Company Build Out Workbook Congratulations! You have a new client. Your team has been meeting with the law firm, Emily Conlan and Associates, for quite some time and have finally closed the deal! This workbook will provide all of the information you need to get this group up and running. However, like any client, Emily Conlan is somewhat unpredictable, sometimes indecisive, and may change things up on you along the way. This book will prepare you for those scenarios.
Transcript
Company Build Out WorkbookCongratulations! You have a new client. Your team has been meeting with the law firm, Emily Conlan and Associates, for quite some time and have finally closed the deal! This workbook will provide all of the information you need to get this group up and running. However, like any client, Emily Conlan is somewhat unpredictable, sometimes indecisive, and may change things up on you along the way. This book will prepare you for those scenarios.
Company Build Out WorkbookTable of Contents
Chapter 1 – Adding a Company...................................................................................................................3
Chapter 2 – Company Settings.....................................................................................................................4
Chapter 3 – Basic Plan Builds.......................................................................................................................8
Chapter 6 – Voluntary and Buyup Disability Plans.....................................................................................32
Chapter 7 – Voluntary Life Insurance........................................................................................................35
Chapter 8 – Cafeteria and Consumer Directed Health Plans.....................................................................42
Chapter 9 – Customizing the Employee Experience..................................................................................50
Chapter 10 – The Employee Experience....................................................................................................54
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Chapter 1 – Adding a Company
Chapter Objectives:
Identify Company information required to strategically use Employee Navigator Create a Company from your Agency HOME page
When adding a group to Employee Navigator, you will want to gather as much information as possible from the group up-front to save you time in the long run. Gathering information such as Class Structure, Payroll Calendars, Benefits offered which also includes the company contribution structures, and tracked Employee Demographic data will simplify the build out process. You should also speak to the group to verify which features they want to utilize within the system. For more information and a sample Data Gathering Form, see the article on Group Setup Checklists.
Exercise 1.1: Adding a Company
To Add a Company, from the Agency level:
Go to HOME > add a company > Add a company (start from scratch)
Company Name Emily Conlan and AssociatesUnique Identifier [Your Name] EConlanState MassachusettsSIC Code: 8111 - Legal ServicesAgency User Access Select your name only
Build a Class Structure to align with a Company’s organizational benefit structure Configure Payroll Groups Describe the Pay Frequency hierarchy for Class Structures and Payroll Groups Create HR users with defined permissions Customize Employee Profile fields
ProfileThe company Profile stores basic company demographic and industry information. To access and complete the company profile:
Go to SETTINGS > COMPANY > Profile
ContactsKeep track of your company contacts in Employee Navigator so that you have all your information in one place. Company Contacts can also be set to Display for Employee which will post the contact information on the Employee Home Page. You might decide to add carrier or broker information to allow easy access to these contacts for employees. To add Contacts:
Go to SETTINGS > COMPANY > Contacts > Add a contact +
Class StructureThe system is built upon a rules engine which uses class structure as the foundation for all rules. You will be able to use the rules engine to build benefit eligibility rules, varied benefit or contribution structures, assign onboarding tasks and even determine which employees can view specific documents. Once you have a good understanding of this feature, you will be able to review each new group to determine how the class structure should be configured instead of using a piecemeal approach and having to back track later. For more information on this important foundation of the system, see the article on Defining Class Structure.
Exercise 2.1: Adding Class StructureAt Emily Conlan and Associates, there are three classes of employees and two divisions with differences in the pay frequency and the benefits available to these classes of employees: The table below has this information populated. The HR department also wants to make sure that they can run reports and separate employees by Division so you need to make sure to build out the class structure appropriately. Let’s do this now.
Go to SETTINGS > COMPANY > Class Structure.
You will see the default Class is already set up for you. Since Classes are required for all employees, the system is prepopulated with the default Class, but this can be changed by simply clicking the Edit link. To add additional Classes, click on Add a class +.
The Class structure for your group is as follows:
Class Name Pay FrequencyPartners Monthly (12 periods)Associates Bi-Weekly (26 Periods)Staff Bi-weekly (26 Periods)Part Time-Ineligible Bi-weekly (26 Periods)
TIP: It is important to always add an ineligible class to each group you build, even if the group does not currently have ineligible employees. Doing so allows you to easily add any additional class in the future and keeps your plan builds clean.
Now you will add the Divisions. Click the Divisions link at the top of the Class structure setup page. You will see there is not a default Division created, so use the Add a division + link to add the law firm’s two Divisions below:
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Division NameGovernmentCommercial
Payroll Group Setup
Payroll groups are not currently required for all groups, but we strongly recommend you add them. Configuring Payroll groups allows you to set the pay frequency and build a payroll calendar which will be used throughout the system to determine per pay costs, PTO accruals on a per pay frequency, YTD contributions to cafeteria and consumer directed health plans, etc. For more information on when Payroll groups are required, see the article on Payroll Setup.
TIP: By adding a Payroll Group you are telling the system that you are configuring the pay frequency and pay dates for each employee. This means that the pay frequency on the Class setup will no longer be used to determine per pay costs. Payroll Groups always trump the pay frequency set on your Classes.
Exercise 2.2: Adding Payroll GroupsYou will now add the Payroll Groups for Emily Conlan and Associates.
The Payroll group information for this company is below:
Go to Payroll > GENERAL > Dashboard > Add a group
Add the Name and Pay Frequency for your group and Save.
Calendar > Define Pay Dates > enter the first pay date > select the appropriate option to indicate when the check will be dated if the pay date falls on a weekend. Review and Save your calendar! The system will then auto-populate the payroll calendars through 2022.
The Payroll groups for this company are below:
TIP: If you are building prior year plans in the system, it is important to build payroll calendar dates to coincide with the plan effective date (i.e. it is 2018 and you are building plans effective 08/01/2017, make sure that you add payroll dates on the entire 2017 calendar)
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Payroll Group Name Pay Frequency
First Pay Date of the year
If pay date falls on a weekend, when will checks be dated?
Monthly Monthly (12 periods) 01/31/2017 On the Friday BeforeBi-Weekly Bi-weekly (26 periods) 01/06/2017 On the Closest Day
HR UsersAdding HR Users to the system allows HR to have administrative rights in the system and take on some of your workload. You can set permissions and access controls for HR Users if needed. This is a nice way to prevent them from messing up your hard work versus telling them “Don’t touch the plans!”
To add an HR User:
Go to SETTINGS > COMPANY > HR Users > Add a new user +
Depending upon if the HR user is also an employee, this process can get a bit tricky. Make sure to read the HR Users and HR Permissions article for detailed instructions on this process.
HRIS Field TrackingThe HRIS Field Tracking tool allows you to customize the Employee Profile fields and indicate which fields are being tracked for changes, which fields are visible to HR, and which fields are required to be completed by HR for every employee. For more information on configuring these settings, see the article on HRIS Field Tracking / Employee and Dependent Profile Fields.
Exercise 2.3: Setting your HRIS tracked fields You are almost finished with your basic group setup. Let’s set up the group so that the Division will be required for all employees to make sure it doesn’t get skipped.
Go to SETTINGS > COMPANY > HRIS Field Tracking > Profile > Division > check off HR Required > Save
Define the components of a Basic Plan Create a base medical model plan using the new Add Plan Create a medical model buyup plan using the new Add Plan
In this chapter, you will learn how to build a Basic Plan in Employee Navigator. Basic Plans are all medical model plans meaning that each of the plans in the Basic Plan List have consistent features and are built the same way. When you are familiar with one of these plan builds, you will be able to apply your knowledge and build additional plans which utilize the same Basic model.
For more information, read the Basic Plans article.
The first steps to adding a plan are the same no matter what type of plan you are building. We will go over the initial steps to building a plan below and then you can utilize these steps for every plan build.
Go to BENEFITS > BASIC > Add A Plan > select from the following options:
Add a new plan: Select a plan model and build the plan from scratch Copy a plan from this company: Copy a selected plan from the current company and only make
the necessary changes. Copy a plan from another company: Copy a selected plan form another company under your
Agency and only make the necessary changes. Copy a plan from library: Copy a selected plan from a Company Library created at the Agency
level. This option will only be visible if a Company library with existing plans was previously created.
When using the Add a New Plan option, continue as follows:
Select Plan model > Select Carrier > Enter New Plan Name > Save
Included below are details on the primary building blocks of Basic Plans. Keep in mind, Policy Information and Eligibility Rules are consistent through all plan models.
You will notice that on each plan model there are required fields which must be completed to turn on a plan for enrollment. There are also optional fields which can be built out to provide additional information for employees and utilize advanced tools and functionality in the system. Click on the hyperlink for each Plan Setup Tab to review the detailed support article.
Policy Info Plan Name – Name this something unique from year to year so that you don’t get confused
as to which plan you are reviewing (ex: 2017 HMO Gold Plan) Carrier Plan Type Start and End Dates Policy #
Communications Customize the employee experience by adding optional plan resources and documents.
Employees can access this information during enrollment by clicking on a plan's details link, or throughout the year from their Benefits Overview page.
TIP: Plan Termination rules must be assigned to ALL groups of employees regardless of the plan eligibility. They can be rules based but each employee must have a termination rule. Whenever possible, use the Everyone rule.“Why?” you ask. Think about this. An employee is in the Executive class and is eligible for the STD Buyup plan. The employee then has a class change and is now in the Staff class. The employee is no longer eligible for the plan, but if there are no termination rules for that class, the system is unable to terminate coverage for the employee. Therefore, all employees must have a termination rule assigned for every plan.
Demographic Change RulesChange Rules allow a different set of rules to be configured for newly eligible employees. This would be used if a company has a waiting period such as 30 days for a new hire, but if an employee has already been employed more than that period, they wouldn't need to complete the waiting period again once they become benefit eligible. If nothing is set on "Change Rules", the new hire rules will be applied. See the article on Demographic Changes for more information.
RestrictionsIf enrollment in the plan is dependent upon enrollment in another plan, Restrictions can be configured based on enrollment in a specific plan or a benefit category. Additional configuration options such as ‘Enforce same coverage level’ and ‘Require enrollment if restrictions are satisfied’ are also available. See the article on General Plan Rules on the support site for more details.
COSTSRates
o Monthly Carrier Rates Composite Rates – One set carrier rate for each coverage tier. Does not
consider Employee or Dependent demographics. ACA Rates – allows for configuration of rates based on individual age,
geographic rating area, and tobacco usage. Rates are calculated for each individual enrolled (employees and dependents).
Banded Rates – Carrier rates are Banded and based on the Employee’s Age, Gender, Tobacco Use status, or any combination of the three. Does not consider dependent demographics.
Individual Banded – Employee and Spouse are rated individually based on their own age and gender. Children are given a flat rate based on each enrolled child, instead of an age-based rate.
ContributionsMedical contributions can be set up to apply to all employees or use the rules engine to define different contributions for employees based upon Class, Department, Tobacco use, Wellness participation and other settings.
When adding plan contributions, you must always enter a monthly amount. Select from the following contribution configuration options for each of the applicable coverage tiers:
The Employee Cost $: Amount the employee pays per month The Company Cost $: Amount the company pays per month The Company Contribution %: Percentage of the total cost the employer pays. Useful
when rates are age banded. Additional Employee Cost $: (Dependent only option) Amount of $ the employee pays in
addition to the cost of the Employee Only coverage in the same plan. Additional Company Cost $: (Dependent only option) Amount of $ the employer pays in
addition to the cost of the Employee Only coverage in the same plan. Additional Company Contribution %: (Dependent only option) Additional % the
employer pays in addition to the cost of the Employee Only coverage in the same plan.
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Exercise 3.1 Building a Basic PlanEmily Conlan and Associates offers two medical plans for their employees to choose from. The firm covers 75% of the cost of the Base Plan for their employees and the employee is responsible for the remainder of the employee cost, any dependent costs, and the difference in cost when the buyup plan is selected. This might seem a bit complicated, but rest assured, we have this configuration covered.
Follow the steps below to build the Medical Plans for this group.
Go to BENEFITS > BASIC > Add A Plan > Add a new plan > under the Basic models, select Medical.
Carrier = Anthem Blue Cross Blue Shield New Plan Name = 2017 Base Medical Plan
1. Build Your Base Medical Plan
Be sure to hit Save after each section.
Field EntryPOLICY INFO Policy Info
Plan Name 2017 Base Medical PlanCarrier Anthem Blue Cross Blue ShieldPlan Type HMOStart Date 01/01/2017End Date Will populate to 12/31/2017 but can be modified
SAVEELIGIBILITY & ENROLLMENTEligibility Rules
Eligibility Based on Class > Associates, Partners, and StaffCoverage Waiting Period Based on Class > Partners > 0 Days
Based on Class > Associates and Staff > 30 DaysCoverage Begins/Entry Date
Based on Class > Partners > Hire Date
Based on CLASS > Associates and Staff > 1st of the month coinciding with or after
Termination Date Everyone > End of Month of TerminationSAVE
Eligibility OptionsDependent age not eligible 26
Student Age not eligible 26Over age dependent drop rule End of month
Enable auto drop of over age dependents
SAVEEnrollment Options
Primary Care Physician Required12
PCP Link https://www.anthem.com/health-insurance/provider-directory/searchcriteria
SAVECOSTSRates
Is this plan based on composite, ACA, banded, or individual banded rates?
ACA
Age child rated as an individual 21
Max # children rated 3Rate based on Based on Effective Date
SAVEACA Rates
IN-STATE Everyone > Add +Upload Rate Table
Select Worksheet > Age with Dash SAVE
ContributionsContribution Groups Based on > Everyone > Add +
Employee Company Contribution % = 75%Employee + Spouse Additional Company Contribution % = 0%Employee + Child(ren) Additional Company Contribution % = 0%Employee + Family Additional Company Contribution % = 0%
SAVEPolicy Info Turn on Enrollment
2. Build your BuyUp Medical Plan
Field EntryPOLICY INFOPolicy Info
Plan Name 2017 BuyUp Medical PlanCarrier Anthem Blue Cross Blue ShieldPlan Type HMOStart Date 01/01/2017End Date Will populate to 12/31/2017 but can be modified
SAVEEligibility Rules
Eligibility Based on Class > Associates, Partners, and StaffCoverage Waiting Period Based on Class > Partners > 0 Days
Based on Class > Associates and Staff > 30 DaysCoverage Begins/Entry Date Based on Class > Partners > Hire Date
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Based on Class > Associates and Staff > 1st of the month coinciding with or after
Termination Date Everyone > End of Month of TerminationSAVE
Eligibility OptionsDependent age not eligible 26
Student age not eligible 26Over age dependent drop rule End of month
Enable auto drop of over age dependents
SAVEEnrollment Options
Primary Care Physician RequiredPCP Link https://www.anthem.com/health-insurance/
provider-directory/searchcriteriaSAVE
COSTSRates
Is this plan based on composite, ACA, banded, or individual banded rates?
ACA
Age child rated as an individual 21
Max # children rated 3Rate based on Based on Effective Date
SAVEACA Rates
Rate Groups > In State Grouped by Everyone > Add +Use the attached spreadsheet to determine the 21-year-old rate and audit the system generated ratesEnter 21-year-old Rate: 21-year-old rate = $475.83Audit system generated rates
Use the to increase the 37-year-old rate to $548.24.Use the to decrease the 51-year-old rate to $720.77.
SAVEContributions
Contribution Groups Grouped By > Everyone > Add +Use Plan Based Contributions Select 2017 Base Medical Plan
SAVEPolicy Info Turn on Enrollment
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3. Build your Vision Plan
Vision plans are Basic (Medical Model) plans. Since you have already built two of them, this should be easy. Apply your knowledge of Basic plans and build you Vision plan using the information below.
Field EntryPOLICY INFORMATIONPolicy Info
Plan Name 2017 Vision PlanCarrier Anthem Blue Cross Blue ShieldPlan Type Basic VisionStart Date Same as Medical
SAVEEligibility Options Same as Medical
SAVECOSTSRates
Is this plan based on composite, ACA, or banded rates?
CHALLENGE!!!You just learned that employees are only eligible to enroll in the Vision plan if they have also enrolled in the Medical Plan. That could be a tricky scenario to build. Luckily, you’ve been reading and reviewing your resources so you know that you can use Plan Enrollment Restrictions to set up these advanced eligibility rules.
Go back to your Vision Plan and follow the path below:
ELIGIBILITY & ENROLLMENTS> Restrictions >
Is enrollment dependent upon enrollment in a benefit category? Select Medical
Check the boxes for
Enforce restriction at the same coverage level
Require enrollment in this plan if restriction conditions are satisfied
SAVE
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Chapter 4 – Importing
Chapter Objectives:
Describe the 5 steps involved in every import process Identify best practices for importing data Import an Employee and Dependent census for a company
Employee Navigator’s import engine provides you with a tool to import Employee and Dependent demographic information, current enrollment records, demographic changes, beneficiaries, and manager assignments. This tool is very powerful and can overwrite good information if you are not careful. It is important to make sure that you understand the process and what the outcome of your import will be as imports are NOT able to be undone.
Import templates can be downloaded from the system to simplify the task of gathering the necessary data and formatting it appropriately.
To download import templates:
Go to HOME > Helpful Tools & Information > Import Employees & Enrollment > Download templates > select the appropriate template
For information on selecting the correct import template for your data, see the Import Templates article.
During the Import process, the system will lead you through the following 5 steps:
1. Upload – add a file by browsing your PC or use the drag and drop option 2. Options – Indicate what type of data is being imported3. Map – Map your column data to the correct system fields4. Audit – Audit any data from your import spreadsheet that does not match the system options5. Commit – Presents a final overview of the data you are importing and commits the data to the
queue for processing
TIP: During each step of the Import process, you will see additional resources to assist you in the process. There is a link on each step to view the corresponding article on the Employee Navigator Support site. On the Options step, you will also see important on screen text which will update based on the selection made in the “What are you importing” field. The text includes tricks and reminders that will help you in achieving a successful import, so check it out!
To start a new import:
Go to HOME > Helpful Tools & Information > Import Employees & Enrollment > Start a new import+
Exercise 4.1: Importing your censusThe HR department at Emily Conlan and Associates has provided you with the Employee and Dependent census included below*. You will need to download this workbook to your computer.
Follow the steps below to upload the Employee and Dependent Census:
Go to HOME > Helpful Tools & Information > Import Employees & Enrollment > Start a new import+
1. Upload: Click to add a file > Browse to select the file from your computer.2. Options:
a. Overwrite the File Name to Emily Conlan and Associates EE and Dep Censusb. What are you importing? Select Employee Censusc. Are dependents included in the file? Check Yesd. Save
3. Map: a. Scroll to the right to ‘Street Address’ column. From the dropdown menu, map to
Address 1.b. Save
TIP: It is important to always make sure all column headers are mapped to the correct system fields. If you are ever doing an import with a column that has blank values (i.e. There is no information included in the Address 2 column of your spreadsheet) delete that entire row before starting the import process. This will reduce the chance of clearing out good data (if you import a blank value over an existing value, it will wipe out the existing value).
4. Audit: a. Class
i. Map ‘Assoc’ Associatesii. Map ‘Partner’ Partners
b. Divisioni. Map ‘government’ Government
c. Save5. Commit: Review the number of employee and dependent records, then click Commit.
Note: Depending upon the size of your import, this process could take some time to complete. You will receive an email notifying you when this import has been fully processed.
All the group’s employees and dependents are now uploaded in the system.
*The census can also be found in the Company Build-out Workbook and Supplemental Documents article on the Support Site
Identify the 4 options for Group Life Benefit amounts Convert monthly rates for Group Life Benefits Build Group Life and Disability plans Distinguish and select tax options for Group Disability plans Convert rate per covered benefit to rate per covered payroll
Group Life and Disability plans are typically Employer paid, meaning that they are offered at no cost to employees. Generally, these plans are offered as a component of a competitive benefits package to attract and retain talented employees, providing income protection to employees in a scenario where they are injured and unable to work and providing financial protection for beneficiaries in the event of an employee’s passing.
The Group Life and Disability plan models are included in the Life Insurance and Disability Insurance categories. Don’t be fooled and pick the models that include the word Voluntary. Those will be explained later.
Group LifeBuilding a Group Life plan is easy. There are a limited number of components that go into building these plans, although they can be configured differently for specific groups of employees and use of the Rules Engine will allow you to do this successfully.
Group Life plans do not provide options for the amount of benefit the employee will elect; instead, this is determined in the policy and uses one of the 4 options below:
Flat Amount – Employees in the specified group receive a set benefit. Multiple of Earnings – Employees in the specified group receive a benefit equivalent to a
multiple of their salary. Rounding rules and min and max benefit amounts may be applied. Multiple of Earnings Plus – Employees in the specified group receive a benefit equivalent to a
multiple of their salary plus a flat amount. Rounding rules and min and max benefit amounts may be applied.
Multiple of Earnings Minus - Employees in the specified group receive a benefit equivalent to a multiple of their salary minus a flat amount. Rounding rules and min and max benefit amounts may be applied.
The Rates for Group Life plans are also easy to configure. There is one rate that applies to all employees. The rate entered should be the MONTHLY rate per $1000 of Benefit. If this is not the way the carrier provided the rates, you will need to convert them.
Rounding is another tricky area of the Group Life setup, but it doesn’t have to be. You will need to know how the carrier calculates the benefit rounding when it comes to the following 2 components:
1. Benefit Rounding Type (Up, Down, Closest) 2. Round to the Nearest ($1,000, $500, $10, etc.)
See the article on Group Life Plans for additional details.20
TIP: Rounding information is not usually included in the quote summary Often you may need to ask someone at the carrier. This is another reason to offer the same plan to multiple groups. You don’t want to have to contact the carrier each time you add a new Group Life plan.
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Exercise 5.1 Building a Group Life Plan
The firm provides their Partners Group Life benefits of 2.5x their salary, however, Associates and Staff are provided with 1.0 x their salary in Group Life Insurance. Therefore, it will be necessary to use your Class rules again to build this plan. Notice how many times we are coming back to those classes. That is why it is so important for you to understand how class structure impacts the rest of the company build BEFORE you start building.
Follow the steps below to build the Group Life Plan for this group.
Go to BENEFITS > BASIC > Add A Plan > Add a new plan + > under the Life Insurance models, select Life Insurance.
Carrier = UNUM New Plan Name = 2017 Group Life
Field EntryPOLICY INFO Policy Info
Plan Name 2017 Group LifeCarrier UNUMPlan Type Basic Group LifeStart Date 01/01/2017End Date 12/31/2017
SAVEELIGIBILITY & ENROLLMENTEligibility Rules
Eligibility Based on Class > Associates, Partners, and StaffCoverage Waiting Period Based on Class > Partners > 0 Days
Based on Class > Associates and Staff > 30 DaysCoverage Begins/Entry Date Based on Class > Partners > Hire Date
Based on Class > Associates and Staff > 1st of the month coinciding with or after
Termination Date Everyone > End of Month of TerminationSAVE
Enrollment OptionsCapture Beneficiary Required
SAVEBenefitsBenefits
Based on Class > PartnersBenefit Type Multiple of EarningsMultiple of Earnings Max 2.5Minimum Benefit $20,000Maximum Benefit $500,000Benefit Rounding Type UpRound to the Nearest $10,000
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Require Enrollment Reductions Age Range 65 to 70 > Reduced by 35%
Age Range 71 to 99 > Reduced by 50%SAVE
Add + Based on Class > Associates and StaffBenefit Type Multiple of EarningsMultiple of Salary Max 1.0Minimum Benefit $10,000Maximum Benefit $150,000Benefit Rounding Type UpRound to the Nearest $10,000Require Enrollment Reductions Age Range 65 to 69 > Reduced by 35%
Age Range 70 to 99 > Reduced by 50%SAVE
COSTSRates
Employee Monthly Rates per $1,000 of Benefit $0.11
Group Short Term Disability (STD)Group STD is another easy benefit to build. You may run into that tricky rounding again, so remember, if the information is not in the quote summary, you should contact the carrier.
You will also need to know if the costs are being calculated with a rate per $10 of benefit, or if the carrier is charging an Administrative Services Only (ASO) Flat Fee. Paying only the ASO Flat Fee means that the employer would be liable for all claims and related expenses; basically, a self-funded plan.
Within the Benefit portion of this build you will be able to add in details about the policy that are used for communication purposes only, such as the Accident and Sickness Waiting Period and the Benefit period. Remember that these fields are used to provide information about the benefit to the employee. Employee Navigator does not apply these waiting periods to any system workflows since Disability Claims and usage are not tracked through the system.
Notice new options on this plan that pertain to Taxes. Three different tax options are available.
1. Company Pays – The company is paying the cost of the coverage. Employee is taxed on the benefit received.
2. Employee Post Tax Deduction – Employee pays the costs of the coverage post-tax, resulting in a tax-free benefit.
3. Employee Imputed Income – Employee pays the tax on the premium, resulting in a tax-free benefit.
You can decide not to select any of these options, in which case, the system would default to the ‘Company Pays’ option, but this would not be communicated as such on the plan details. Or, you can choose one, two, or all three of these options to present this information to the employee during the enrollment flow, and let them decide. Employee Navigator’s recommendation is to establish the tax option used at the company level and do not allow employees to choose individually. This makes the administration of the benefit much easier for everyone.
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Exercise 5.2 Building a Short-Term Disability PlanThe law firm has decided to only offer the Associates and Staff any Group STD benefits.
They have also decided to allow employees to select from any of the three tax options. This will be harder to administer, but it is a great example for you to build and understand.
Follow the steps below to build the Group Short Term Disability plan for this company.
Go to BENEFITS > BASIC > Add A Plan > Add a new plan + > under the Disability Insurance models, select Short Term Disability.
Carrier = UNUM New Plan Name = 2017 Group Short Term Disability
Field EntryPOLICY INFO Policy Info
Plan Name 2017 Group Short Term DisabilityCarrier UnumPlan Type Group STDStart Date 01/01/2017End Date 12/31/2017
SAVEELIGIBILITY & ENROLLMENTEligibility Rules
Eligibility Based on Class > Associates and StaffCoverage Waiting Period Based on All Eligible > 30 daysCoverage Begins/Entry Date
Based on All Eligible > 1st of the month coinciding with or after
Termination Date Everyone > End of Month of TerminationSAVE
BenefitsBenefits
Based on Class > Associates and StaffBenefit Type % of Weekly EarningsBenefit as a % of weekly earnings 40%
Rounding value Salary Rounding type UpRound to $10Minimum weekly benefit $100Maximum weekly benefit $750Require Enrollment Employer Contribution Type Percent
Employer contribution percentage 100
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Accident Waiting Period (days) 1
Sickness Waiting Period (days) 7
Benefit Period (weeks) 13SAVE
COSTSRates
Cost basis Rate per $10 of benefitMonthly rate per $10 of weekly benefit $0.31
Company Pays YesEmployee Post Tax Deduction Yes
Employee Imputed Income Yes
SAVEPolicy Info Turn on Enrollment
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Group Long Term Disability (LTD)Building a Group Long Term Disability plan is very similar to building a Group Short Term Disability plan. You will see many consistent features between the two. This means that once you have mastered the STD plans, LTD plans should be easy.
There is, however, one significant difference which often seems to trip up users, but it doesn’t have to if you know what you’re doing. The difference comes when entering rates and calculating costs for the LTD plan.
Pay attention to this part!
Long Term Disability costs are calculated based on the monthly rate per $100 of COVERED PAYROLL.
Did you see that? It said COVERED PAYROLL not benefit.
Many carriers already provide the rates based on unit of covered payroll (which is why the system was designed this way), but some carriers will provide you with a rate per unit of covered benefit. In that case, you need to convert the rate into the rate per unit of covered payroll before you enter it into the system. We'll give you the formula to do the math.
To convert a rate that is provided in rate per unit of covered benefit, use the formula below:
(Rate per $100 of Benefit) × (benefit as a % of salary) = Rate per $100 of covered payroll
Example:
Rate per $100 of benefit = $0.40 Benefit = 60% of covered payroll ($0.40) × (60%) = $0.24 per $100 of covered payroll
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Exercise 5.3 Building a Group LTD Plan
Our quote summary from the carrier has the rate listed as $2.48 per $100 of monthly covered payroll. Let’s use the formula to adjust the rate:
Rate per $100 of benefit = $2.48 Benefit as a % of salary = 40%
Therefore, my rate per $100 of covered payroll = ($2.48) × (40%) = $0.992 per $100 of covered payroll
Go to BENEFITS > BASIC > Add A Plan > Add a new plan + > under the Disability Insurance models, select Long Term Disability.
Carrier = UNUM New Plan Name = 2017 Group Long Term Disability
Field EntryPOLICY INFO Policy Info
Plan Name 2017 Group Long Term DisabilityCarrier UnumPlan Type Group LTDStart Date 01/01/2017End Date 12/31/2017
SAVEELIGIBILITY & ENROLLMENTEligibility Rules
Eligibility Based on Class > Associates, Partners, and Staff
Coverage Waiting Period Based on All Eligible > 30 daysCoverage Begins/Entry Date
Based on All Eligible > 1st of the month coinciding with or after
Termination Date Everyone > Employment TerminationSAVE
BenefitsBenefits
Based on Everyone > Add +Benefit as a % of monthly earnings 40%
Rounding value Salary Rounding type UpRound to $10Minimum monthly benefit $100
Maximum monthly benefit $5000
Require Enrollment Employer Contribution Type Percent
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Employer contribution percentage 100
Waiting Period (days) 90Benefit Period Age 65
SAVECOSTSRates
Monthly rate per $100 of covered payroll $0.992
SAVEPolicy Info Turn on Enrollment
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Bulk EnrollmentThe Bulk Enrollment tool allows users to bulk enroll all employees in group plans for which Enrollment has been set as ‘Required’. This tool will enroll all eligible employees in a plan and will use the plan configuration rules to calculate the benefit for each employee. This is a more efficient process than enrolling each employee one by one or importing these enrollment records.
To Bulk Enroll employees in a group plan, go to:
BENEFITS > BASIC > Enrollment Tools > under ‘Plans That Can Be Bulk Enrolled’, find the plan you need > Enroll
For more details on this process, see the Bulk Enroll Employees in Group Plans article.
Exercise 5.4 Bulk Enrolling in Group Plans
Let’s go ahead and Bulk Enroll the employees in the Group Life and Group Disability plans.
Follow this path:
BENEFITS > BASIC > Enrollment Tools > 2017 Group Life > Enroll > Run
Repeat for the 2017 Group Long Term Disability and 2017 Short Term Disability Plans.
CHALLENGE!!!After bulk enrolling employees in the Group LTD plan, the HR user has called you in a panic. She said the Group LTD premium is not calculating correctly for the Emily Conlan herself. She’s afraid that her Self Bill Summary Report* which she uses to determine the total Premium for the group is returning incorrect data. She needs help!
This is the information she provided:
What should you do?
A. Hang up and immediately call Employee Navigator support.
B. Let her know you understand her concerns and you will get back to her as soon as you look into it, and then you call Employee Navigator support.
C. Let her know you understand her concerns and you will look into it right now and give her a call back. Then take a look at the information she provided and try to troubleshoot on your own.
The Correct Answer is C. Here's how you do this.
Ms. Conlans’ benefit amount is $5,000.00…which is also the maximum monthly benefit. If there wasn’t a cap on the benefit, her monthly benefit would be much higher.
Technically that means the benefit is not covering the entire amount of her monthly payroll. How much of her payroll are they covering? Let’s see. If the benefit is $5,000 which is 40% of the covered monthly payroll, then the covered monthly payroll would be:
($5,000) ÷ (.40) = $12,500
Let’s use that to calculate the premium:
1. Monthly covered payroll = $12,5002. Monthly covered payroll ($12,500) ÷ 100 = 125 units of covered payroll3. 125 units of covered payroll × $0.992 = $124.00 per month
Mystery solved. You are now an expert at troubleshooting Long Term Disability Costs and you were able to figure it out all on your own.
*The Self-Bill Summary Report can be located on the company REPORTS tab > CARRIER REPORTS > Self Bill Summary
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From the Carrier Billing: Employees with Rates and Groups report:
According to her calculations below, the Premium for Ms. Woods should be $248.00.
1. Monthly covered payroll = Annual Salary ($300,000 ÷ 12) = $25,0002. Monthly covered payroll ($25,000) ÷ 100 = 250 units of covered payroll3. 250 units of covered payroll × $0.992 = $248.00 per month
Chapter 6 – Voluntary and Buyup Disability Plans
Chapter Objectives:
Explain the difference between Voluntary and Buyup LTD Build a Buyup LTD plan
Voluntary Short and Long-Term Disability Plans (also referred to as VXTD plans) can be offered to employees to provide income replacement above and beyond any employer paid benefits in the event of a non-occupational related injury.
VXTD plans support:
Benefit as a % of earnings / increments Rounding Rules Guaranteed Issue for new hires, late entrants and additional benefit enrollments Communication of waiting periods and benefit periods
VXTD Plan types can be configured as voluntary or buyup.
Whereas the voluntary plan type is typically a stand-alone benefit that is not tied to the enrollment in Basic XTD, the buyup plan type is linked to the employer paid base plan. When a buyup plan type is configured, the user indicates which LTD plan is the linked (base) plan, and the Aggregate Maximum % of employee salary and Aggregate maximum benefit $. When an employee elects the buyup plan, they will be presented with the benefit options available based on the benefit configuration; however, they will not be able to elect an amount that would put the combined benefits between the employer-sponsored and the buyup over these aggregate maximums.
Multiple Voluntary Short and Long-Term Disability plans can also be offered to employees. This functionality is typically used if an employer offers a voluntary disability plan that offers multiple elimination period options. Each plan would be configured as a separate plan, and an employee is presented with a choice to enroll in any of the available selections.
Tip: When offering more than one Voluntary Short or Long-Term Disability plan, all plans must have the same increments or all have no increments, and the benefit percentage must be the same.
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Exercise 6.1 Building a Voluntary Disability Plan (VXTD)During a recent meeting with the benefits department at the law firm, you discussed the possibility of them offering more voluntary benefits to their employees. These offerings will help to make their benefits package more attractive to employees and fill the gaps of a limited benefits package with little increase in cost to the firm. (Of course, we know that you have another motive here. Selling more voluntary benefits can significantly increase your agency’s commissions too. It’s a WIN-WIN-WIN.)
Let’s add this to the company build.
Go to BENEFITS > BASIC > Add A Plan > Add a new plan + > under the Disability Insurance models, select Voluntary Long-Term Disability.
Carrier = UNUM New Plan Name = 2017 Long Term Disability Buyup
Field EntryPOLICY INFO Policy Info
Plan Name 2017 Long Term Disability BuyupCarrier UnumPlan Type Voluntary LTD BuyupStart Date 01/01/2017End Date 12/31/2017
SAVEELIGIBILITY & ENROLLMENT
Eligibility RulesEligibility Based on Class > Associates, Partners, and StaffCoverage Waiting Period Based on All Eligible > 0 DaysCoverage Begins/Entry Date Based on All Eligible > 1st of the month after
Termination Date Everyone > Employment TerminationSAVE
Enrollment OptionsUpdate benefits on salary change
Beneficiary RequiredSAVE
BENEFITS Benefits
Based on Everyone > Add+Benefit as a % of monthly earnings 30%
In Increments of No incrementsRounding value SalaryRounding type UpRounding to the nearest $10Minimum monthly benefit $100
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Maximum monthly benefit $15,000
New Hire/Newly Eligible GI Amount $15,000
Late Entrant GI Amount (new enrollment) $0.00
Max Increase Without EOI (existing enrollment) $0.00
Employer Contribution Type Percent
Contribution percentage 0%Waiting Period (days) 90Benefit Period (age) Age 65
SAVECOSTS Rates
Use flat rate Monthly rate per $100 of covered payroll 1.0260
Company Pays NoEE post tax deduction NoEE Imputed income NoBUYUP: Linked plan 2017 Group Long Term DisabilityAggregate max % 70.00%Aggregate max $ amount $15,000Premium calculation Buyup Only
SAVEPolicy Info Turn on Enrollment
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Chapter 7 – Voluntary Life Insurance
Chapter Objectives:
Define configuration settings unique to Voluntary Life models Identify the 3 Policy Settings required for proper plan set-up
Voluntary Life Insurance Plans models include the plan types below:
Voluntary Life Voluntary AD&D Voluntary Life & AD&D (combined) Critical Illness Permanent Life
These plans are the most complex plans to build because they can include so many options:
Benefits of different increments or multiples of salary Rates based on Age, Gender, and/or Tobacco Status, Age Reductions Guaranteed Issue rules for new, existing and additional coverage need to be configured
Voluntary LifeBelow is a summary of some of the configuration settings unique to Voluntary Life model plans.
Rate SettingsSince the majority of Voluntary Life plans have age-banded rates, the Rate Settings section is used to indicate how rates and premiums will be calculated for new hires, employees aging up mid-year and employees reaching an age where reductions apply. There are three different policy settings that need to be configured to ensure that the system is appropriately calculating the employee’s rate based on their age:
New Hire Rate Effective – Drives how newly hired and newly eligible employees will be rated when enrolling in VL for the first time under a NH/Newly Eligible window.
Change Rates – Drives how mid-year age bracket changes will be calculated. Age Reduction Effective – Drives how employees reaching age reduction rules mid-year will be
calculated.
Benefit StructuresVoluntary Life plans can be configured with one of three Benefit Structures shown below:
Increments – Used when employees can elect a benefit amount in “X” increments between a minimum and maximum benefit amount.
Increments with Multiple of Salary Max - Use when employees can elect a benefit amount in X increments between a minimum and maximum amount, not to exceed X times employee's salary
Multiples of Salary - Used when employees can elect benefits in X multiples of their salary between a minimum and maximum benefit.
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Guaranteed IssueGuaranteed Issue (GI) amounts are used to determine the amount of benefit employees and dependents can elect (new) or increase (existing) without needing to submit an Evidence of Insurability (EOI) form to the carrier for approval. GI rules can be setup the same for all employees, or they can be grouped by any of the Class structures (department, business unit, etc.), tobacco use, dynamic classes, etc.
OptionsThere are many Benefit Options and Rate Options that can also be configured which allows groups to capture required information and accurately calculate dependent benefits and rates for all enrollees.
RidersSupplemental benefits, or riders, can be added to the plan as a way to offer additional coverage to employees for an additional cost. For easy administration, Employee Navigator’s recommendation is to build any riders offered into the policy and not to offer the option of electing or declining riders.
For complete details on all configuration options for Voluntary Life plans, see the Plan Setup: Voluntary Life Model article on our support site.
Let’s go ahead and build the Voluntary Life plan now. The company offers Vol Life increment based benefits to employees and their dependents.
Go to BENEFITS > BASIC > Add A Plan > Add a new plan + > under the Life Insurance models, select Voluntary Life.
Carrier = Guardian New Plan Name = 2017 Voluntary Life
Field EntryPOLICY INFO Policy Info
Plan Name 2017 Voluntary LifeCarrier GuardianPlan Type Voluntary LifeStart Date 01/01/2017End Date 12/31/2017Issue Age Policy NO
SAVEELIGIBILITY & ENROLLMENTEligibility Rules
Eligibility Based on Class > Associates, Partners, and StaffCoverage Waiting Period Based on All Eligible > 0 daysCoverage Begins/Entry Date Based on All Eligible > 1st of the month after
Termination Date Everyone > Employment TerminationSAVE
Eligibility OptionsRestrict spouses over age 70
SAVEEnrollment Options
Capture Beneficiary Required SAVE
BENEFITSBenefits
Based on Everyone > Add+Employee Benefit Benefit Type Increments
In Increments of $10,000Minimum Benefit $10,000Maximum Benefit $500,000Employer Contribution Choice Benefit Amount
Benefit $20,000Age Reductions Age Range 65 to 69 > Reduced by 35%
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Age Range 70 to 99 > Reduced by 35%SAVE
Spouse Benefit Benefit Type Percentage of Employee ElectionPercent 50%Maximum Benefit $250,000Employer Contribution 0%Age Reductions Age Range 65 to 69 > Reduced by 50%
SAVEChild Benefit Benefit Type Increments
In Increments of $1,000Minimum Benefit $2,000Maximum Benefit $10,000Max % of Chosen Employee Benefit 50%
view increments remove all except $2K, $5K, and $10KEmployer Contribution 0%Minimum Days Not Eligible 14 Days
Dependent Age Not Eligible 19
Student Age Not Eligible 25SAVE
Guaranteed IssueBased On EveryoneNew Hire/Newly Eligible Enrollment
GI Type FlatEmployee flat $100,000Spouse flat $30,000Child flat $10,000
Open Enrollment (late entrant)
GI Type FlatEmployee flat $0Spouse flat $0Child flat $0
Open Enrollment (existing enrollment)
Type Additional Amount up to FlatEmployee increase
by$10,000 Up to flat $100,000
Spouse increase by $0 Up to flat $0Child increase by $0 Up to flat $0
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COSTSRate Settings
Rate new hire/newly eligible employees according to age on
Calculated Eligibility Date
When age-band changes occur, update rates on First of Month Following
When age reductions occur, reduce benefits on First of Month Following
There are two Critical Illness plan models to choose from depending upon how the policy and rates are structured; the models are Medical and Voluntary Life. If the plan does not allow dependents to select their benefit and the plan has composite rates, you would build the plan in the Basic (Medical Model): Critical Illness plan model.
For help determining which Critical Illness plan model you should use, see the article titled ‘What Type of Critical Illness plan should I configure?’ on the support site.
However, if the policy supports employee enrollment in selected benefits and optional dependent coverage the plan would be built in a Life Insurance: Critical Illness plan model. This is the option we will explain. Since this plan model is configured like Voluntary Life plans, they support a selection of benefit options, guaranteed issue, and age/gender/tobacco rate tiers.
Critical Illness plans (Medical and Vol Life models) also support Issue Age. The Issue Age functionality allows employees to enroll in an age banded plan, and the cost of the coverage does not increase as the employee ages. The costs will change, when there are coverage level additions. Issue age policies can be configured as Re-Rated or Stacked.
Re-Rated: Coverage level additions through life event or open enrollment will cause the employee and spouse to get re-rated at the age of his coverage addition for all coverage.
Stacked: Coverage level additions will split the policy, where the original cost of the employee and spouse coverage at original age + the cost of the additional coverage as of the age of the change was made.
For more information, see the Issue Age article on our support site.
One difference between the Vol Life: Critical Illness plan model and the Voluntary Life plan model is that Critical Illness Plans can be configured with an Annual Policy Fee.
Note that Riders can also be configured on Vol Life: Critical Illness plan models.
TIP: Employee Navigator Recommendation - Bake the riders into the Critical Illness policies. In other words, do not allow employees to choose whether to enroll in the riders. This makes the enrollments and costs easier to communicate and to administer.
Permanent InsuranceThe Permanent Insurance plan model is also similarly configured to the Voluntary Life model. Not many companies offer Permanent Life, but if yours do, you'll know how to set it up.
Important Information specific to Permanent Life that needs to be included in the plan build is:
Policy Fee – This might be hard to track down. There is a chance that the carrier reps aren’t even sure on this one, so you may need to do some searching before you find the answer.
Cash value benefits at age 65. This information will also need to be obtained from the insurance carrier.
Guaranteed Issue: Reviewing Insurability RequestsGuaranteed Issue Amounts can be configured on Voluntary Life models plans and are used to determine the amount of benefit employees and dependents can elect (new) or increase (existing) without needing to submit an Evidence of Insurability form to the carrier for approval. GI rules can be setup the same for all employees, or they can be grouped by any of the class structures (department, business unit, etc.), tobacco use, dynamic classes, etc.
If an employee elects over the designated GI amount, then the benefit amount over the GI will be in PENDING status. The employee will be presented with an Evidence of Insurability form in the ‘Form’ section of the enrollment flow. Instructions should be provided to employees to complete and submit the form as per the company or carrier process.
Pending Insurability Requests for employees and dependents can be reviewed and the status updated appropriately by following this path:
Company HOME > HELPFUL TOOLS & INFORMATION > Review Insurability Requests
By selecting the Pending link next to the individuals name you can complete the action of Approving, Declining, Rejecting, or Withdrawing the amount of insurance requested greater than the Guaranteed Issue amount.
What does each option mean? When do I use it?Approve: A portion or the entire amount of insurance requested above the Guarantee Issue Limit has been approved by the insurance company. Insert the amount and date of approval provided by the insurance company. This option is used when a partial or full amount has been approved.
Decline: Select this action if the entire amount of insurance requested above the Guarantee Issue Limit is denied by the insurance company after completing the Evidence of Insurability (EOI) leaving only the guaranteed amount.
Reject: Select this action if the entire application, including the Guarantee Issue Amount has been denied by the insurance company (meaning the employee has no life insurance).
Withdrawn: The employee has withdrawn the request for additional insurance coverage which requires completing an Evidence of Insurability (EOI). For example, the EOI form was not completed or the employee decided not to complete the form. The pending request is no longer applicable.
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Chapter 8 – Cafeteria and Consumer Directed Health Plans Chapter Objective:
Identify which Cafeteria Plans are supported by Employee Navigator Build a Healthcare, Limited Purpose or Dependent Care FSA Create Consumer Directed Health plans including HSA or HRAs Manually Adjust Deduction Dates by plan
Cafeteria PlansA "Cafeteria Plan" is a benefit provided by an employer which allows an employee to contribute a certain amount of his or her gross income to a designated "account" before taxes are calculated. This "account" can be used to reimburse the employee for insurance premiums, medical, or dependent care expenses throughout the plan year or claim period as the employee incurs qualified expenses.
Employee Navigator’s Cafeteria Plan models include the following:
Healthcare FSAHealthcare FSAs (Flexible Spending Accounts) allow employees to set aside pre-tax dollars to use toward out of pocket Healthcare expenses.
IRS regulations dictate that employees are not allowed to enroll and contribute to a Healthcare FSA and an HSA at the same time. Therefore, the system logic will not allow an employee who has enrolled in one of these two plan types to also enroll in the other. The system is designed with rules in place so it will not allow an employee to contribute over the IRS CALENDAR year maximum into their FSA.
Healthcare FSA plan models include the options to set a minimum and maximum plan year election, configure rules for new hires, set rounding, and COBRA eligibility.
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Exercise 8.1 Building an FSA PlanEmily Conlan and Associates offers employees the opportunity to enroll in a Healthcare FSA with a standard configuration. Additionally, the FSA plan year is based on the calendar year AND coincides with the Medical Benefit plan year.
Let’s go ahead and build the Healthcare FSA plan now. To get started, follow this path:
Go to BENEFITS > BASIC > Add A Plan > Add a new plan + > under the Cafeteria Plans models, select Healthcare FSA.
New Plan Name = 2017 Healthcare FSA**NOTE** Cafeteria Plans are not assigned carriers in the system.
Field EntryPOLICY INFO
Policy InfoPlan name 2017 Healthcare FSAPlan Type Flexible Spending AccountStart Date 01/01/2017End Date 12/31/2017
ELIGIBILITY & ENROLLMENT
Eligibility RulesEligibility Based on Class > Associates, Staff, and PartnersCoverage Waiting Period Based on All Eligible > 0 DaysCoverage Begins/Entry Date Based on All Eligible > 1st of the month after
Termination Date EveryoneEmployment Termination
Enrollment OptionsMinimum election $100.00Maximum election $2,550.00Mid-year new hire maximumSubject to COBRA?
SAVEPolicy Info Turn on Enrollment
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Limited Purpose FSALimited Purpose FSA plans, although similar to the FSA, can only be selected if the employee has also enrolled in an HSA. This logic is built into the system and enforced during the enrollment process.
Like the FSA, the system is designed with rules in place that will not allow an employee to contribute over the IRS CALENDAR year maximum into their LPFSA. This plan model also includes the options to set a minimum and maximum plan year election, configure rules for new hires, set rounding, and COBRA eligibility.
Dependent Care FSADependent Care FSAs (Flexible Spending Accounts) allow employees to set aside pre-tax dollars to use toward out of pocket child care expenses.
The system is designed to not allow an employee to contribute over the IRS CALENDAR year maximum into their Dependent Care FSA. These plans also include the options to set a minimum and maximum plan year election, configure rules for new hires and set rounding and COBRA eligibility. Additionally, this plan configuration allows configuration on how contribution changes are applied.
Private InsuranceThese types of accounts can be employer and/or employee funded and allow an employee to use tax-free dollars to pay for private insurance which is not sponsored by an employer. This plan allows the employee to choose a plan that best suits their needs. Not all policies qualify and are not frequently offered. The design of the private insurance plan in our system follows the same model as the standard Healthcare FSA.
Parking Reimbursement AccountParking Reimbursement Accounts allow employees to set aside pre-tax dollars to use toward out of pocket expenses related to work related parking expenses.
The system design on this plan is similar to the Daycare FSA.
Transit Reimbursement AccountTransit Reimbursement Accounts allow employees to set aside pre-tax dollars to use toward the out of pocket expenses related to work related mass transit expenses.
The system design on this plan is similar to the Daycare FSA.
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Exercise 8.2 Building a Transit Reimbursement Plan
The firm is located in the midst of a bustling city. Most employees are taking some form of mass transit to commute to work. In an effort to help employees take advantage of a tax break, they offer employees the ability to participate in a Transit Reimbursement Account. This plan is based on the regular calendar year.
Let’s go ahead and build the Parking Transit Reimbursement Account plan now. To get started, follow this path:
Go to BENEFITS > BASIC > Add A Plan > Add a new plan + > under the Cafeteria Plans models, select Transit Reimbursement.
New Plan Name = 2017 Transit Reimbursement **NOTE** Cafeteria Plans are not assigned carriers in the system.
Field EntryPOLICY INFOPolicy Info
Plan name 2017 Transit ReimbursementPlan Type Transit ReimbursementStart Date 01/01/2017End Date 12/31/2017
ELIGIBILITY & ENROLLMENTEligibility Rules
Eligibility Based on Class > Associates, Partners, and StaffCoverage Waiting Period Based on All Eligible > 0 daysCoverage Begins/Entry Date Based on All Eligible > 1st of the month after
Termination Date Everyone > Employment TerminationEnrollment Options
Minimum election $100.00Maximum election $3,060.00Mid-year new hire maximum
SAVEPolicy Info Turn on Enrollment
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Adoption InsuranceAdoption Insurance plans are designed to allow employees to set aside funds to help cover the expenses incurred while going through the adoption process.
The system design on this plan is similar to the standard Medical FSA.
Consumer Directed Health PlansConsumer Directed Healthcare products provide plans which the employee and employer may contribute to in order to reimburse the direct expenses related to routine healthcare under a High-Deductible Health Plan. Unlike the FSA accounts, funds not used under the CDH plans are not lost if unused but instead will be rolled into the available funds for the following year.
Employee Navigator’s Consumer Directed Health Plan models include the following:
Health Savings Account Health Reimbursement Account
Health Savings Account (HSA)The Health Savings Account (HSA) allows employees to set aside pre-tax dollars to use to cover qualified routine healthcare expenses paid out-of-pocket. The employer may also make contributions to assist employees with the costs associated with their High-Deductible Health Plan expenses. Unlike the FSA, funds contributed to these accounts will roll over and continue to accumulate year to year if unused.
Similar to the FSA, IRS regulations dictate that employees are not allowed to enroll and contribute to a Health Savings Account unless they are enrolled in a High-Deductible Health Plan. Therefore, the system logic will not allow an employee who has not enrolled in the HDHP to enroll in the HSA. It is also designed with rules in place so as not to allow an employee to elect a contribution over the IRS CALENDAR year maximum for their HSA and will include any employer contribution in the calculation of that maximum.
Health Savings Account plan models include the options to set a minimum and maximum plan year election, configure rules for employer contributions and set links for contingent medical plans.
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Exercise 8.3 Building an HSA plan
Emily Conlan and Associates offer a High Deductible Health Plan medical enrollment option and is also offering employees the opportunity to enroll in a HSA with a standard configuration. Additionally, the HSA plan year is based on the calendar year AND coincides with the Medical Benefit plan year. Employee Navigator recommends all plans have the same plan year start dates.
Let’s go ahead and build the Health Savings Account. To get started, follow this path:
Go to BENEFITS > BASIC > Add A Plan > Add a new plan + > under the CDH-Consumer Directed models, select Healthcare Savings Account.
Carrier = HSA Bank New Plan Name = 2017 HSA
Field EntryPOLICY INFOPolicy Info
Plan name 2017 HSACarrier HAS BankPlan Type Healthcare Savings AccountStart Date 01/01/2017End Date 12/31/2017
SAVEELIGIBILITY & ENROLLMENTEligibility Rules
Eligibility Based on Class > Associates, Staff and PartnersCoverage Waiting Period Based on All Eligible > 0 daysCoverage Begins/Entry Date Based on All Eligible > 1st of the month after
Termination Date Everyone > Employment TerminationSAVE
Enrollment OptionsAllowed to Decline
SAVEBENEFITSContingencies
Select “+ Add”Contingent Plan 2017 BuyUp Medical PlanEmployee Can Contribute Minimum Employee Election $0.00
Employer Annual ContributionEmployee $1,000Employee Plus Spouse $1,500
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Employee Plus Child $1,500Employee Plus Children $1,500Employee Plus Family $1,500
SAVEFunding Calendar
Funding Calendar Enter the 1st of each month for every month listed (January 2017 = 1/1/2017)
SAVEPolicy Info Turn on Enrollment
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Health Reimbursement AccountHealth Reimbursement Accounts are solely funded by the employer and cannot be funded through employee deductions. The employer can use these types of accounts to provide a contribution to the employee to reimburse employees for out-of-pocket medical expenses. The types of expenses that can be paid under the HRA are generally the same as those covered under the FSA.
Unlike HSA’s there is no minimum or maximum contribution limit on the employer’s contribution to an HRA and any unused funds will remain with the employer if the employee leaves the company. Again, with this type of plan, our system will allow the employer to record their desired contribution using the rules based engine and will also prevent enrollment in the plan for an employee unless they have enrolled under a contingent medical plan.
Customize Deduction Dates by Plan
Some companies will not take deductions for the cafeteria plans on the same payroll schedule. For example, some companies may be on a 26-pay period payroll schedule and will only take cafeteria deductions for enrollment under a Parking or Transit Reimbursement Account on a monthly basis.
Employee Navigator provides the flexibility for you to manually adjust the deduction dates for each plan.
Exercise 8.4 Customizing Deduction DatesIn our scenario, the employees are paid 26-times a year but the FSA deduction is only taken out of 24 pays.
Let’s go ahead and see how to set the payroll deduction schedule for this benefit. To get started, follow this path:
Go to PAYROLL > Select “Bi-Weekly” > Options > Customize Deduction Dates > select the plan (2017 Healthcare FSA) that is to have deductions skipped
Skip the following 2 Pay Dates
Pay Day Skip Deduction03/31/2017 09/29/2017
You will then need to recalculate. At the top of your page click “Resolve” next to “some enrollments may require recalculation.
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Chapter 9 – Customizing the Employee Experience
You have now completed the Benefits setup. So, what’s next? You want to start working on the overall feel and look of the company to create a unique experience for your client’s employees. Employee Navigator offers many tools to help you brand and customize each company. Customizing the Employee Experience helps employees understand that they’ve come to the right place and can provide comfort in navigating their Home page for online enrollment and changes to their sensitive information all year round. Below you will read about some of our most commonly used tools.
Agency BrandingAgency level branding controls the default Theme, Footer, Login URL, Logout URL, and Login Widget for all your clients. From your Agency Home Page, Go to the BRANDING tab.
Within the Theme setup you can upload your agency’s website logo which will display on the right-hand side of the HR home page to help promote your agency.
Other default customizations include:
Footer
Replace the default Powered by Employee Navigator appearing on the bottom right of your screen with your own footer.
Login URL
Used with login widgets. Enter the URL of the secure site hosting the login widget so that email templates will pull in your login URL instead of the default Employee Navigator login URL.
Logout URL
Instead of dropping your clients on the main Employee Navigator site once they log out, drop them on your own site for Broker Support.
For more information on this topic, review the Agency Branding article on the Employee Navigator support site.
Company BrandingEach Branding tool found on your Agency level can also be customized with information specific to your client as well. This is done at the Company level:
Go to SETTINGS > EMPLOYEE EXPERIENCE > Company Logo & Branding
Home Page Welcome MessageEmployee Navigator has created standard default text to display on an employee’s Home Page within a Welcome banner upon login. During the year, an employee will be in 1 of 3 “Welcome” stages. Each Welcome Message can be customized by you or the company HR Users to their liking:
Default Welcome – This Welcome Message displays mid-year when an employee is not in an activate enrollment window.
Welcome New Hire – This Welcome Message displays for as long as an employee is in their active New Hire window.
Welcome Open Enrollment – This Welcome Message displays for as long as an employee is in their active Open Enrollment window.
To configure the Home Page Welcome Messages and the additional communications items below, go to SETTINGS > COMMUNICATIONS
Enrollment ConfirmationOnce an employee is signed in to their Home Page, they may have the opportunity to complete their enrollment. Upon completion, they will be presented with a set of Instructions for Agreeing to their elections as well as standard default Agreement language. Each set of text can be customized by your or HR to their liking. There are 4 types of summaries or agreements to choose from:
New Hire Enrollment Agreement New Hire Enrollment Summary Instructions Open Enrollment Agreement Open Enrollment Summary Instructions
Home Page Articles, News & Email AlertsHome Page Articles are a way for your HR to post customized messages for employees to their Home Page. Articles are not condition specific (articles will be displayed for all employees) but can be inactivated at any time. Articles can be used quite literally to add articles about the company or to let employees know that there are internal job openings.
Home Page News and Email Alerts are a way for HR to not only create and post articles, but they will also can E-mail the posting to alert employees of the news. Home Page News can be sent out conditionally (by a specific Class Structure).
Customize Email TemplatesDefault text has been provided for each automatic or manually triggered e-mail that comes from Employee Navigator. Each Email can be edited to fit a company’s needs, add specific contact information, or additional Tokens. Tokens simplify the process. We will pre-fill certain data into the email for you, like the employee’s Name or your branded Login URL.
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Exercise 9.1 Customizing the Company Experience
First, we are going to add the company logo. It’s so important with all the employee’s sensitive information in the system that once they’ve logged in, they see a familiar logo and can rest easy that they’ve come to the right place.
Here is the firm’s logo to upload onto the site:
*The logo in .jpg format can also be found in the Company Build-out Workbook and Supplemental Documents article on the Support Site
Go to SETTINGS > EMPLOYEE EXPERIENCE > Company Logo & Branding
Next to Logo & Themes > click add > then Add a new logo & theme
Name your theme: Emily Conlan and Assoc Theme
Click upload to add Emily Conlan and Associates’ logo
Click Save
Next, we are a going to add a customized message for New Hires to welcome them to the team.
Go to SETTINGS > COMMUNICATIONS > Home Page Welcome Message
Click Add communication +
Select the Type of message you are customizing from the drop-down: Welcome New Hire [home page]
Enter the Name of this Welcome New Hire message: Welcome New Hire (custom)
Enter the example text below in the text box provided:
[Company] is delighted to have you on board and are sure that your presence will make our team
even more complete! Please proceed to ‘Start Benefits’ to add your newly eligible health insurance
elections. To make your transition to our group and our benefits easier, we have enclosed several
documents containing plan and company policies from your RESOURCES tab. Have questions? Please
contact your HR.
Now let’s create a Home Page Article to let them know about an upcoming team building picnic that your brokerage is sponsoring.
Go to SETTINGS > COMMUNICATIONS > Home Page Articles
Click Add an article +
Enter the Article Name: Reminder: Company Picnic
Enter your Home Page Article customized Text in the text box provided:
Friendly reminder that our company picnic sponsored by our [Brokerage Name Here], is this weekend.
We still need volunteers to help with games and dessert. You can sign-up for any open positions in the
conference room. Please contact HR with any questions?
Finally, before we begin adding employees and sending out Registration E-mails, let’s customize our E-mail template.
Go to SETTINGS > COMMUNICATIONS > Email Templates
Click Edit to change the Welcome New Hire Email Template
You can use the formatting tools to BOLD the [Company Identifier] Token so that employees don’t miss
this vital information needed to register. Also, add your HR User’s contact information to the signature
of the E-mail.
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Chapter 10 – The Employee Experience
Chapter Objective:
Add a demo employee for registration and test purposes Define the steps required to view and complete the enrollment process for an employee (Add
demographic information and assign onboarding tasks) Outline best practices for testing a company build
The Employee Point of ViewCongratulations. At this point the company should be in excellent shape and is almost ready to go live for employees. Prior to rolling out this company to your users, we recommend creating a demo employee and going through the complete life cycle of an employee on the system starting from manually adding the employee, creating their account and completing their enrollment process. This will provide you the opportunity to become familiar with all aspects of an employee and understand how the company setup and plan configuration translates to the employee.
Let’s go ahead and build out our demo employee.
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Exercise 10.1 Adding a Demo Employee
Go to the company EMPLOYEES tab> EMPLOYEE ACTIONS > Add Demo Employee and enter the following information:
Field Entry
Add Personal Information
First Name TestLast Name EmployeeGender FemaleDate of Birth 08/29/1990State Massachusetts
Add Employment Info
Hire Date [Today’s Date]Job Title AssociateClass Assignment AssociatesPayroll Group Bi-Weekly
Salary fields Pay Basis SalaryAnnual Base Salary $60,000
ACA/Statutory Classifications ACA Classification Eligible (Regularly works more than 30 hours a week)
Send [user] a registration email? Enter your email address > Send
Finished
Note: It is important that the group collects as much employee information as possible at the time the employee is added to the system. Although certain fields such as ACA classification are not necessarily required for groups not using EN as their ACA solution, adding employee ACA classifications will allow the group to easily utilize this platform as their ACA solution down the road.
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Employee Registration
Your test employee has now been successfully added to the company. Part of the account creation process was sending a registration email to the employee (your email address). The email stems from the new hire email template located under the company Settings > Email Templates tab. Go ahead and pull up the email sent to your email account which contains a clickable Registration link highlighted in blue.
Selecting the Registration link from the email will direct you to an account creation page where all you must do is enter a unique username, password, pin (last 4 digits of SSN), and agree to the terms of use in order to complete the registration process.
*Note: A fake SSN was applied to your demo employee during creation. You will need to access the SSN to obtain the last 4 digits which are needed for registration purposes.
To access the demo employee’s SSN:
Go to the company Home page > search for your demo employee by last name > select the ee Profile tab > Profile > write down the last 4 digits of the SSN.
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Exercise 10.2 The Enrollment Process
Now that we have successfully registered your employee, let’s take the employee through their new hire enrollment process:
Address 1 1212 Old Rock RoadCity Old RockZip 02639Phone Number 555-867-5309
Save & ContinueDependent Information
Add dependent +First Name SpouseLast Name EmployeeRelationship SpouseGender MaleDate of Birth July 10, 1990Fulltime College Student NoAddress Home
Save & Continue
Benefits:The next category in the enrollment flow is the benefits portion. Now that our personal and dependent information is entered, we can select the desired benefits.
Eligible dependents will appear within each benefit category on the top of the screen. Selecting their name will result in the coverage tier level to change along with the employee per pay cost.
Field EntryBenefitsMedical
Medical EE + Spouse 2017 Base Medical PlanConsumer Directed Health Ineligible
Dental EE + Spouse 2017 Dental PlanVision EE + Spouse 2017 Vision PlanLife, STD, LTD Save and ContinueVoluntary LTD Don’t want this benefit > CostVoluntary Life Select $50,000.00 > Enroll my spouse Flexible Spending Don’t want this benefit > Not interested
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AccountDependent Care Spending Account Don’t want this benefit > Not interested
Limited Purpose FSA Don’t want this benefit > Not interestedContinue
As you may remember, we setup Medical plans to require PCP information upon enrollment. Since we enrolled our employee in the 2017 Buy Up Medical Plan, the next step in the enrollment flow is to enter this required information for participants enrolled in the benefit.
Beneficiary was a required field contingent upon life enrollment. The employee will need to enter, at a minimum, a primary beneficiary prior to completing enrollment flow.
Select add a Primary Beneficiary > select Person as the beneficiary type > Spouse as the relationship > Assign 100% within Allocation field > Save.
Select Continue to view the full enrollment summary of enrolled plans, declined plans/declination reasons and Agree to the terms. You may print and save this summary as well for record keeping purposes.
You've just completed an entire company setup and enrolled an employee in benefits. Congratulations.
