You use the implementation features of Standard and Advanced Benefits to design the benefit programs that you offer to your employees and other eligible participants. You can define eligibility and enrollment requirements for programs and plans, set up activity rate calculations, and define reporting groups and system extracts.
Advanced Benefits includes all the components of Standard Benefits plus features for managing life events and setting up flexible benefit programs.
See: Advanced Benefits Setup: Overview
Use the administration features of Standard and Advanced Benefits to manage benefits enrollments and to maintain your benefit programs.
See: Standard and Advanced Benefits Administration: Overview
See: Advanced Benefits Administration: Overview
The application provides a Total Compensation Setup Wizard to guide you through the setup process.
See: Total Compensation Setup Wizard
Standard and Advanced Benefits share a number of common setup features:
Plan Design: You can design the program structure of the benefits you offer to your employees and other qualified participants and dependents. Use the Total Compensation Setup Wizard to help automate the setup process.
Eligibility Profiles: You set up participant eligibility profiles and dependent coverage eligibility profiles to restrict who is able to participate in a benefit plan.
Enrollment Requirements: You define enrollment requirements to determine when an eligible person can enroll in a benefit plan.
Activity Rates: You define an activity rate calculation to determine the standard or variable contribution or distribution for a benefit. Activity rates also control the calculation of coverage amounts, monthly premiums, and imputed income taxation.
Communications: Oracle HRMS helps you manage employee communications. You set up communication type definitions to control the data the application generates for inclusion in a communication. For example, you can extract a participant's available benefit choices and price tags into a flat file that you then merge into the body of a pre-enrollment letter.
Note: The application restricts Standard Benefits users to setting up communications for COBRA and HIPAA administration.
System Extract: The system extract feature lets you manage the extract and format of person benefits data for delivery to organizations such as third party benefits administrators.
Plan Design Copy: Use this feature to save time during your implementation. You can set up your plan design in a test database, for example, then use Plan Design Copy to transfer the finalized design into your production database without repeating data entry. For plans that share components, you can define a plan once, then modify copies of the base plan as necessary.
You can set up Standard and Advanced Benefits so that individuals can manage their elections through a web browser, thus saving the back office from the task of election processing.
For information on setting up Self-Service Benefits enrollments, refer to My Oracle Support Note 215159.1, Self-Service Benefits Enrollments with Standard and Advanced Benefits.
To broaden your understanding of Standard Benefits, and features common to both Standard and Advanced Benefits, see:
Eligibility Requirements for Total Compensation
Self-Service Benefits Enrollments
Advanced Benefits enables administration based on life events that occur to participants. You can generate enrollment actions, activity rate changes, and communications based on seeded life events or events you define.
You also use Advanced Benefits to design benefit programs that are based on flex credit accrual.
In addition to the core features available with Standard Benefits, Advanced Benefits comprises several distinct features:
Life Events: The system lets you trigger enrollments, activity rate changes, and communications based on the occurrence of a life event to a primary participant or dependent.
Life Event Reasons: These are the changes to a person's HR record that you define as valid reasons for an enrollment action. Life events can be external, such as the birth of a dependent, or internal, such as a work location change or the start of an open enrollment period.
Online Benefits Administration: This feature is useful for HR call centers. Using the Benefits Service Center, you can record a change to a person's HR record, evaluate the change for enrollment impact, and process an election online all from a centralized form. You control the application windows, reports, and processes available to your benefits administrators.
Flex Credit Calculation: For those programs where you offer a choice of benefits and coverage levels, you can define flex credit calculations that determine the amount of flex credits a person must spend to purchase a benefit. You also define restrictions as to how a participant can distribute unused flex credits.
To learn more about Advanced Benefits, see:
Online Benefits Administration
Use Total Compensation Setup Wizard for a fast and easy way to enter your plan design into Oracle HRMS. Total Compensation Setup Wizard uses the Oracle Applications Framework to provide a task-oriented process for creating Health and Welfare programs and the business processing rules associated with them.
Advanced Benefits customers can use Total Compensation Setup Wizard to set up:
General program details for flex credit and non-flex credit programs
Health and Welfare plans, options, coverage amounts, coverage restrictions, interim coverages, standard and variable rate calculations, dependent and beneficiary eligibility, and designation requirements
Annual open enrollment periods
Explicit life events from a set of pre-determined data triggers that generate a corresponding enrollment period
Enrollment requirements for unrestricted programs
Enrollment requirements for specific life event processing (along with available dependent changes)
General or life event specific default enrollment requirements
Final plan design review page and submit process to load data into the business group
For Standard Benefits, the Total Compensation Setup Wizard automatically determines your configuration options. Use the Wizard to:
Configure your plan design
Set up unrestricted programs
Define participant eligibility requirements
Set up activity rates, including variable rates and coverage calculations
After you complete your plan design, you can use the Wizard to:
Update FastFormula in plan design objects
Update multiple standard and variable activity rates simultaneously (Mass Update of Rates)
You can then use the professional user interface to:
Define flex credit calculations and benefit pools (OAB)
Set up actual premium calculations
Define colliding life event logic (OAB)
Set up distribution rules if you offer reimbursement plans
Define communication types
Set up the Benefits Service Center for centralized administration (OAB)
As an Advanced Benefits customer, you can take advantage of a range of features, including:
Automated Life Event Management
What-If Eligibility Determination
Mass Enrollment Processing
Oracle strongly recommends that you implement the Life Event processing model to automate benefits administration. This model enables you to configure enrollment restrictions based on specific life events that you define. Life event processing manages complex situations; for example, when a participant reports a life event that occurred in the past and other elections are already in place, or when the elections and rates for a life event must become effective in the past.
Consider the following questions that illustrate the advantages of the Life Event processing model:
Do you want to process mid-year election changes automatically for a single participant? Would you like to perform mass enrollment updates or corrections?
Do you need to automatically assign certain benefits to employees or family members?
Do you anticipate automating your administration practices in the future? Do you need to enforce business rules, such as requiring or reminding a participant to designate dependents or requiring a participant to provide "Evidence of Insurability?"
Do you restrict an employee's benefit choices based on life events, such as a marriage or the addition of a child?
Would you like to operate in a Self-Service environment where employees record their own elections through a web browser? Would you like to allow employees to use Self-Service for mid-year election changes and to restrict the allowable updates based on the reason for the change?
Answering Yes to any of the above questions--in conjunction with planning the components of your benefits program--should justify implementing the life event model. The Total Compensation Setup Wizard assists you with this configuration.