You can set up plan coverage details under coverage section. Process to enter coverage details for Medical, Dental, & Vision plans are the same.
Coverage details provided here are not involved in any system level calculations. It is just for employee’s information during their enrollment experience. You can display coverage information in one, two, or three different columns by categorizing as In-network, out-of-network etc. See how it will be displayed different columns during employee’s enrollment process when an employee tries to compare or view plan details.
You need to complete the Policy Info section first. Internal Name, Group#, Plan Type, Levels are not mandatory fields, but providing this information will help users to track plans and enrollments better.
Select appropriate columns, and provide column title. Then select coverage options from the provided dropdown menu.
Select the checkbox This is a High Deductible Plan…. if this is an HDHP medical plan. If the checkbox is checked, then enrollment in this plan allows employees to enroll in HSA and/or Limited Purpose FSA plans.
Eligibility Options
- Under the Eligibility Option, you can set up Domestic partner’s eligibility by switching eligibility to Yes or No
- Provide age when a child becomes ineligible as a dependent child. Default provided is 19 years. You can change accordingly. Any children above this age will not be eligible unless child is a disabled child or a full time student. All disabled dependents are eligible as long as employee is eligible to enroll.
- A full-time student dependent age can be set up in the Age Students Become Ineligible field. Default value is 26 years. If there is an age limit for employee’s enrollment, that can be set up under Age Employees Become Ineligible. If none, leave it blank. Same for Spouse age limitation - use Age Spouses Become Ineligible, leave blank if none.