R12 Oracle HRMS Advanced Benefits Fundamentals Student Guide D48246GC20 Edition 2.0 April 2009 D59753
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Table of Contents R12 HRMS Advanced Benefits Fundamentals...1-1 R12 HRMS Advanced Benefits Fundamentals...1-3 Objectives...1-4 Agenda...1-5 Overview of Implementing Advanced Benefits...2-1 Overview of Implementing Advanced Benefits...2-3 Introduction...2-4 Topics...2-5 Introducing Advanced Benefits...2-6 Total Compensation...2-7 Flexible Benefits Programs...2-8 Build a Benefits Program...2-9 Plan Types...2-10 Life Events...2-11 Eligibility Profiles...2-12 Contributions and Distributions...2-13 Actual Premiums...2-14 Advanced Benefits and Oracle Payroll...2-15 Communications...2-16 Benefits Service Center...2-17 View Program Structure...2-18 Eligibility Management...2-19 Enrollment Cycle Automation...2-20 Total Compensation Setup Wizard...2-21 Reviewing a Sample Implementation and Enrollment...3-1 Reviewing a Sample Implementation and Enrollment...3-3 Vision...3-4 Vision - Seeded Compensation Objects...3-5 Vision - Seeded Plan Design...3-6 Enrollment...3-7 Following the Implementation Steps...4-1 Following the Implementation Steps...4-3 Building Blocks...4-4 Building Blocks Examples...4-5 Implementation Sequence...4-6 Summary...4-10 Life Events...5-1 Life Events...5-3 Objectives...5-4 Topics...5-5 Overview...5-6 Defining Life Events...5-9 Life Event Types Explicit...5-10 Life Event Types Temporal...5-11 Life Event Types Scheduled...5-12 Seeded Life Events...5-13 Life Event Detection...5-14 Potential Life Events...5-15 Active Life Events...5-16 Life Event Occurred Date...5-17 i
Managing Life Events...5-18 Overriding Life Events...5-19 Overriding Life Events: Example...5-20 Person Changes and Related Person Changes...5-21 Defining a Person Change Single Database Column...5-22 Defining a Person Change Multiple Database Columns...5-23 Trigger Life Events from Multiple Table Triggers...5-24 FastFormula Rules for Person Changes...5-25 Causes Related Person Life Events...5-26 Related Person Life Events...5-27 Implementation Considerations...5-28 Defining Collapsing Life Events...6-1 Defining Collapsing Life Events...6-3 Collapsing Life Events...6-4 Collapsing Life Events - Example...6-5 Collapsing Life Events...6-6 Linking Life Events to Compensation Objects...7-1 Linking Life Events to Compensation Objects...7-3 Life Event Reasons and Compensation Objects...7-4 Life Events Usage...7-5 Life Events Versus Eligibility Profiles...7-7 Impact on Eligibility and Enrollment...7-9 Summary...7-10 Benefits Enrollment Requirements...8-1 Benefits Enrollment Requirements...8-3 Introduction...8-4 Enrollment Requirements and Plan Design...8-5 Topics...8-6 Objectives...8-7 Introducing Enrollment Requirements...8-8 Key Concepts...8-9 Enrollment Methods...8-10 Enrollment Codes...8-11 Default Enrollments...8-12 Enrollment Timing...8-13 Coverage and Rate Dates...8-14 Enrollment Types...8-15 The Participation Process...8-16 Enrollment Hierarchies...8-17 Defining Program and Plan Enrollment Requirements...9-1 Defining Program and Plan Enrollment Requirements...9-3 Defining Enrollment Requirements...9-4 Program Enrollment Requirements...9-5 Plan Enrollment Requirements...9-6 Layout of Enrollment Requirements Window...9-7 General Enrollment Requirements...9-8 Timing Enrollment Requirements Scheduled...9-11 Timing Enrollment Requirements Life Event...9-12 Life Event Change Requirements...9-13 Plan Enrollment Requirements...9-15 Defining Action Items and Certifications...10-1 Defining Action Items and Certifications...10-3 Overview...10-4 Action Items...10-5 ii
Enrollment Action Types...10-6 Action Items - Required or Optional...10-7 Completing Action Items...10-8 Certifications...10-9 Enrollment Certifications...10-10 Link Certifications to Compensation Objects...10-11 Completing Certifications...10-12 Suspended Elections and Interim Coverages...10-13 Managing Suspended Elections and Interim Coverages...11-1 Managing Suspended Elections and Interim Coverages...11-3 Suspended Enrollments...11-4 Interim Coverage...11-5 Coverage Restrictions...11-6 Summary...11-7 Dependent and Beneficiary Designation...12-1 Dependent and Beneficiary Designation...12-3 Overview...12-4 Topics...12-7 Objectives...12-8 Dependent Coverage Eligibility Profiles...12-9 Relationship Profiles...12-11 Age Profiles...12-12 Status Profiles...12-13 Postal Zip Profiles...12-14 Other Profile Types...12-15 Link Profiles to Compensation Objects...12-16 Designation Levels...12-17 Other Designation Information for Compensation Objects...12-18 Dependent Certifications (Advanced Benefits)...12-19 Dependent Coverage and Life Events...12-20 Dependent Designation Requirements...13-1 Dependent Designation Requirements...13-3 Overview...13-4 Relationship Groups...13-5 Designation Requirements...13-6 Family Member Codes...13-7 Eligibility Check Codes...13-9 Beneficiary Designations...14-1 Beneficiary Designations...14-3 Beneficiary Certifications (Advanced Benefits)...14-5 Summary...14-6 Activity Rates and Coverage Calculations...15-1 Activity Rates and Coverage Calculations...15-3 Introduction...15-4 Link Variable Rate Profiles to Rate Calculations...15-6 Standard Rates - Basic Diagram...15-7 Rate Characteristics...15-8 Topics...15-10 Objectives...15-11 Defining Variable Rate Profiles...15-12 Variable Factors...15-13 Variable Rate Profiles...15-14 Link Variable Rate Profiles to Rate Calculations...15-15 Example - Variable Standard Rate...15-16 iii
Example - Variable Premium...15-17 Example - Variable Coverage Calculation...15-18 Variable Rate Calculation...15-19 Calculation Methods...15-20 Defining Coverage Calculations...16-1 Defining Coverage Calculations...16-3 Coverage Calculations...16-4 Coverage Association Levels...16-5 Building Coverage Calculations...16-6 Example - Fixed Coverage...16-7 Example - Variable Coverage...16-8 Defining Coverage Calculations...16-9 Calculation Methods...16-10 Defining Actual Premiums...17-1 Defining Actual Premiums...17-3 Introduction...17-4 Premium Calculations...17-5 Link Premiums to Compensation Objects...17-6 Examples - Actual Premium...17-7 Defining Premium Calculations...17-8 Premium Assignment...17-9 Premium Assignment Level...17-10 Calculation Methods...17-11 Partial Month and Prorated Processing...17-12 Premium Credits...17-13 View Premium Results...17-14 Setting Up Benefits Elements...18-1 Setting Up Benefits Elements...18-3 Elements and Benefits...18-4 Element Entries...18-5 Defining the Element...18-6 Linking Elements for Benefits...18-7 Element Links...18-8 Defining Standard Contributions and Distributions...19-1 Defining Standard Contributions and Distributions...19-3 Overview...19-4 Standard Rates Concepts...19-5 Defined, Communicated, and Annual Amounts...19-6 Building Standard Rates...19-7 Standard Rates - Basic Diagram...19-8 Standard Rates Levels...19-9 Standard Rates - Multiple of Coverage...19-10 Standard Rates - Multiple of Premium...19-11 Standard Rates - Parent/Child...19-12 Key Concepts...19-13 Activity Types...19-14 Activity Types - Specific Types...19-15 Elements and Input Values...19-16 Calculation Methods...19-17 Partial Month Determination...19-18 Annual Rates...19-19 Processing Information...19-20 Summary...19-23 iv
Flex Credits and Benefits Pools...20-1 Flex Credits and Benefits Pools...20-3 Objectives...20-4 Topics...20-5 Defining Flex Credits...20-6 Introduction...20-7 Key Concepts...20-8 Setting Up a Flex Program...20-9 Flex Credits Shell Plan...20-10 Flex Credit Shell Plan and Standard Rates...20-11 A Statement of Earnings - Total Credits...20-12 Net Credits...20-13 Defining Flex Credits...20-14 Flex Credits Levels...20-15 Defining Combinations of Compensation Objects...20-16 Activity Types for Flex Credits...20-17 Calculation Methods for Flex Credits...20-18 Defining Benefits Pools...21-1 Defining Benefits Pools...21-3 Benefits Pools...21-4 Benefits Pools: Credit and Debit Ledger...21-6 Setting Up a Benefits Pool...21-7 Excess Treatment...21-8 Benefits Pools for Net Credits...21-9 Flex Credit Application...21-10 Flex Credit Rollovers...21-11 Summary...21-12 Benefits Communications...22-1 Benefits Communications...22-3 Overview...22-4 Communication Types...22-5 Communications...22-6 Topics...22-7 Objectives...22-8 Defining a Communication Type...22-9 Communication Types...22-10 Kits and Pieces...22-11 Communication Triggers...22-12 Communication Usages...22-13 Defining Usages...22-14 Communications Delivery...22-15 Person Communications...22-16 Summary...22-17 U.S. Benefits Regulations...23-1 U.S. Benefits Regulations...23-3 Overview...23-4 Topics...23-5 Objectives...23-6 Setting Up Imputed Income Plans...23-7 Overview...23-8 Plans Subject to Imputed Income...23-9 Imputed Income Shell Plans...23-11 Imputed Income Plan Hierarchy...23-12 Imputed Income - Standard Rates...23-13 v
Imputed Income - Variable Rates...23-14 Imputed Income Calculations...23-15 Introducing COBRA...24-1 Introducing COBRA...24-3 COBRA Overview...24-4 COBRA Administration with Oracle HRMS...24-7 COBRA Processing...24-8 Benefits Assignments...24-9 Setup for COBRA Administration...24-10 COBRA Administration...24-11 Defining COBRA Programs and Plans...25-1 Defining COBRA Programs and Plans...25-3 Defining COBRA Plans and Programs...25-4 Defining Plans Subject to COBRA...25-5 Defining COBRA Programs...25-6 COBRA Enrollment Period Level...25-7 Length of COBRA Coverage...25-8 Defining COBRA Life Events and Eligibility Profiles...26-1 Defining COBRA Life Events and Eligibility Profiles...26-3 COBRA Life Events (Advanced Benefits)...26-4 Subsequent Life Events (Advanced Benefits)...26-5 Defining a COBRA Qualified Life Event...26-6 Defining COBRA Enrollment Requirements...26-7 COBRA Eligibility Profiles...26-9 Defining COBRA Activity Rates...27-1 Defining COBRA Activity Rates...27-3 COBRA Activity Rates...27-4 Defining COBRA Rates...27-5 Generating HIPAA Certificates...28-1 Generating HIPAA Certificates...28-3 Overview...28-4 HIPAA...28-5 HIPAA Certifications...28-7 HIPAA Certification Setup Steps...28-8 Defining Plans Subject to HIPAA...28-9 HIPAA Communication Types...28-10 HIPAA Processing...28-11 Summary...28-12 Online Benefits Services...29-1 Online Benefits Services...29-3 Introduction...29-4 Topics...29-5 Objectives...29-6 Setting Up the Benefits Service Center...29-7 Concepts...29-8 Real-Time Life Event Management...29-9 Desktop Activities...29-10 Message Configuration...29-12 Summary...29-13 Benefits Enrollment...30-1 Benefits Enrollment...30-3 Introduction...30-4 Topics...30-5 vi
Objectives...30-6 Overview of Administering Advanced Benefits...30-7 Overview...30-8 Benefits Administration...30-9 Enrollment Cycles...30-10 Monthly Administration Cycle...30-12 Open Enrollment (Scheduled)...30-14 Enrollment Processing...30-16 Eligibility Management...30-17 Enrollment Cycle Automation...30-18 Employee Communications...30-19 Premium Calculation...30-20 System Extract...30-21 Management Reporting...30-22 Continuing Benefits...30-23 Running the Participation Process...31-1 Running the Participation Process...31-3 Overview...31-4 Implementation...31-5 Run the Participation Process...31-6 Process Enrollments...31-7 The Participation Process...31-8 Participation Process: Modes...31-9 Participation Process: Selection...31-10 Participation Process: Life Event...31-11 Participation Process: Scheduled...31-12 Participation Process: Temporal...31-13 Participation Process Parameters...31-14 Managing Life Events...32-1 Managing Life Events...32-3 Overview...32-4 Life Event Management...32-5 Life Event Detection...32-6 Multiple Potentials...32-7 Life Event Statuses...32-8 Viewing a Person's Life Events...32-9 Viewing Participation...32-10 Life Events Summary Report...32-11 Enrolling Participants...33-1 Enrolling Participants...33-3 Overview...33-4 Benefits Enrollment...33-5 Enrollment Windows...33-6 Flex Program Window...33-7 Non-Flex Program Window...33-8 Savings Plan Window...33-9 Miscellaneous Plan Window...33-10 Enrollment Process...33-11 Deleting an Enrollment...33-12 Other Considerations...33-13 Covering Dependents and Designating Beneficiaries...34-1 Covering Dependents and Designating Beneficiaries...34-3 Overview...34-4 Dependent/Beneficiary Designation Window...34-5 Dependent Designation...34-6 vii
Unrestricted Designations...34-7 Designation Details...34-8 Beneficiary Designations...34-9 Reviewing Enrollment Results...35-1 Reviewing Enrollment Results...35-3 Overview...35-4 Displaying Enrollment Results...35-5 When to View Results...35-6 Viewing Results By Date...35-7 Viewing Element Entries...35-8 Enrollment Reports...35-9 Benefits Enrollment Kit Report...35-10 Benefits Enrollment and Summary Report...35-11 Summary...35-12 Using the Total Compensation Setup Wizard...36-1 Using the Total Compensation Setup Wizard...36-3 Objectives...36-4 Advantages of Using the Total Compensation Setup Wizard...36-5 Providing a Complete Solution...36-6 Configuring Plan Design...36-7 What You Cannot Do...36-8 Summary...36-9 Summary...37-1 Summary...37-3 viii