Configuring Insurance Plans

Objective

After completing this lesson, you will be able to configure and use insurance plans.

Insurance Plans

An insurance plan represents the actual insurance provided to an employee by the insurance provider or carrier.

Insurance plans provide protection to the policy holder and his or her dependents from life's uncertainties or medical emergencies. Certain events such as the unexpected death of an earning member, critical illness, medical emergencies, accidents, natural and man-made calamities, and so on, can adversely affect a family's well-being and finances. Insurance plans provide protection for all such events.

To create an insurance benefit, create two objects:

  1. Insurance Plan
  2. Insurance Rate Chart

Form titled Insurance Plan with fields for Plan ID, Effective Start Date, Plan Name, Insurance Provider, Frequency, and Coverage Options. Drop-downs for eligibility, premiums, and proof of good health.

Types of Insurance

Types of insurance examples are:

  • Health/Medical

  • Dental

  • Vision

  • Travel–Leisure/Business

  • Occupational Disability

  • Long-Term Disability/Accident

  • Short-Term Disability

For example, under the Medical plan type, an insurance provider might offer Medical HMO, Medical PPO A, and Medical PPO B. Each plan can have varying coverage amounts, premium, areas of coverage, and so on.

Insurance Providers

When creating an insurance plan, you will also be prompted to select or create the insurance provider. The insurance provider record will contain a unique provider ID, company name, contact name, and other optional information such as contact phone and policy documents.

Insurance Rate Charts

Global Benefits uses the rate chart to determine the premium that employees and employers contribute for a given coverage. The system calculates this premium based on the different parameters maintained in the rate chart.

An administrator can define a rate chart for every unique combination of insurance plan, insurance provider, and coverage.

The Details form, with options for rate chart type, gender, age, contributions, and enrollment.

Additional Help Text

The Additional Help Text section allows an administrator to add help text about the savings plan selected by the employee in the Select Benefits view. Up to three fields can be added by an administrator that include a title and a description of the help text.

This information will appear for the employee during the benefits enrollment process.

Screen to define additional help text for enrollment featuring fields for title and description with actions like delete and move for What is an HSA and Additional Details.

Set Up an Insurance Benefit

In this exercise, you will add a dental insurance plan to your organization's benefit package.

Task 1: Create a Schedule and Schedule Period for a Dental Insurance Plan

ExerciseStart Exercise

Steps

  1. Create a new benefit schedule with the following details:

    FieldValue
    Schedule ID2025DENTAL
    Schedule Name2025 Dental Plan Schedule
    Schedule PeriodSelect + and enter the following data:

    • Period ID: 2025DENTAL

    • Period Name: 2025 Dental Plan Schedule Period

    • Enrollment Opens: 01/01/2025

    • Enrollment Closes: 12/01/2025

    • Enrollment Effective From: 01/01/2025

    • Enrollment Effective Until: 12/31/2025

    1. Use the Action Search and navigate to Benefits Admin Overview.

    2. Choose Create New:→Benefit Schedules.

    3. Enter the given Schedule ID and Schedule Name.

    4. In the Schedule Period field, choose +.

    5. Enter the details given in the table for the Schedule Period .

    6. Choose Save and close the Benefits Schedule Period screen.

    7. Choose Save.

Task 2: Create a Pay Component for a Dental Insurance Plan

ExerciseStart Exercise

Steps

  1. Create a pay component with the following details:

    FieldValue
    Effective as of01/01/2025
    Pay Component IDDentalPlan
    NameDental Plan
    StatusActive
    Pay Component TypeAmount
    Is EarningNo
    CurrencyUSD
    FrequencyMonthly
    RecurringYes
    Can OverrideYes

    1. Use the Action Search to open Manage Organization, Pay, and Job Structures.

    2. Choose Create New:→Pay Component.

    3. Enter the data from the table.

Task 3: Create a Dental Insurance Plan and Rate Chart

ExerciseStart Exercise

Steps

  1. Create the Dental Insurance Plan using the data in the following table:

    FieldValue
    Benefit TypeInsurance
    Plan IDDENTAL
    Effective Start Date01/01/2025
    Plan NameDental Plan
    Insurance ProviderACE Dental
    Premium Payment FrequencyMonthly
    Employer contribution pay componentDental Plan
    Employee contribution pay componentDental Plan
    Premium forEmployee and Dependents
    Enrollment ForEmployee
    CoverageDental Plan Coverage
    Coverage TypeOther

    1. Use the Action Search and navigate to Benefits Admin Overview.

    2. Select Create New→Insurance Plan.

    3. Populate the fields using the preceding table.

      • To add the insurance provider, select the Add (+) icon next to Insurance Provider.

      • To add the Enrollment For, select the Add (+) icon next to Enrollment For under the Coverage Options in the lower left.

        • Enrollee Options ID: EMPLOYEE

        • Enrollee Options Name: Employee

        • Dependent Option: Employee

      • To add the Coverage and Coverage Type, select Details in the Coverage Options section.

        • Coverage Name: Dental Plan Coverage

        • Coverage Type: Other

        • Coverage ID: DENTAL

    4. ChooseSave.

  2. Create an Insurance Rate Chart and add it to your insurance plan.

    Insurance Rate Chart

    FieldValue
    Effective Start Date01/01/2025
    Rate Chart IDDentalPlanRateChart
    Insurance PlanDental Plan
    Insurance ProviderACE Dental
    Insurance CoverageDental Plan Coverage
    Factor-1
    CurrencyUSD
    Rates Base OnStandard Fields

    Plans Covering Employee and Dependents' Details

    FieldValue
    Age From0
    Age To80
    Enrollment ForEmployee
    Employee Contribution90

    1. Use the Action Search and navigate to Benefits Admin Overview.

    2. Select Create New→Insurance Rate Chart.

    3. Enter the data from the preceding table. To enter the Employee Contribution, select the Details link next to the Rate Chart and enter the value in the Employee Contribution field.

    4. Select Save.

    5. Add the rate chart to the insurance plan.

      • Use the Action Search and navigate to Benefits Admin Overview.

      • In the Search field, select Insurance Plan.

      • In the field to the right, select Dental Plan.
      • Select Take Action→Make Correction

      • In Step 2: Provide Coverage and Rate Chart Details, select the Details link under Enrollment For.

      • Go to the Rate Chart field and add the rate chart created.

      • Select Done.
      • Select Save.

Task 4: Create a Dental Insurance Plan Benefit

ExerciseStart Exercise

Steps

  1. Create the dental benefit using the data in the following table:

    FieldValue
    Benefit TypeInsurance
    Benefit IDDENTAL
    Benefit NameDental Plan
    Effective From01/01/2025
    StatusActive
    CurrencyUSD
    Benefit Short DescriptionDental Plan
    Integration ModeBenefit Objects
    Legal EntitiesAce USA
    Benefit ScheduleDental Plan Schedule Period
    Enrollment RequiredYes
    Days Remaining to EnrollShow
    Allow Waiving of BenefitYes
    Enrollment TypeManual
    Allow automatic updates of enrollmentYes
    Insurance TypeDental
    Enrollment applicable forEmployee and Dependents
    Insurance PlanDental Plan

    1. Use the Action Search and navigate to Benefits Admin Overview.

    2. Select Create New→Benefit.

    3. Enter the data from the table.

    4. Select Save.

  2. In the Allowed Dependent Types section, add Spouse and Child as dependent relationship types.

    1. In the first field, select Spouse from the dropdown list.

    2. In the second field, select Child from the dropdown list.

    Note

    Spouse and Child were configured using the relationShipType picklist.

  3. Confirm if Dental Plan benefit appears in the People Profile→Benefits tab under the Open Enrollment tab.

    1. From the User menu, select Proxy As.

    2. Enter the user name Carla Grant.

    3. Select View My Profile.

    4. Select the Benefits tab.

    5. Under My Active Enrollments, select Go To Benefits.

    6. Verify the dental plan appears under Open Enrollments.

Summary

  • Insurance plans provide protection to employees and their dependents from life's uncertainties or medical emergencies.
  • Insurance types include health/medical, dental, vision, travel, occupational disability, and short/long-term disability.
  • Creating an insurance benefit requires two objects: Insurance Plan and Insurance Rate Chart.
  • Administrators can define a rate chart for each unique combination of insurance plan, provider, and coverage.

Learning

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