Defining Types of Group Benefit Plans

Group benefit plans can cover more than one employee coverage situation. For example, an organization can use a benefit plan for single employees, employees who have one child, or employees with large families. Each situation is defined by a group benefit plan type (also called a tier).

Each group benefit plan specifies the plan types it covers.

Before defining group benefit plans:

To define group benefit plan types:

1. Open the Group Benefit Plan Types form.
Use this option To define this

Type Code

The code representing the benefit plan type (for example, ES). You cannot enter a zero in the Type Code field on the Group Benefit Plan Types form. If you do, you will get an error message stating Invalid Type Code. Click OK. The zero will be removed from the Type Code field.

 

Type Description

The description of the type code (for example, Employee + Spouse).

Type Description (Spanish)

The description of the type code in Spanish.

TPA Type Code

The third‑party type code that corresponds to the billing rate.

• Single
• Couple
• 1 Parent + 1 Child
• Parent + more than one child
• Family

Coverage Class

The class that describes the insurance coverage.

• Single (employee) coverage
• Dual (employee + 1) coverage
• Family (employee + 2 or more) coverage

Cover Spouse

Whether the plan can cover a spouse.

• Yes, Can Cover Spouse
• No, Cannot Cover Spouse
• Only Can Cover Spouse

Dependent Min/Max Type

Whether the plan can cover the employee’s dependents.

• Regular Dependent
• Domestic Partner Children
• Both

Minimum Dependents

The minimum number of dependents to include.

Maximum Dependents

The maximum number of dependents to include.

Spouse Required

Whether a spouse is required.

Domestic Partner Required

Whether a domestic partner is required.
2. Click Save to save the record.
3. Click Delete to delete the selected Type Code.
• If an existing Type Code on the Group Benefit Plan Types form is tied to any of the following, then you cannot delete it and will receive an error message stating There are records associated with (Plan Type). Code cannot be deleted:
• The Type Code field under the Plan Types section on the Group Benefit Plans form.
• If an Effective Date field is set up for the Plan Type field on the Billing Rates or Premium Rates forms.
• The Plan Type field under the Contribution Rules section on the Benefit Rules form.
• The Plan type field under the Coverage Details section on the Employee Benefits Enrollment form.
• If an existing Type Code on the Group Benefit Plan Types form is not tied to any of the above, then you can delete it.
4. Click Cancel to clear this form at any time. Any unsaved changes will be lost.