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Select the “Health Plan Details” link
The “Health Plan Details” page appears.
The system displays the following.
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Date format |
The date format of the previous page. |
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Benefits Definition Unit |
The benefits definition unit selected in the previous page |
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Currency |
The currency in which premium is paid for the benefit plan. |
To specify Coverage limits of the health plan
Enter the following details in the “Coverage Limits” group box.
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Deductible per Year (Amt) |
The maximum amount that can be deducted from the employee salary for a benefit year. |
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Per |
From the drop-down list box select the value for which the deductible amount is applicable. The drop-down list box displays two values namely “Individual” and Family. By default the system will display with blank. For example, if you enter $1000 dollars in the deductible per year field, and select “Individual” from the “Per” drop-down list box, you indicate that the maximum amount the employee can contribute for the plan for individual coverage in the benefit year s $1000. |
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Coinsurance (%) |
The percentage of coverage amount that the benefit provider agrees to contribute for the plan. |
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Maximum Out of Pocket Expenses (Amt) |
The maximum amount that can be covered for a benefit year. |
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Life Time Maximum (Amt) |
The maximum amount that the employee can be covered for the entire life. |
To specify COBRA Details for a health plan
You can enter the COBRA related details only if the health plan is COBRA enabled.
Enter or select the following in the Cobra Details group box.
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Validity Period |
The period for which the employee can be enrolled for the health plan. This period is defined under the statute. Enter the period for which the employee can enroll in the plan under COBRA. The drop-down list box beside, will display with “Days”. For example, if the employee is separated from the company, he can be enrolled in the plan for a period of 18 months. |
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Waiting Period |
The period for which the employee has to wait before enrolling in the plan under COBRA. Enter the waiting period in the field and from the drop-down list box select the required unit. The drop-down list box contains the following values namely days and months. Select one value. By default the drop-down list box will display with a blank value. |
To compute the employee contribution under COBRA
To compute the employee contribution you can specify a rule name that will compute the employee contribution for the plan if is not equal to the sum of employer and employee contribution and service charges.
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Premium is a Sum of Employee And Employer Contribution |
Select the check box to indicate that the premium paid by the employee under the COBRA is the sum of the employee and employer contribution. |
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Service Charge (%) |
Enter the percentage of the contribution amount that is charged by the company for the services rendered. |
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Rule |
Enter the rule name that will compute the contribution amount for the employee. |
Note that you can either select the check box or define the rule for computing employee contribution for the plan and not both.
To specify the family coverage details applicable for the plan
he system displays the list of all the family coverage categories that have been in the “Create Family Coverage Category” activity of Benefits General Information component in the multiline.
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Family Coverage Description |
The description of the family coverage category |
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Maximum Dependents Allowed |
The maximum dependents allowed for the family coverage. |
Select the “Applicable” check box in the multiline to indicate that the corresponding family coverage categories are applicable for the plan.
Select the “Save ” pushbutton to save the details entered.
Use this page to define or modify a health plan
To specify Coverage limits of the health plan
To specify COBRA Details for a health plan
To compute the employee contribution under COBRA
To specify the family coverage details applicable for the plan
Through this page, you can define various health related plans. The different types of health plans are medical, dental, vision, etc. you can define the plan only if the provider of the plan has been defined in the “Create Benefit Provider” activity of the Benefits General Information component.