After you set up your benefit types and the optional benefit rate tables, you are ready to set up your insurance plans. The Insurance Plans page contains codes, descriptions and data for every insurance plan your employer provides. Examples might include AD+D for Accidental Death and Dismemberment, HMO for HMO Health Care Insurance, and PPO for PPO Health Care Insurance.
Before you set up an insurance plan, we recommend you review Rules for Benefit Plan Data and Calculations.
Use the sample information to guide you through defining your insurance plan information. Refer to To Set Up an Insurance Plan Using Fixed Amounts and Expressions for a sample of setting up a simple group benefit plan, and To Set Up an Insurance Plan Using a Rate Table for a sample of setting up an insurance plan using a rate table.
Important! If you are using Sage ESS, you should never change or delete an insurance plan that is in use in a life event or attached to a life event that has not yet been transferred to Sage HRMS.
To Set Up a Benefit Insurance Plan
Steps to set up a Benefit Insurance Plan.
- Select Setup > Employees > Benefits > Insurance Plans.
- Select the level at which you want to set up the plan. Select Enterprise or a specific employer from the Employer list. Use the following information to help you decide:
- If you want the plan to only be available to a specific employer, select the Employer.
- If you want the plan to be available to all employers, select Enterprise.
- If you are using Sage ESS for Benefits Enrollment and you want the same plan to be available to multiple employers, but you want different open enrollment periods for each employer, you must set up a separate employer-level plan for each employer.
- If you are using Sage ESS for Benefits Enrollment, we recommend you set all insurance and savings plans at the employer level (not the Enterprise level).
- Click (if the setup interview dialog box displays, click ). The Benefits Insurance Plans Detail page opens. If you want to create a new insurance plan from an existing plan, click Copy.
- In theCode field, enter
a code to represent the plan. This code uniquely identifies the group benefit plan.
Note: Do not use special characters to define the code, specifically single quote ( ' ), percentage sign ( % ), and underscore ( _ ).
- In the Description field, enter a longer description of the plan you are setting up. This description will appear as a selection on the employees' Insurance Benefits page. It will also print on benefit statement reports, such as the Benefit Enrollment by Plan and Benefit Premium Totals by Plan.
From the Benefits Insurance Plans Detail page you can:
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Define General Information
This will include general information about the plan, including the code and description, employee contribution frequency, plan type, and COBRA continuation.
The General Information tab contains the following fields.
Field Label Field Description Benefit Type
Select a benefit type. These types originate from the Benefit Type code table.
Employee Contribution Frequency
Indicate the frequency at which employee deductions are made. Select a default value from the drop-down list: weekly, biweekly, semimonthly, or monthly.
Note: The frequency at which the employee pays the contribution might differ from the frequency at which premium charges are paid. Premium charges always appear as monthly figures in reports and on other pages.
Benefit Continuable Under COBRA
Indicate whether or not your employer offers this benefit to employees according to COBRA guidelines. When you terminate an employee, Sage HRMS gives you the opportunity of entering a date on which COBRA and non-COBRA benefits will expire for the employee.
Plan Is In Effect
Indicate when this plan is being offered. Employee coverage in the plan cannot start before the beginning of the plan's Effective Period, and employee coverage will automatically expire at the end of the plan's Effective Period.
If you don't want any restrictions as to when employees can be covered by this plan, leave the dates blank.
Note: If you are using Sage ESS for benefits enrollment, you must provide a From and To date, regardless of whether the plan will be used for open enrollment or life events.
Current Amounts Went Into Effect On
Enter the date the new amounts should go into effect. On this date, all employees enrolled in the benefit plans will be updated with the current amounts. Plan amounts are updated for employees regardless of whether they were enrolled using Employee Self Service or enrolled using Sage HRMS.
If you are using Sage ESS for Benefits Enrollment, this date will automatically be updated when the new plan year takes effect.
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Define the Coverage Per Employee and Dependents
Coverage is the amount of benefits an insurance plan provides to eligible employees. In some insurance plans, coverage is the same for all participants. For other participants, coverage varies according to the participants job group, salary, seniority or benefit choices.
Dependent coverage is the amount of benefits an insurance plan provides to the dependents of eligible employees.
Note: If coverage is applicable to this plan and you are using Sage ESS for Benefits Enrollment, you must define the coverage in order to make this plan available for open enrollment or life events.
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Define the Employee Premium
The monthly employee premium is the amount of the monthly bill from the insurance company for the employee's benefit. It includes both the employees and the employers contribution. For self-insured plans, this amount is the premium-equivalent and is always paid monthly, which is not necessarily the same period as the employee contribution.
Note: If you are using Sage ESS for Benefits Enrollment, you must define the employee premium in order to make this plan available for open enrollment or life events.
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Define the Dependent Premium
The monthly dependent premium is the amount of the monthly bill from the insurance company for the employee's dependents. It includes both the employees and the employers contribution toward the dependent premium. For self-insured plans, this amount is the premium-equivalent, paid monthly, which is not necessarily the same period as the employee contribution.
Note: If a dependent premium is applicable to this plan and you are using Sage Employee Self Service for Benefits Enrollment, you must define the dependent premium in order to make this plan available for open enrollment or life events.
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Define the Employee Contribution
This is the amount the employee contributes toward the total premium charges.
The Employee Contribution Frequency determines how often the employee pays their contribution for the plan. The selection in this field defaults to the selection you made on the General tab.
Note: If an employee contribution is applicable to this plan and you are using Sage ESS for benefits enrollment, you must define the employee contribution in order to make this plan available for open enrollment or life events
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Define Eligibility Requirements
Not every employee is eligible to participate in every plan. The eligibility requirements you set up for an insurance plan define which employees are eligible and which are not. After you define eligibility, you can direct Sage HRMS to automatically add the benefit to all eligible employees.
If all employees are eligible for the plan, leave the fields blank. Refer to your employer's policies and the particular insurance policy for eligibility requirements.
Note: If you are using Sage Employee Self Service for open enrollment, you do not need to define eligibility requirements here. Rather, you will define them in the Sage Employee Self Service module when you set up your plans for open enrollment or life events.
The Standard Eligibility tab contains the following fields.
Field Label Field Description Salaried/Hourly
Indicate which employees are eligible for this plan. Select a default value from the drop-down list: Salary, Hourly, or Salary and Hourly.
Employee Type
Use this field to limit eligibility to Regular Full-Time, Regular Part-Time or any other employee type you defined in the Employee Type code table. If you select None Specified, the benefit plan applies to employees of all status codes.
Minimum Age
The start date for the benefit becomes the date on which the employee reaches the minimum age.
Minimum Hours
This field can limit a benefit plan to employees who work at least a specified number of hours or units per pay frequency. Sage HRMS compares this field to the Hours/Units field on the Current Pay page.
Minimum Days Employed
The effective start date for the benefit is the date the employee reaches the minimum number of days employed. Entering zero means the benefit requires no minimum days employed and employees are eligible on the first day of the following month.
Automatically Add To Eligible Employees
Indicate whether to have Sage HRMS add the benefit to all active employees who meet all the eligibility requirements (both Standard and Custom). When you have finished setting up the plan and click to save all your data, Sage HRMS proceeds to add the benefit to eligible employees.
Some points to consider:
- An active employee has an employee status of Active (defined on the Current Job page). Sage HRMS does not automatically add benefits to employees who are terminated, on leave of absence or classified as COBRA dependents.
- When you add new active employees to the program, Sage HRMS assigns the benefit if they meet the eligibility requirements.
- If you define eligibility criteria incorrectly and direct Sage HRMS to automatically add the benefit to the wrong group of employees, delete the benefit code from all employees. You can then re-enter the benefit code and specify a different group of employees.
Use <Date> to Start Benefit
Use these fields to define a waiting period for eligibility after the employee meets all other requirements. You can use the Original Hire Date, Last Hire Date or the Adjusted Seniority Date to determine when to start the benefit. Choose to start the benefit on the first day (click the Day radio button) following a specific number of months or on the first day of the month (click the Month radio button) following a specific number of months.
If you need to enter additional eligibility criteria, click the Custom Eligibility tab. You can enter an expression or use the Expression Builder to specify even more precisely those employees eligible for the benefit plan. For instance, Sage HRMS will exclude Regular Part Time employees if you enter the expression, PE.P_EMPLOY<>"RPT".
Defining custom criteria does not affect the start date of the benefit. For more information, see Expressions and Functions.
Complete the Process
After you've entered all your insurance benefit plan information, click . Sage HRMS asks if you want to update the employee benefit file with the new calculations.
Click to update the employee benefit file and then click when Sage HRMS completes the update.
Note: To enroll an employee in an insurance benefit plan, open the employee's Insurance Benefits page, click , then enter the appropriate information for the employee.
Set Up the Plan as an Open Enrollment Plan
If you also use Sage ESS for Benefits Enrollment and you want this plan to be available to your employees for open enrollment or life events, go to Set Up Open Enrollment Insurance Plans for instructions.