The BENEFIT PLANS screen allows you to access different sections that make up the plan build.  Click on the plan name to view these sections:

  • Profile
  • Eligibility
  • Rates
  • Contributions
  • Forms
  • Documents


The Profile section includes information such as the Admin Name, Display Name, and Effective Date of the plan. For medical and dental plans, the Primary Care Clinic ID and Primary Care Clinic Name are just a few of the options that can be checked to be required at enrollment. Detailed benefit information can be added in this section, such as Deductible amount, Office Visit amount, Inpatient and Outpatient amounts.


Eligibility rules are viewed in the Eligibility section. Eligibility can be restricted by Organization Types: Job Classes, Divisions, Locations and Job Titles (any combination of these). By clicking the Eligibility drop down, you can view the different eligibility classes that have been created and assigned. The different eligibility classes can have different benefit options such as Waiting Period and Rates. Information such as Policy Number, Subgroup Number and Provider Network are housed in this section. The Tax Determination for the plan for employees and domestic partners are set here. If the plan requires the employee to work a minimum number of hours, the hours are set in the Scheduled Hours field.  In this section, you will find the Eligible Dependents and dependent age rules.  




In the Rates section, you will find the monthly premiums for the plan.  If there are different eligibility classes, you can view each of the different rates for that class by clicking the drop down arrow next to Eligibility.  If the rates need to be hidden from employee view, the option to do so is in this section. Information such as Rate Adjustment Factor, Tobacco Surcharge, Rate Type (Table, Tier, or Tier-Table) and Table Columns (rate format such as Employee & Spouse Rates, Gender Rates, Tobacco Rates, Gender & Tobacco Rates, Employee & Spouse Tobacco Rates)  are found here. 


In the Contributions section, you will find the contribution detail for the plan. If there are different eligibility classes, you can view each of the different contributions for that class by clicking the drop down arrow next to Eligibility. In this section, the broker has the option to enter either the Employer or Employee contribution.   


The Forms section contains the enrollment form/application and any instructions that have been added for the benefit.  The Forms Library is also accessed from this section. The Forms Library contains all of the different carrier forms in our system.


The Documents section includes any documents that have been added for the benefit, such as a plan summary.