Related topics

Sample Benefit Plans

Set Up an Insurance Plan Using a Rate Table

This example shows you how to set up a simple group benefit plan for a health maintenance organization (HMO) using a rate table. The sample employer offers the HMO as part of a 125 cafeteria plan to Regular full-time employees who work a minimum of 40 hours a week. The ABC insurance company charges $100 per month for each employee enrolled in the HMO and charges the following rates for any enrolled dependents:

The employer pays half of the employee's premium but only pays 25% of the employee's dependent premiums. Consequently, employees contribute half of their own premiums and 75% of the premiums for enrolled dependents.

You must first set up the plan's rate table so you can reference it when you set up the group benefit plan.

Note: You cannot have more than one benefit plan reference the same rate table. For example, if you set up an "HMO" rate table and you know you will want five benefit plans to reference it, set up five separate rate tables with the same values, naming them HMO, HMO1, HMO2, HMO3, and HMO4. Using the Copy Table button on the Benefit Rate Table Setup page enables you to copy a rate table with the same values, but enter a different code and description.

Example of a Benefit Rate Table Setup

ClosedSet Up a Rate Table
  1. Select Setup > Employees > Benefits > Rate Table Setup.
  2. From the Employer drop-down list, select DEU (or DEC for Canadian sample data).
  3. Click Add. The Benefit Rate Table Setup Detail page opens.
  4. For our example, enter HMO1 in the Code field and 2016 Dep Plan Rates in the Description field.
  5. On the Column 1 tab, enter Insured Spouse as the Column Heading.
  6. From the Column Match Types drop-down list, select Up To and Including since we are defining rates for employee contributions.
  7. Enter a function to count the number of insured spouses an employee has. For our example, we will use the COUNTDEP() function to count the different types of enrolled dependents. In the Column Expression field, type COUNTDEP("HMO1","SPOUSE").
    • This means Sage HRMS will count the number of dependents who are enrolled in the HMO1 benefit plan ("HMO1" is the benefit plan code) and who are defined as a Spouse.
  8. Click the Column 2 tab.
  9. Enter a column heading for the second condition to check for the number of children the employee has. For our example, enter Insured Child in the Column Heading field.
  10. Select Up To and Including for the Column Match Type.
  11. In the Column Expression field, use the same COUNTDEP() function to count the number of children. Type COUNTDEP("HMO1","CHILD").
    • This means Sage HRMS will count the number of dependents who are enrolled in the HMO1 benefit plan and who are defined as a child. Because you are only checking for two conditions, do not enter any information for Column 3.
  12. Click the Rate Table tab. Notice that Sage HRMS has defined the two columns Insured Spouse and Insured Child. Now you can set the order and rates for these two conditions.
ClosedEnter Rate Table Data

When you set rates for the conditions you are checking for (in our example, Insured Spouse and Insured Child), you specify the order in which Sage HRMS checks the conditions and the rates it should use for those conditions.

Remember, we are setting these rates:

  • $0 for no spouse and no children
  • $100 for a spouse and no children
  • $75 for no spouse and one child
  • $150 for a spouse and one child
  • $250 for a spouse and two or more children
  1. On the Rate Table tab, click Add. Sage HRMS automatically inserts the number 1 in the Order column of the first row. Press Tab to move to the Insured Spouse column.
  2. To set up the first rate, enter 0 for Insured Spouse,press Tab to move to the Insured Child column and enter 0. Press Tab to move to the Rate column and enter 0, since there is no charge for no spouse and no children. Press Enter to save your rate and move back to the Order column.
  3. Click Add to set the next rate. Sage HRMS inserts the number 2 in the Order column. Press Tab and enter 1 in the Insured Spouse column. Press Tab and enter 0 in the Insured Child column. Press Tab and enter 100 in the Rate column. Press Enter to save your rate and move back to the Order column.

    4. The order and conditions for the rate table follow a simple progression illustrated by the following table.

    Order Insured Spouse Insured Child Rate

    1

    0

    0

    0

    2

    1

    0

    100

    3

    0

    1

    75

    4

    1

    1

    150

    5

    1

    99

    250
  4. Repeat the process, clicking Add for each new rate, until you've completed the rates for the example plan.
  5. Click OK to save your rate table. Sage HRMS returns you to the Benefit Rate Table Setup page. Notice the HMO1 plan has been added to your list of rate tables.
  6. Now that you've set up your rate table, you're ready to add the HMO1 benefit plan.

Published: April 11, 2017
© 2017 The Sage Group plc or its licensors. All rights reserved. Privacy Policy | Copyright/Trademarks