Eligibility Profile Criteria

You can define from one to dozens of eligibility criteria for an eligibility profile. Criteria are divided into personal criteria, employment criteria, derived factors, and other criteria, as follows.

Note: The criteria that you can select depends on whether you have accessed the Participation Eligibility Profiles window from the Total Compensation or Collective Agreements area of the application.

Personal Criteria

You select personal eligibility criteria from the Personal tab of the Eligibility Profiles window.

Competencies: Uses the first three enabled segments defined for the Competency Key Flexfield for the business group as criteria.

Disability: Uses an employee's disability category as eligibility criteria.

Gender:Uses an employee's gender as eligibility criteria.

Leaving Reason: Uses an employee's termination reason as eligibility criteria. This criteria are often used for continuing benefits eligibility, such as for COBRA in the US

Opted for Medicare: Uses whether or not an employee is enrolled in Medicare as eligibility criteria.

Person Type: Uses a person's person type(s) as eligibility criteria.

Postal Zip: Uses individual zip/postal codes or ranges of zip/postal codes as eligibility criteria.

Qualification Title: Uses a person's qualification title as eligibility criteria.

Service Area: Uses a person's service area, such as a city or other geographical area, as an eligibility criteria.

Tobacco Use: Uses whether or not a person uses tobacco as a variable factor to associate with an activity rate. In countries where it is illegal to hold information about a person's tobacco usage, for example, Italy, this personal factor is unavailable.

Employment Criteria

You select employment criteria from the Employment tab of the Eligibility Profiles window.

Assignment Set: Uses an employee's assignment or a set of assignments as eligibility criteria.

Assignment Status: Uses a person's state of employment (Active, Inactive, or On Leave) as an eligibility criteria.

Bargaining Unit: Uses an employee's bargaining unit (local union group) as eligibility criteria.

Full/Part Time: Uses whether an employee works full-time or part-time as eligibility criteria.

Grade: Uses an employee's grade as eligibility criteria.

Hourly/Salaried: Uses an employee's pay basis, either hourly or salaried, as eligibility criteria.

Job: Uses an employee's job classification as eligibility criteria.

Labor Union Member: Uses whether an employee is a union member as eligibility criteria.

Leave of Absence: Uses an employee's leave of absence reason as an eligibility criteria.

Legal Entity: Uses an employee's legal entity (GRE) as eligibility criteria for a benefit (US only).

Organization Unit: Uses an employee's organization as eligibility criteria.

Pay Basis: Uses an employee's pay basis as eligibility criteria.

Payroll: Uses the employee's payroll as eligibility criteria.

People Group: Uses a person's People group as eligibility criteria.

Performance Rating: Uses an employee's performance rating as criteria.

Position: Uses a person's position as eligibility criteria.

Quartile in Grade: Uses an employee's pay range for a grade, divided by four, to determine the quarter into which the person's salary amount falls.

Range of Scheduled Hours: Uses the number of hours an employee is scheduled to work as eligibility criteria. This is taken from the Working Hours field on the assignment. For employees with more than one assignment, the hours are totaled across all assignments if you check the 'Use All Assignments for Eligibility' check box on either the Programs or Plans window. If you define multiple scheduled hours ranges, the Participation Process evaluates each range as an 'Or' condition.

Work Location: Uses an employee's work location as eligibility criteria.

Derived Factor Criteria

You select derived factor eligibility criteria from the Factors tab of the Eligibility Profiles window.

Age: Uses an employee's age as eligibility criteria.

Combination Age/LOS: Uses an employee's combination age and length of service factor as eligibility criteria.

Compensation Level: Uses an employee's compensation level as eligibility criteria.

Full-time Equivalent: Uses an employee's percent of full-time employment as eligibility criteria. The full-time equivalent source derives from the Assignment Budget Values window.

Hours Worked: Uses an employee's hours worked in a given period as eligibility criteria.

Length of Service: Uses an employee's length of service as eligibility criteria.

Other Criteria

You select miscellaneous eligibility criteria from the Other tab of the Eligibility Profiles window.

Benefits Group: Uses a person's benefits group as eligibility criteria.

COBRA Qualified Beneficiary: Uses whether a person is considered a qualified beneficiary under COBRA regulations to determine eligibility (US only).

Continuing Participation: Used to set the date on which an ex-employee's payment for a continuing benefit must be received.

Participant in Another Plan: Uses a person's participation in another plan as eligibility criteria.

Total Coverage Volume: Uses the total coverage elected for a plan or option in plan by all participants as a variable factor in determining the actual premium owed by a plan sponsor to the benefits supplier.

Total Participants: Uses the total number of participants covered by a plan or option in plan as a variable factor in determining the actual premium owed by a plan sponsor to the benefits supplier.

User Defined Criteria: Displays the user-defined criteria that you created to meet the particular needs of your organization. These criteria are not part of the standard criteria that Oracle HRMS delivers, and you must create these on your own. See: User-defined Eligibility Criteria

Rule: Uses an eligibility rule, instead of an eligibility profile, to refine or augment eligibility criteria for a benefit or collective agreement entitlement.

Related Coverages

The criteria available under the Related Coverages tab are designed primarily for COBRA administration in the US but, you can use them for other purposes.

See: COBRA Eligibility Profiles