in Benefits Administration automatically updates the Base Benefits tables.





FOUR PHASES OF THE BENEFITS ADMINISTRATION PROCESS:

1. Determine Population:

The system determines processing based on the population selected. Benefits Administration can be programmed to look at a particular company, benefits program, or a particular group of individuals. You can use BAS GROUP ID, which determines the participants for an Event Maintenance or Open Enrollment schedule. In the Open Enrollment process, you must define and associate an Open Enrollment Definition ID with the schedule.

2. Scheduling and Program Assignment
The system evaluates information in HRMS against the eligibility rules to determine which benefit program an employee is eligible to participate.

During the process, the application assigns events to a BAS processing schedule. And the scheduled events are then assigned to benefit programs.

3. Prepare Options
After determining the proper Benefit Program, the Ben Admin process opens up the plan options available to the employee based on the benefit program and eligibility rules for data entry. It will generate an enrollment form for an employee with only the plan options in which an employee is eligible to participate. When a participant’s enrollment statement in printed, the process status is updated from PR to Notified (NT)

4. Validate and Load Elections
The system validates the changes and loads updated election information. It evaluates and loads election entries based on event rules into the Base benefit tables. If the process runs successfully, its status changes to Finalized/Enrolled (FE). It will generate a confirmation statement which are printed and mailed to participant assigned with FE status.

You would do a third run, for which the BAS process finalizes investment elections for participants who submitted incomplete or incorrect enrollment statements. In case of any errors, the Election Error (EE) process status is displayed. Errors may occur due to an incomplete rule setup, inconsistent HR data, or an invalid election entry by the employee. Events are assigned a process status for each run, which enables you to determine the status and correct the errors. Run the BAS process again after reviewing and correcting any errors.

Benefits Terminology

We must understand the basic terminology used in Base Benefits or Ben Admin Setups/Processes before going further in detail. You will come across different terms like Plan Type, Benefit Program, and Benefit Plan etc.

Benefits Terminology:

Benefit Program:

A collection of benefit plans i.e. it contains a set of benefit plans.
Benefit programs are used to group the set of benefit offerings provided to a specific group of employees. For example, you might have one benefit program for hourly employees, another for salaried employees, and a third for executives.


Plan Type:

The first component of the benefit plan is the plan type. They group individual plans or options that may be elected by an employee for a particular type of benefit, such as basic life insurance or medical. Plan types are groupings that allow PeopleSoft to process benefit requests systematically. You use plan types to describe a category of benefits such as health plans, dental plans, savings plans, disability plans and vacation plans;

Plan types are two-character codes that are defined in Translate Table (PSXLATITEM) and PeopleSoft offers a set of predefined benefit plan types. You can change or add new plan types, but do not delete the delivered plan types.

PeopleSoft adds plan types starting from the beginning of the alphabet; you should start with Z and work backward to A.


Benefit Plan

Benefit plans are the benefits you want to offer to your employees. A benefit plan is a code that represents like medical plan, HMO plan, dental plan, life insurance plan, etc. A benefit plan option is a specific benefit option within a plan type.

Benefit plans are associated with benefit programs and can be linked to any number of benefit programs. Each benefit plan has associated costs, calculation rules, and coverage codes. After choosing a plan, employees make additional decisions to determine their coverage. During benefit enrollment, you enter the options that employees select into PeopleSoft.

If your company offers 25 possible PPO or HMO plans, each may require a separate benefit plan code to identify it. Look at the below table:

Event Maintenance:

Before we understand what event maintenance is, we want to know how PeopleSoft defines an event:

A change in employee data within PeopleSoft that may affect an employee’s status. I.e. Events are the changes performed to an employee’s job record that can affect employee benefit options


Three types of events affect Benefits Administration: job events, non-job events, and passive events.

Job events are effective-dated events related to changes in an employee’s job, such as regular/temporary, full/part time status, pay group, employee type, standard hours, hourly rate, and annual rate.

Non-job events are changes in an employee’s personal or demographic information that might affect eligibility or elections. These include a change in marital status, state or postal code, dependent or beneficiary, and union code.

Passive events are based on an employee’s ate of birth or service date. These can be set up to automatically trigger events for Event Maintenance.

Now coming to event maintenance, In order to process changes i.e. different events during the plan year, you need to schedule Event Maintenance at intervals based on your operational requirements.

For example, you might perform Event Maintenance every day, twice a week, or three times a month-whatever you think is necessary. You base your schedule on how frequently you want to process new hires, enrollment changes, and updates of payroll benefit deductions.

Event Maintenance identifies eligible enrollments and defaults for new hires and participants with changes (terminations, transfers, etc.), and calculates prices, credits, and coverage.

So, Event Maintenance is a Process that you use to enroll new employees and to track and react to employee benefit changes during the plan year, such as those resulting from a marriage or termination of employment.

Open Enrollment:

Open Enrollment is the period of time employers set up to allow employees to choose from the plans available to them. I.e. Open enrollment is when employees have the ability to change their plans or coverage level each year.
This time period happens on an annual basis. It’s easiest to coordinate with your providers to make sure that open enrollment for each coverage plan falls at the same time of the year, rather than have different open enrollment times for every plan. Most plan providers won’t let you or your employers make a change unless there’s a qualifying event.
The main qualifying event is defined by the IRS as an event that:

Marriage;
Birth;
Adoption;
Divorce or legal separation;
Death of spouse or dependent.

So, Open Enrollment is a Process that you use to enroll or reenroll participants in appropriate benefit programs and plans during the annual enrollment window (For Example Nov 1, 2009 to Nov 21 2009) during the open season periods for health benefits, life plans, and savings plans.

Benefits Administration Introduction

When you buy Oracle's PeopleSoft Enterprise Human Capital Management Application, you can license different Products with it. If you are licensed only for Human Resource, this would includeBase Benefits module. With Base Benefits, you can process employees benefits through manual process. If you need automated process, then you would need to license forBenefits Adminstration Product and have it selected under Installation Table as shown below:




With Base Benefits:
Benefits Supervisor must manually determines eligibility, assigns benefit program and enrolls/terminates/changes enrollments in Base Benefits for an employee.
With Ben Admin:
PeopleSoft Ben Admin process automatically determines eligibility, assigns benefit program and enrolls/terminates/changes enrollments in Base Benefits.

Benefits Administration builds upon Base Benefits Functionality. This means that, you must first setup all relevant tables in Base Benefits; This enables you to link eligblity and event processing rules to your benefit programs , plan types and benefit plan options.

What is Benefits Administration?

1. Benefits Administration allows you to manage your benefit enrollment activity through automated processes.

For example, with BenAdmin, when you Hire an employees, this will be processed through the benefits enrollment process automatically based on the BenAdmin specific rules that were defined in the set-up.

If you had Base Benefits, the enrollment process would have been done manually.

2. These processes are rules-driven based on specific setup.
3. Rules are triggered by changes to an employee’s benefits related fields

So, What is the Benefits Administration (BAS) process?
The process that enrolls employees in benefit programs and updates the Base Benefits tables with any new election information.

There are different stages in BAS Process like Schedule population, determine program eligibility, and prepare options, generate enrollment forms, enter data, validate and load elections, and issue confirmation statements. We will learn them in detail in next posts...