Example: Setting up an insurance plan using a rate table

1. Select Setup > Codes > Employees > Benefits > Rate Table Setup.
2. On the Benefit Rate Table Setup page for Employer, select DEU (for US sample data) or DEC (for Canadian sample data).
3. Click Add.
4. On the Benefit Rate Table Setup Detail page, enter HMO1 for Code and 2023 Dep Plan Rates for Description.

5. On the Column 1 tab:

   1. For Column Heading, enter Insured Spouse.
   2. For Column Match Types, select Up to and including (because we are specifying rates for employee contributions).

   3. For Column Expression, enter a function to count the number of insured spouses an employee has:

      COUNTDEP("HMO1","SPOUSE")

      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.

6. Click the Column 2 tab and:

   1. For Column Heading, enter Insured Child.
   2. For Column Match Types, select Up to and including.

   3. For Column Expression, enter a function to count the number of insured children an employee has:

      COUNTDEP("HMO1","CHILD")

      Sage HRMS will count the number of dependents who are enrolled in the HMO1 benefit plan and who are defined as a child.

7. Click the Rate Table tab.

   Notice that the table includes two columns labeled Insured Spouse and Insured Child. Now you can set the order and rates for these two conditions.

When you set rates for the conditions you are checking for (in this 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.

1. On the Rate Table tab of the Benefit Rate Table Setup Detail page, set up the first rate ($0 for no spouse and no children):

   1. Click Add.

      Sage HRMS automatically inserts the number 1 in the Order column of the first row.

   2. Press Tab (to move to the Insured Spouse column) and enter 0.
   3. Press Tab (to move to the Insured Child column) and enter 0.
   4. Press Tab (to move to the Rate column) and enter 0 (since there is no charge for no spouse and no children).
   5. Press Enter to save this first rate (and move back to the Order column).

2. Set up the second rate ($100 for a spouse and no children):

   1. Click Add.

      Sage HRMS automatically inserts the number 2 in the Order column of the secondrow.

   2. Press Tab (to move to the Insured Spouse column) and enter 1.
   3. Press Tab (to move to the Insured Child column) and enter 0.
   4. Press Tab (to move to the Rate column) and enter 100.
   5. Press Enter to save this second rate.

3. Repeat the process, clicking Add for each new rate, until you've completed the rates for the example plan. The resulting table on the tab should include these numbers:

   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. When complete, click OK to save the rate table and return to the Benefit Rate Table Setup page. Notice the new rate table was added to the list of rate tables.

Now that you have set up the rate table, you can add the HMO1 benefit plan.

1. Select Setup > Codes > Employees > Benefits > Insurance Plans.
2. On the Benefit Insurance Plans page for Employer, select DEU (for US sample data) or DEC (for Canadian sample data).
3. Click Add. (If the system asks if you want to use the setup interview, click No.)
4. On the Benefit Insurance Plans Detail page, enter HMO 2020 for Code and HMO Medical Plan for Description.

5. On the General tab:

   • For Benefit Type, select Medical.
   • For Employee Contribution Frequency, select Monthly.
   • Select the Benefit Continuable Under COBRA or During LOA check box.

   Note: You do not need to enter anything on the Coverage Amount tab.

6. Click the Employee Premium tab and enter 100 for Monthly Employee Premium because the insurance company charges $100.00 monthly for each enrolled employee.
7. Click the Dependent Premium tab. Because the HMO1 rate table you just created is for dependent premiums, double-click it in the list of Available Rate Tables. (Sage HRMS displays in the Monthly Dependent Premium area.)

8. Click the Employee Contribution tab and enter the following information:

   • For Employee Contribution Amount, enter (BE.B_EPREMIUM*.5)+(BE.B_DPREMIUM*.75) to add 75% of the dependent premium to half of the employee premium.

     Tip: Even though half of $8.00 (the employee premium) is $4.00 (the employee contribution), we recommend you enter an expression to calculate the amount, rather than enter 4. Then, if the insurance company raises the premium from $8 to $10, all you have to do is update the Monthly Employee Premium to 8. Sage HRMS will then automatically calculate the employee contribution to be $5.00.

   • For Employee Contribution Frequency, select Monthly.

9. Click the Standard Eligibility tab and enter the following information:

   • For Salaried/Hourly, select Salary and Hourly.
   • For Employee Type, select Regular Full-Time.
   • For Minimum Age, enter 0.00.
   • For Minimum Hours, enter 40.00 because an employee must work at least 40 hours a week to be eligible.
   • For Min Days Employed, enter 0.
   • Select Original Hire Date, Day, and 0 months (so the coverage starts on the hire day).
   • Select the Automatically Add To Eligible Employees check box.
10. Click OK.