Setting up benefit insurance plans

After you set up your benefit types and the optional benefit rate tables, you are ready to set up your insurance plans. The Benefit Savings Plans page contains a table with the codes, descriptions, and data for every insurance plan that is set up for the employer, such as an Accidental Death and Dismemberment plan, HMO Health Care Insurance plan, and PPO Health Care Insurance plan.

Tip: Before you set up an insurance plan, we recommend you review the Rules for benefit plan data and calculations. Use the sample information to guide you through the setup. See Example: Setting up an insurance plan using fixed amounts and expressions and Example: Setting up an insurance plan using a rate table.

To add a benefit insurance plan:

1. Select Setup > Codes > Employees > Benefits > Insurance Plans.

2. On the Benefit Insurance Plans page for Employer, select the level at which you want to set up the plan. Select Enterprise or a specific employer. Considerations...

   • If you want the plan to be available to all employers, select Enterprise.
   • If you want the plan to only be available to a specific employer, select the name of the employer.
   • 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, you must set up all insurance and savings plans at the same level, either Enterprise or Employer. (We recommend you set them up at the employer level.)

3. The table on the Benefit Insurance Plans page shows the insurance plans that are already set up.

   Click Add to add a new plan. (If the system asks if you want to use the setup interview, click No.)

4. On the Benefit Insurance Plans Detail page:

   1. For Code, type the code you want to use to uniquely identify the insurance benefit plan.

      Note: Do not use special characters for the code, such as single quote ( ' ), percentage sign ( % ), or underscore ( _ ).

   2. For Description, type a longer description for the plan. This description appears as a selection on the employee's Insurance Benefits page and prints on benefit statement reports (such as the Benefit Enrollment by Plan and Benefit Premium Totals by Plan reports).

5. On the General tab, enter general information about the plan. Details...

   Item	Description
   Benefit Type	Select a benefit type. These types are from the Benefit Type code table.
   Employee Contribution Frequency	Select the frequency that employee deductions are made, such as weekly, biweekly, semimonthly, or monthly. Note: The employee contribution frequency might differ from the frequency that premiums are paid; premiums always appear as monthly figures in reports and on other pages.
   Benefit Continuable Under COBRA	Select this check box if the employer offers this benefit to employees according to COBRA guidelines. When an employee is terminated, Sage HRMS provides the opportunity to enter a date when COBRA and non-COBRA benefits will expire for the employee.
   Plan Is In Effect From __ To __	(Optional) If the plan is only in effect for a certain effective period, enter the start and end dates. Employer contributions to the plan cannot start before the beginning of the plan's effective period, and will automatically expire at the end of the plans effective period. If you do not 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 both From and Todates.
   Inactive	This check box is automatically selected if the insurance plan is not currently active based on the plan's effective dates.
   Current Amounts Went Into Effect On __	Enter the date the new amounts go into effect for all employees enrolled in the benefit plan (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.

6. Click the Coverage Amount tab and enter coverage information for employees and dependents. Details...

   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 this plan has coverage and you are using Sage ESS for Benefits Enrollment, you must specify the coverage in order to make this plan available for open enrollment or life events.

7. Click the Employee Premium tab and enter the monthly employee premium. Details...

   For Monthly Employee Premium, enter the amount of the monthly bill from the insurance company for the employee's benefit, which includes both the employee's and the employer's 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 specify the employee premium in order to make this plan available for open enrollment or life events.

8. (Optional) Click the Dependent Premium tab and enter the monthly dependent premium. Details...

   For Monthly Dependent Premium, enter the amount of the monthly bill from the insurance company for the employee's dependents, which includes both the employee's and the employer's contribution toward the dependent premium. 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 this plan has dependent coverage and you are using Sage ESS for Benefits Enrollment, you must specify the dependent premium in order to make this plan available for open enrollment or life events.

9. (Optional) Click the Employee Contribution tab and enter the employee contribution per pay period. Details...

   For Employee Contribution Amount, enter the employee contribution amount per pay period.

   The Employee Contribution Frequency determines how often the employee pays their contribution for the plan. (This defaults to the selection on the General tab, but you can change it.)

   Note: this plan has an employee contribution and you are using Sage ESS for Benefits Enrollment, you must specify the employee contribution in order to make this plan available for open enrollment or life events.

10. (Optional) Click the Other Calculated Amount tab and enter the the Other Calculated Amount (which can be from one of the available rate tables).

11. If only certain employees are eligible to participate in the plan, select the eligibility requirements (which an employee must meet to be included in the plan) on the Standard Eligibility tab. If all employees are eligible for the plan, do not make changes on this tab. Refer to your employer’s policies for eligibility requirements. Details...

    Item	Description
    Salaried/Hourly	Select which employees are eligible for this plan: Salary, Hourly, or Salary and Hourly (all employees).
    Employee Type	To limit eligibility to employees with a particular type (such as Regular Full-Time or any other employee type set up in the Employee Type code table), select the type. Select None Specified if the benefit plan is not limited by employee type.
    Minimum Age	To limit eligibility to employees above a certain age, specify that age. The start date for the benefit becomes the date on which the employee reaches this minimum age. Enter 0.00 if this is not a requirement.
    Minimum Hours	To limit eligibility to employees who work at least a certain number of hours or units per pay period, specify those hours. Sage HRMS compares this number to the Hours/Units on their Current Pay page. Enter 0.00 if this is not a requirement.
    Minimum Days Employed	To limit eligibility to employees who have been with the employer at least a certain number of days, specify the number of days. The effective start date for the benefit is the date the employee reaches the minimum number of days employed. Enter 0 if this is not a requirement. A new employee becomes eligible on the first day of the following month.
    Automatically Add to Eligible Employees	Select this check box to have Sage HRMS automatically add the benefit plan to all active employees who meet all the eligibility requirements (both Standard and Custom) when you click OK to save the plan. An active employee has an Employee Status of Active on their Current Job page. (Sage HRMS will not automatically add benefits to employees who are terminated, on a leave of absence, or classified as COBRA dependents.) When you add new active employees, Sage HRMS assigns the benefit if they meet the eligibility requirements. Tip: If you set 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 __ to start benefit on first <Month/Day> following __ months	Select the type of date for starting the benefit (such as the original hire date, last hire date, or adjusted seniority date), select either Month or Date, and then specify the number of months before the benefit starts (which defaults to 0). waiting period for eligibility after the employee meets all other requirements.   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.

    Note: If you are using Sage Employee Self Service for open enrollment, you do not need to specify eligibility requirements. Instead, eligibility requirements are specified in Sage Employee Self Service when the plan is set up for open enrollment or life events.

12. If you need to enter additional eligibility criteria to specify more precisely those employees eligible for the benefit plan:

    1. Click the Custom Eligibility tab.

    2. For Eligibility Expression, either type an expression or click the Expression Builder button, create the expression, and click OK.

       For example, Sage HRMS will exclude Regular Part Time employees if you enter the following expression: PE.P_EMPLOY<>"RPT"

13. When you finish entering the insurance benefit plan information, click OK.
14. When Sage HRMS asks if you want to update the employee benefit file with the new calculations, click Yes. When Sage HRMS completes the update, click OK.
15. (Optional) 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, see Selecting open enrollment insurance plans.

Copying a benefit insurance plan

To create a new insurance plan from an existing plan, see Copying a benefit plan.

Enrolling employees

To enroll an employee in a insurance benefit plan, open the employee’s Insurance Benefits page, click Add, then enter the appropriate information for the employee.