PeopleSoft Manage Base Benefits Business Process

The PeopleSoft Manage Base Benefits business process includes four core phases of operation:
1. Setting up supporting tables and benefit plans.
2. Building benefit programs.
3. Assigning employees to benefit programs and enroll them in plans for which their program enrollment
makes them eligible.
4. Calculating rates and benefit deductions.
If you use PeopleSoft Enterprise Payroll for North America, you calculate deductions through the payroll
process.

The following diagram illustrates the four core phases of operation that make up the structure upon
which benefit programs are built:

Setting Up Base Benefits Core Tables

This chapter provides an overview of the core tables for PeopleSoft Manage Base Benefits and explains
how to:
• Set up benefit providers.
• Set up dependent relationships.
• Set up coverage codes.
• Set up coverage group codes.
• Set up Federal Employees' Group Life Insurance (FEGLI) codes.
• Set up the service step table.
• Set up benefit rates.
• Set up annual benefits base rates (ABBRs).
• Set up calculation rules.
• Set up deduction codes.
• Set up special accumulators.
• Set up limits for qualified savings plans.
• Set up dependent rules for health plans.
• Set up earnings for leave and vacation buy/sell plans.
• Set up benefits certifications.

Setting Up Benefit Providers

A benefit provider is a vendor. It is the entity that sponsors the benefit plan that your company offers
your employees. For example, if your company offers a Blue Cross/Blue Shield health insurance plan,
Blue Cross/Blue Shield is the provider. If your organization has a self-funded medical plan but uses a
third-party administrator (TPA) to handle administrative functions such as eligibility and claims, the TPA
can be considered a vendor.
You use the Provider/Vendor Table component (PROVIDER_TABLE) to set up an ID for each vendor.
To include a benefit provider in the HIPAA (Health Insurance Portability and Accountability Act) EDI File
Creation process, you must specify the vendor's Federal Employer Identification Number (FEIN).
Warning! If your organization uses PeopleSoft Enterprise Payroll for North America or PeopleSoft
Enterprise Payroll Interface to pay a benefit vendor, add the vendor using the Payables Vendor table,
not theBase Benefits Provider/Vendor table.

Understanding Dependent Relationships

You define the relationships—for example, child, grandparent (grandmother or grandfather), nephew,
or
niece (other relative)—that qualify as dependents according to your organization's rules. You cannot
enroll dependents in benefits if their relationships are not defined. For example, if you had not defined
child as an allowable dependent type, you couldn't enter an employee's son as a dependent. The
characteristics that you apply to the relationship will be used later by the system to validate the
relationship.

Page Used to Set Up Dependent Relationships

Page Name Definition Name Navigation Usage
Dependent Relationships Table DEPBEN_TYPE_TBL Set Up HRMS, Product Related, Base Benefits,
Dependent Relationships Table, Dependent Relationships Table
Define dependent relationships.
Defining Dependent Relationships
Access the Dependent Relationships Table page (Set Up HRMS, Product Related, Base Benefits,
Dependent
Relationships Table, Dependent Relationships Table).
Dependent Relationships Table page
Relationship to
Employee
Displays the relationship that you selected to access the page.
Effective Date Enter the date on which the dependent relationship goes into effect.
Status Select whether the dependent relationship is Active or Inactive.
If the status is Inactive, the relationship is no longer considered a valid dependent
relationship.
Covered Person Type Select the covered person type you are using to define the relationship.
The delivered values are:
• Employee
• Spouse
• Child (child, grandchild, domestic partner child, other child, step child, foster
child)
• Other Qualified Dependent
• Domestic Partner
• Non-qualified Dependent
• ExSpouse
Age Limit Flag When the COBRA process for overage dependents runs, the system uses this
check box to indicate which dependent roles should have the overage rules
applied.
Certificate ID Select to define a certification form for a relationship. The certificate ID defined
here appear in the Oracle's PeopleSoft eBenefits Self-Service application.
Mutually Exclusive Select to limit each participant to one dependent with a relationship that has been
flagged as mutually exclusive at one time. The system allows the participant to
save more than one mutually exclusive dependent in eBenefits, but makes the
dependent a beneficiary. An informational message appears to the employee.
Gender Validation Values include:
• No Gender Validation: Select for no gender validation to occur.
• Opposite Sex Only: Select to ensure that when a dependent is added or a
relationship changes, that person is the opposite sex from the participant.
• Same Sex Only: Select to ensure that when a dependent is added or a
relationship changes, that person is the same gender as the participant.

Setting Up Coverage Codes

To set up the coverage code that defines who can be covered by a benefit; use the Health Coverage
Codes (COVERAGE_CODES) component.
This section provides an overview of coverage codes and discusses how to define coverage codes.
Understanding Coverage Codes
You define and manage coverage codes for your benefit programs using the Coverage Code table. You
will attach these coverage codes to your benefit plan options on the Benefit Program table.
PeopleSoft Manage Base Benefits delivers nine basic coverage codes for which you define a minimum
and maximum allowable for each eligible covered person type. These delivered coverage codes are
described in this table

Set Up HRMS, Product Related, Base Benefits, Plan Attributes, Health Coverage Codes, Health Coverage Codes

Setting Up Coverage Group Codes

To set up coverage group codes, use the Life and AD/D Coverage Groups (COVERAGE_GROUP_TBL)
component.
This section provides an overview of coverage group codes and discusses how to enter coverage group
code information.

Understanding Coverage Group Codes

Life insurance and accidental death and dismemberment (AD/D) plans use coverage group codes to
establish the maximum lifetime coverage allowed.
For example, if you define a coverage group code with a 500,000 USD maximum, then enter that
coverage group code for a supplemental life plan and a group life plan, and associate both benefit plans
with a benefit program. If you were to enroll an employee in both of those plans, the system would ensure
that the employee's total coverage by both plans does not exceed 500,000 USD.
If the total coverage for a participant exceeds the coverage maximum, the system reduces the total
coverage to meet the coverage maximum. When the system processes the deduction, it accumulates the
coverage amounts and begins reducing coverage when the coverage group maximum is reached. The
system processes plans in order of deduction priority, and if more than one plan has the same priority, it
processes in increasing plan type order.

Set Up HRMS, Product Related, Base Benefits, Plan Attributes, Life and AD/Coverage Groups, Life and AD/D
Coverage Groups

Setting Up the Service Step Table

To set up the service step table, use the Service Step Table (SERVICE_STEP_TABLE) component.
This section provides an overview of the service step table and discusses how to enter service step table
information.
Understanding the Service Step Table
When you set up savings plans, you can define your organization's employer match according to the
Employee’s years of service. The Service Step Table defines the different intervals, tax classification, and
Amount of match.
You can also define deduction classifications based on either a percentage of the employee's gross salary
or a percentage of the employee's contribution amount.